Swayback (Lordosis)

The spine normally curves at the neck, the torso and the lower back area. This positions the head over the pelvis naturally. The curves also work as shock absorbers, distributing the stress that occurs during movement.

When the spine curves too far inward, the condition is called lordosis or swayback.

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Symptoms

Lordosis can cause pain that sometimes affects the ability to move. It is usually found in the lower back, where the inward curve can make the buttocks seem more prominent.

When lying on the back on a hard surface, someone with a large degree of lordosis will have a space beneath the lower back and the surface. If the curve is flexible (or reverses itself when the person bends forward), there is little need for medical concern. If the curve does not change when the person bends forward, the lordosis is fixed, and treatment may be needed.

Causes and Risk Factors

Lordosis can affect persons of any age. Certain conditions can contribute to this condition, including achondroplasia, discitis, kyphosis, obesity, osteoporosis and spondylolisthesis.

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Diagnosis

To diagnose lordosis, a doctor may take the patient's medical history and perform a physical examination. The medical history will cover such issues as when the excessive curve became noticeable, if it is getting worse and whether the amount of the curve seems to change. During the examination, the patient will be asked to bend forward and to the side to see whether the curve is flexible or fixed, how much range of motion the patient has and if the spine is aligned properly. The doctor may feel the spine, checking for abnormalities.

The doctor may order a neurological assessment if the person is having pain, tingling, numbness, muscle spasms or weakness, sensations in his or her arms or legs or changes in bowel or bladder control. Other tests may be ordered, including X-rays of the spine as a whole and the lower back where the spine joins the pelvis.

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Treatments

If the doctor decides that conservative treatment is best, it may include:

  • Drugs to relieve pain and swelling
  • Physical therapy to build strength and flexibility and to increase range of motion
  • Braces to control the growth of the curve, especially in children and teens
  • Reducing excess body weight to ideal

If the curvature is severe and causing other symptoms, spinal instrumentation, artificial disc replacement and kyphoplasty are all potential surgical treatments for lordosis.