Lumbar Lordosis - the deep curve in your lower back

Lumbar lordosis is the word used to describe the spinal curve in your lower back. It is not a disease or a back injury. The human spine is divided up into three main sections your neck, called the cervical spine, your mid back, called the thoracic spine and your lower back, called the lumbar spine.  These three areas roughly form an S shape when viewed from the side.

The medical term used to describe a curve inwards is called lordosis, a curve outward is called a kyphosis.  That’s all there is to it..

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diagram of the human spine showing the places where you get lordosis and kyphosis typical lumbar lordosis or deep low back curve
Anatomy of the spine showing the S shape and the lumbar Lordosis A typical lordotic posture

So where at the top of the spine the neck curves in, this is called the cervical lordosis, where your spine curves out between your shoulder blades is called the thoracic kyphosis and the inward curve in your lower back is your lumbar lordosis.

If you have a deep curve in your lower back and a round shouldered posture this is often described as a kypholordotic posture.  It is just a postural type however, many people have it and it isn’t necessarily a bad thing. There is an illustration of this postural type here.

I have been told my back problem is lordosis...

I have met many people who have been told that their back pain is caused by a this type of posture. but this is just a word used to describe a postural type its not a back condition.

Some research has found that when you study different postural types it's not more likely that one more than another will go on to get back pain. (see reference 2 below). So there are many people with a deep lower back curve who never get back pain. But there is also a growing school of thought which thinks it is important to plan treatment around a direction specific problem (reference 1 below).

Having worked with many people with lower back pain I do think that having poor core stability, a deep curve and stiffness in the low back leads to problems. If you spend a lot of time in a posture which exaggerates this deep curve it will increase the stresses through the facet joints and may cause discomfort..If you look at the plumb line on the diagram below you will see that the line of gravity in this posture passes further back than in a less lordotic posture.This increases forces through the joints.

This type of problem is known as an extension pattern and if you have it you may find it uncomfortable to stand for long periods or to lie on your back with your legs stretched out.

 

picture of kypholordotic posture showing deep curve in lower back and round shouldered posture
Typical Kypho-lordotic Posture

What Treatment is there?

So, lordosis isn't a disease or a diagnosis but having a lordotic posture or a deep curve in your lower back may mean you are increasing stresses and strains elsewhere which may lead to pain.

Treatment for this might include;

  • learning to be able to move your pelvis and your lower back independently from one another
  • teaching your brain to recognise when you are in a very extended position
  • having the position awareness (proprioception)
  • muscle strength and
  • flexibility to move out of the extremes of the position.
  • You also need to have reasonable core stability be able to stay in this slightly adjusted more comfortable posture.

 

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References

1. Sheeran, L. et al., 2012. Spinal Position Sense and Trunk Muscle Activity During Sitting and Standing in Nonspecific Chronic Low Back Pain. Spine, 37(8), pp.E486–E495.

2.Norton, B., Sahrmann, S. & Van, D. Differences in measurements of lumbar curvature related to gender and low back pain. Journal of Orthopaedic and Sports Physical Therapy 34, 524-534(2004).

Lower Back Pain Toolkit Home Page

29-Jul-2017

 

 

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