lordosis

Lordosis refers to the inward curvature of the spine in the sagittal plane. In humans, the cervical and lumbar regions are normally lordotic, meaning they curve toward the front of the body, while the thoracic region is normally kyphotic (curving outward). The term is used to describe these natural curves as well as abnormal increases or decreases in curvature. The concept and measurements are used in anatomy, radiology, and musculoskeletal medicine to assess posture and spinal alignment.

Hyperlordosis, or excessive lumbar lordosis, denotes an exaggerated inward curve that can be associated with swayback posture and back pain. Hypolordosis or flattened lordosis describes a reduced curvature, which can accompany stiffness or muscular imbalance. Both conditions can be localized to the lumbar spine, though lordosis can refer to cervical or thoracic segments as well.

Causes include normal variation with age, posture, obesity, and pregnancy in which the lumbar region becomes more curved to balance the changing center of gravity. Muscular imbalances, particularly tight hip flexors and weak abdominal muscles, sedentary lifestyle, and degenerative or congenital spinal conditions (such as spondylolisthesis or spinal osteoarthritis) can contribute. Neuromuscular disorders may also alter curvature.

Many people with mild lordosis experience no symptoms. When curvature is pronounced, symptoms may include low back pain, muscle fatigue, stiffness, and altered gait. Diagnosis is usually based on physical examination and imaging, especially X-ray measurements of the lumbar or cervical curve. The Cobb angle or other spinal measurements can quantify curvature.

Treatment focuses on addressing underlying causes and functional improvement. Conservative options include physical therapy with core strengthening and flexibility training, posture education, weight management, and ergonomic adjustments. Bracing may be used in growing children with significant lordosis. Surgery is considered only for severe, refractory cases or when nerve compression results from deformity.