Lordosis is defined as an excessive inward curvature of the spine primarily seen in the lower back lumbar region. Lordosis is commonly known as swayback. In cases of Lordosis the lower spine has a deeper than normal curve producing a visible arch or “C” shape appearance of the lower back. Individuals with lordosis appear to be sticking out their stomachs and buttocks.

A healthy spine exhibits a series of normal front to back curves. When viewed from the side these curves give the spine a soft “S” shaped appearance. Each of these curves is designed to manage the load applied to the spine from the weight of the body and to allow the head to balance directly over the pelvis. A small degree of lordotic curvature in the cervical or lumbar areas of the spine is natural.

Lordosis can occur in individuals of any age. It can be caused by a number of contributing factors such as poor posture, family genetics, trauma, obesity, diseases and conditions of the spine, or surgery to the spine. When kyphosis causes an exaggerated curve in the thoracic area of the spine, lordosis may then develop in the lumbar area to compensate for the imbalance. One childhood type of lordosis, known as benign juvenile lordosis, may occur without an identifiable cause.

In evaluating lordosis the doctor will take a complete medical history and perform a physical examination. Questions will be asked as to when the excessive curve became noticeable, if it has gotten worse over time, and if there is any pain or neurological symptoms. During the physical portion of the examination the doctor will evaluate if the patient’s lordotic curve corrects itself when bending in a forward direction, as well as check spine alignment and range of motion. Additional tests may be recommended if symptoms of pain, tingling, numbness, muscle spasms, weakness, impaired bowel or bladder function are present.

Treatment depends on the severity of curvature and symptoms. Conservative therapy may include medication for pain and inflammation, weight loss, physical therapy to improve core strength and flexibility, or bracing to prevent the curve from worsening. In severe cases with neurological involvement, surgery may be recommended.