The spine is naturally curved to support body weight more efficiently. However, an excessive inward curvature of the lower spine called hyperlordosis can limit movement or contribute to back pain and stiffness. Also referred to as swayback or saddleback, hyperlordosis can affect anyone, although it’s rarely seen in children. Usually identified when an individual has a C-shape appearance from a sideways profile caused by the spine pushing the stomach forward and the buttocks backward, the condition is often mild and reversible.
Determining the Type of Hyperlordosis
Treatment depends on whether a patient has flexible or hypermobile hyperlordosis or rigid hyperlordosis. With the hypermobile version of the abnormality, the spine retains its natural flexibility. This form of the condition usually responds well to exercises that enhance posture. If the affected area of the spine is stiff, it’s rigid hyperlordosis. The type of hyperlordosis involved also determines the severity of symptoms, which may include:
- Restrictions with movement
- Lower back or neck pain
- Muscle weakness
- Limited range of motion
Identifying a Likely Source of Hyperlordosis
Another factor that determines how the condition is treated is the likely source of the abnormal inward curvature. Oftentimes, years of poor posture contributes to the development of hyperlordosis. The shape of the spine can also be affected by:
- Excess weight
- Neuromuscular disease
- Weak spine-supporting muscles
- Habits that throw off spinal alignment, such as wearing high heels
- Sudden spinal injuries
- Pregnancy
Making a Diagnosis
A treatment plan will also be based on a positive diagnosis of the condition, which is needed to rule out or identify other issues that may be contributing to pain. Patients are often asked to describe their symptoms and discuss what movements seem to be triggering discomfort. X-rays and other image tests may be performed to determine the extent of the abnormality or whether other parts of the spine are also affected. Hyperlordosis is sometimes a sign of:
- Bone loss in the spine
- Nerve compression (“pinched nerves”)
- Damage to a spinal disc
Treating Flexible/Mild Hyperlordosis
Hyperlordosis that doesn’t affect the flexibility of the spine usually results in mild symptoms. If this is the case, patients usually respond well to therapeutic exercises that target core muscle groups and enhance posture. Younger adults and teens with the condition may be advised to temporarily wear a brace to correct spinal alignment. Non-surgical options for relief may also involve:
- Over-the-counter or prescription anti-inflammatory or pain medications
- Spinal strength training
- Weight loss for obese or overweight patients
- Gentle forms of exercise that also target spine-supporting muscles such as yoga
Treating Rigid Hyperlordosis
The rigid form of hyperlordosis usually affects other parts of the spine, including supporting discs, due to the increased immobility in the affected area. If nerves are compressed, various types of physical therapy may be attempted to ease discomfort. Neurological tests may also be performed to determine how soft tissues and nerves are affected.
Opting for Surgery
Surgery is rarely necessary for hyperlordosis. When it is, it’s usually in the form of a spinal fusion done to restore stability to the affected part of the spine by limiting movement around certain vertebrae. There are many minimally invasive procedures or techniques commonly performed today that reduce surgery risks and recovery time. When combined with physical therapy, surgery is often effective if other treatment attempts fail to provide relief.
Since poor posture is the most common cause of hyperlordosis, trying to sit, stand, and sleep in a way that prevents excessive stress on the spine often helps. In fact, patients with mild symptoms primarily caused by posture issues are usually able to reverse the curvature over time. However, if back pain and other distracting, persistent, and severe symptoms are experienced with the condition, it’s time to see a doctor or a Santa Monica spine surgeon.
Whether you need traditional fusion surgery or one of the many alternatives to spinal fusion surgery, put your trust in Dr. Hyun Bae and his team of expert spine surgeons to find the most effective path to relieving your chronic pain. Call The Spine Institute today at 310-828-7757.