Lordosis refers to the natural inward curves of the spine at the neck and lower back. When those curves are exaggerated, it's called hyperlordosis, a postural condition that can cause neck and back pain. 

The terms "lordosis" and "hyperlordosis" are often used interchangeably, even though lordotic curves are normal. They're only considered abnormal when those curves are extreme. The following details causes and symptoms of hyperlordosis and treatment options for when lordosis becomes severe. 

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Contents

• Lordosis defined
• Lordosis vs. kyphosis vs. scoliosis
• Lordosis tests
• Lordosis causes
• Lordosis symptoms
• Lordosis treatments
• How to prevent lordosis

Lordosis defined

Lordosis is the natural inward curve of your spine. When we're talking about lordosis as a  postural problem, we're generally talking about hyperlordosis – an exaggerated curve – in one of two areas: 

• Cervical lordosis: The neck's natural curve, which typically has a lordotic range of 20 to 35 degrees. If the curve exceeds 35 degrees, you have cervical hyperlordosis
• Lumbar lordosis: The lower back's natural curve, which typically has a lordotic range of 40 to 60 degrees. If the curve exceeds 60 degrees, you have lumbar lordosis (also called swayback)

Source: Science Direct by Elsevier, Simancek, J. (2012). Deep tissue massage treatment (2nd ed.). Mosby.

In both cases, the exaggerated curve could lend an unappealing posture, cause pain, and lead to long-term complications. 

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"Lordosis typically occurs in people who have disc issues, bone issues such as arthritis, kyphosis in the mid-back – lordosis can happen as a compensation – or are overweight," says Dr. Matt Tanneberg, DC, CSCS, who owns and operates Body Check Chiropractic & Sports Rehabilitation in Scottsdale, AZ. He works with elite athletes from the NFL, MLB, NHL, USA Track and Field, NCAA and high school. "Lordosis, in most cases, is quite painful; pain in the lower back and hips is quite common. The improper curvature may also produce nerve damage and related symptoms such as sciatica."

Lordosis vs. kyphosis vs. scoliosis

This question comes up a lot, and it's important to understand the distinction between common postural conditions so you can design the proper treatment plan. 

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• (Hyper)Lordosis: an exaggerated inward curve of the neck or lower back. The "opposite" condition is hypolordosis, a straightening of the spine's natural curves
• Kyphosis: An exaggerated outward curve of the upper back
• Scoliosis: The spine curves, twists, or rotates to the side

Read: Can a posture corrector fix kyphosis?

Lordosis tests

Here are three ways to tell if you have lordosis (hyperlordosis). 

Mirror test

Look at yourself sideways in a mirror to see if your neck or lower back have an excessive inward curve. If you have lumbar lordosis, you might also notice your butt sticking out and your belly protruding, which can also happen with a related condition called anterior pelvic tilt. 

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Wall or floor test

Stand straight against the wall or lie on the floor so the back of your head, shoulder blades, glutes and heels touch the wall or floor. Place your hand between your lower back and the wall or floor. If you can fit your forearm into that arch, you likely have lumbar lordosis. 

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Imaging

Doctors can use visual examinations plus imaging such as X-rays, MRIs or CT scans to confirm your lordosis diagnosis. 

Lordosis causes

Lordosis causes – or, more accurately, hyperlordosis causes – range from congenital conditions and neuromuscular disorders to environmental influences and injury. Much of the time, though, lordosis is caused by poor posture. 

Lordosis causes include:

Environmental and musculoskeletal

• Poor posture from sitting or standing for long periods, wearing high heels too long, slouching at your desk and other work-related posture
• Weak core muscles, lower back muscles and hamstrings
• Muscular imbalances in the neck, back and core
• Anterior pelvic tilt (often occurs with lumbar lordosis)
• Kyphosis (lordosis occurs as compensation)
• Injury
• Pregnancy (the baby's weight can cause lordosis)
• Obesity
• Spine surgery (laminectomy)

Disorders and other conditions

• Arthritis
• Osteoporosis
• Muscular dystrophy
• Spondylolisthesis
• Degenerative discs and other disc issues
• Rickets
• Achondroplasia (dwarfism)
• Neuromuscular disorders
• Congenital spine conditions

Lordosis caused by postural issues, muscular imbalances and environmental factors is easier to treat than hyperlordosis caused by underlying congenital conditions and neuromuscular disorders. For many people, fixing lordosis is a matter of improving posture and strengthening and stretching core muscles. 

"Hyperlordosis is most commonly associated for the neck with poor posture resulting from repetitive activities. These activities may include prolonged typing, texting, or any motion that keeps the neck in forward flexion for long periods of time," says Dr. Allen Conrad, BS, DC, CSCS, who owns Montgomery County Chiropractor Center in North Wales, PA. "Hyperlordosis for the low back has additional things that can cause it, including obesity and spinal injury as well as pregnancy. As the stomach stores additional weight, it pulls forward and downward from gravity. This additional pressure on the spine, in association with weakened abdominal muscles, leads to an increased lordotic lumbar curve, known as hyperlordosis."

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Studies have shown that women who gain excessive weight during pregnancy are more likely to develop hyperlordosis. Dr. Conrad says that in most cases, however, spinal pressure is reduced after the baby is born and the normal lumbar spinal lordotic curve is restored. 

Physiological mechanisms of lordosis

Lordosis typically affects the following muscle groups. 

Cervical hyperlordosis

• Rhomboid major
• Rhomboid minor
• Thoracic paraspinal

Lumbar hyperlordosis

• Lumbar paraspinal
• Quadratus lumborum
• Abdominal muscles
• Piriformis

"For the neck, lordosis most commonly affects the rhomboid muscles and the thoracic paraspinal muscles. The rhomboid major and minor muscles are primarily responsible for keeping your shoulders pulled back, so with prolonged computer work, the shoulders tend to lean forward and sag due to weakened or unconditioned rhomboid muscles. The thoracic paraspinal muscles run parallel to your spine, and they also assist with sitting up straight for good posture, which helps prevent a cervical hyperlordosis from happening," explains Dr. Conrad. 

"The lumbar paraspinal, quadratus lumborum, abdominal muscles and piriformis muscles are the prime muscles responsible for lumbar hyperlordosis. A weak abdominal area, for example, will not hold the body in proper alignment as you gain weight, so this extra weight pulls on your lumbar spine, causing this excessive lordotic lumbar curvature."

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Lordosis symptoms

Lordosis symptoms include: 

• Posture changes, such as your head and neck jutting forward, forward-tilted hip (pelvic tilt), your butt sticking out, pot belly, and an exaggerated C-shaped curve in your neck or lower back
• Lower back and neck pain
• Extended muscle pain
• Muscle spasms
• Limited mobility
• Pain that radiates to the hands and feet

Lordosis can also cause:

• Numbness and tingling
• Muscle weakness and lack of muscle control
• Loss of bladder control
• Sciatica
• Pinched nerves and nerve damage

"Hyperlordotic curves can lead to pain, spasm, and muscle fatigue since the body is working extra to help keep you sitting or standing upright," says Dr. Conrad. 

Lordosis treatments

Treatment depends on severity. If you have no pain or mild pain and your spinal curve isn't extreme, you might be able to fix lordosis on your own. If you have significant pain or an extreme spinal curve, or if your attempts are not working, you should consult a doctor, chiropractor or physical therapist. 

"Seeing a medical professional is necessary once you get to the point of experiencing pain," says Dr. Tanneberg. "Stretching will help to keep symptoms more manageable. Some of the classic yoga stretches such as down dog, pigeon and cobra will help, as will stretching the piriformis and psoas muscles, specifically." 

Treatment options include: 

Exercises and stretches

Cervical lordosis exercises and stretches

1. Prone head lifts

Lie down, resting on your forearms. Slowly lift your head, relax, and repeat. 

2. Supine head lifts

Lie on the floor, knees bent and feet flat. Slowly lift your head and hold. Repeat. 

3. Scapular retraction

While seated, squeeze your shoulder blades together, then release. 

4. Cervical extension

Sit and look up toward the ceiling, then back down. Repeat. 

 5. Isometric neck stretches

While sitting, use your hand to gently resist while you flex your neck forward, extend it backward, and stretch from side to side. 

Lumbar lordosis exercises and stretches

1. Dead bug

Lie down on your back with your arms on the floor above your head. Raise one leg and the opposite arm simultaneously to engage your core. Repeat on the other side. 

2. Glute bridge

Lie on your back with your knees bent and feet flat on the floor. Raise your hips off the floor and engage your glutes. 

3. Pelvic tilt

Lie on your back with your knees bent and feet flat on the floor. Tilt your pelvis to bring your belly button toward your chin and your lower back toward the floor. 

 4. Psoas stretch

Step one foot up on a chair, then rock forward. Raise your arms over your head and hold. Lean to the side for a more advanced stretch. 

5. Piriformis stretch

Lie down with your knees bent and cross one leg over the other. Place one hand on your knee and the other on your ankle, then pull your leg toward your opposite shoulder. 

Constructive rest

Lindsay Newitter, a posture expert who teaches The Alexander Technique – a method to naturally improve posture – from her private practices in Montreal and New York City, recommends practicing constructive rest daily. Constructive rest helps you recognize and release excess tension. 

"Lie on your back on a carpet or exercise mat with a rolled-up towel or some books under your head, knees bent, feet flat on the floor," Newitter says. "Lying on the floor – not a couch or bed – for 10 to 15 minutes gets you using gravity to help release tension so that the spine can gently decompress."

Constructive rest also gives you the opportunity to practice directional thinking. Follow along with Newitter's constructive rest audio guide. 

Yoga for lordosis

Yoga is a terrific tool for many postural issues. Here are some yoga poses for lordosis. 

1. Cat-cow

2. Pigeon

3. Half boat

4. Plow

5. Downward dog

Lordosis braces

Lordosis back braces and posture correctors gently align your spine and help train your muscles to maintain good posture over time so that, eventually, you no longer need a brace. There are different types of back braces for lordosis. Some are rigid and could restrict movement, while others are soft and comfortable to wear over or under clothing. 

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"Posture correctors can help reinforce a good anatomical alignment when part of a chiropractic care plan with flexibility and therapeutic exercises," says Dr. Conrad. "The chiropractic treatment helps keep the spine in alignment, the flexibility and therapeutic exercises help strengthen the associated weak muscles, and the posture corrector helps keep it in place."

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Chiropractic adjustments and physical therapy

Chiropractors and physical therapists can design personalized programs to reverse lordosis and prevent hyperlordosis from developing. 

"Consult a Doctor of Chiropractic for a postural examination if you suffer from hyperlordosis. A comprehensive examination will help determine which areas have abnormal motion, and what course of care is appropriate to improve posture and relieve pain," says Dr. Conrad. "The doctor will demonstrate which postural strengthening exercises are appropriate for your condition and will recommend which type of brace would offer extra support."

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Dr. Conrad adds that chiropractic care is a popular way to alleviate back pain during pregnancy. 

"The patient can't take drugs during pregnancy that could affect the child, and that is why chiropractic care and postural braces can be very helpful for pregnant women with back pain," he says. 

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Posture apps

Posture apps offer guidance for treating hyperlordosis at home. Four types of apps can help with lordosis: 

1. Exercises, stretches and yoga routines for posture
2. Reminders to maintain proper posture throughout the day
3. Posture analysis apps, which use your phone's camera and other sensors to identify postural issues
4. Slouch detectors, which use your webcam to detect and notify you when you begin to slouch at your desk

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Pillows

Sleeping with your head propped on a thick pillow can place stress on your neck and contribute to hyperlordosis, so switching to a thin pillow can alleviate that stress and allow your neck to rest in a natural position while you sleep. Search for "lordosis pillows" or simply choose a thin pillow to see if it helps. 

 

Surgery

Lordosis surgery is rarely required. Most of the time, a combination of the aforementioned therapies can help fix hyperlordosis. However, your doctor might recommend a procedure such as spinal fusion or disc replacement to treat lordosis in severe cases. Consult with your doctor to see if surgery is recommended for your condition. 

Postural mindfulness

Mindfulness can go a long way toward improving posture and reducing hyperlordosis, especially since people are often unaware that they're sitting or standing with poor posture. 

Newitter says that cervical hyperlordosis has two components: pushing the head forward and tipping it back onto the neck, which exaggerates the cervical curve. 

"What this position often feels like is simply pushing the face forward. People don't often feel the tipping of the head back because most people aren't aware of what's happening in the back of the body," she says.  

Newitter also sees two primary postural causes for lumbar hyperlordosis: leaning back to compensate for the weight of forward head posture, and overcorrection, which often occurs with people who slouch. 

"They notice their shoulders going forward and then try to fix it by arching their lower backs, exaggerating the lumbar curve," she says. "They tip the upper torso back and lift the tailbone, which locks the pelvis into an anterior pelvic tilt, and simply untucking your bottom to then correct the hyperlordosis can cause further strain."

Awareness is key, and so is knowing the right way to reverse lordosis – especially since many people use improper and ineffective posture correction techniques. For example, Newitter says that people sometimes make the wrong correction and unintentionally exaggerate cervical hyperlordosis by lifting their chins and therefore tipping their heads back even more. 

Read: How to fix forward head posture: Tips from doctors and therapists

"When I work with people, I don't just address positioning or quick posture fixes. I help people improve their body awareness so that they can feel these habitual movements and positions clearly and know what to do to change them," she says. "Often, what actually corrects posture isn't what people expect because they are unaware of the mechanics of poor posture."

How to prevent lordosis

Follow these tips to prevent hyperlordosis from developing or recurring. 

• Practice good posture: Be mindful of your posture throughout the day, whether you're sitting at your desk, working out in the gym or relaxing at home. Consider wearing a posture brace to remind yourself to maintain proper posture

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• Commit to a postural workout routine: Strong, well-developed postural muscles make it easier to naturally align your spine while you sit, stand, walk and run. Incorporate posture exercises, stretches and yoga into your daily routine for long-term success. 
• Adjust your environment: Consider how your environment might contribute to lordosis, then make adjustments that encourage good posture at all times. For example, you should take regular breaks from sitting and standing, avoid wearing high heels and set up a posture-friendly, ergonomic workstation. 
• Achieve and maintain a healthy weight: Obesity can cause hyperlordosis, especially lumbar lordosis, as the weight of excess belly fat pulls the lumbar vertebrae forward and downward. Losing weight can alleviate that stress and help you regain and maintain a natural lordotic curve. 
• Consult a doctor: If you're unsure whether you have lordosis or which options are best for your condition, consult a medical professional for a formal diagnosis and treatment plan

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Hyperlordosis is a common condition often caused by poor posture, but it can be reversed through a combination of treatments such as exercises, stretches, yoga, chiropractic care, physical therapy, lordosis braces and mindfulness. Follow the tips in this article to help prevent or fix lordosis, and speak to your doctor about the best lordosis treatment options for you. 

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