Due to evolution, our spine has changed drastically from its previous versions found in apes and Neanderthals to the modern version which we have today in the human being. Our spines in a time long ago would have been used to being less up right and the load being shared through four limbs instead of 2. As the developmental process of evolution, according to Charles Darwin took place over many many thousands of years, humans have developed in to a walking creature which stands upright bearing its full weight through 2 limbs.
Our spine is a complex, technical and durable piece of our body’s construction that serves so many functions. Aside from the main function of keeping us in a standing and erect posture the spine serves as protection for the vital parts of the nervous system which keep us alive and operating. Our vertebral column is designed in such a way which helps us to support weight and for the body to work in its most efficient way.
Naturally the spine has an S shaped curve to it and for a very good reason. The outward curve at the top of the spine in our upper back is called a thoracic kyphosis and the lower back region is called the lumbar lordosis which varies in amount from person to person. The curve in the back which goes from front to back, not side to side – this is known as scoliosis and shouldn’t be confused.
The lumbar lordosis is curved in such a way to help take the body’s weight, the curve helps as a natural suspension system and absorbs shock. The lumbar 4th and 5th vertebrae are the largest in the spine and this due to them bearing the most load. It is also typical that the majority of lower back injuries to the spinal discs occur at this level.
Lumbar lordosis is normal and is a necessary part of the spines form, some people may have a flattened lordosis but in some cases there may even be a larger than average curve known as hyper lordosis. This can become a problem as it may cause mechanical lower back pain to develop as it starts to add stress and strain to other structures in the body.
This article will look to inform you about potential causes and risk factors so that you can prevent yourself from developing hyper lordosis and if you already have some signs or problems relating to this issue then hopefully this can help to provide you with the education and an answer as to how you can fix yourself.
Anatomy of the Back
The lower back is an anatomically complex area with multiple structures and tissues and they sit and function properly in a certain form and shape. Any slight changes to how they are positioned can cause issues with pain and function. In hyperlordosis – discs, vertebrae, nerves and other soft tissues can become aggravated due to the way the spine is placed in to excessive curve. Let’s take a closer look at the anatomy involved and why it is important to have a normal lordosis in the back and what can happen to these structures when placed in to an excessive curve.
Lumbar discs are a cartilage like structure with a softer, firm jelly centre which allows the disc to be manoeuvrable in all directions allowing your lower back to move. When you move one way, pressure is placed through the disc in the opposite direction to perform the movement. Your discs sit between the vertebrae and act also as shock absorbers for the spine.
They are extremely strong and durable – however if you place them under too much pressure from a poor lifestyle, repetitive job or a poor technique with heavy lifting it can result in a disc bulge which can cause pain for a long period of time and major loss of function.
Disc injuries can range from irritation, to a bulge, which is a small herniation of the disc outside of its usual structure, to a prolapse which is the wrist injury you can have by the disc wall rupturing and the disc nucleus protruding from the centre – this injury is rare however. Disc injuries can lead to sciatica type symptoms as a bulged disc can press on to a nerve.
In hyperlordosis if there is excessive pressure constantly placed on to the disc it can raise the risk of an anterior disc bulge being caused which would be at the front of the spine, this causing a lot of pain, functional issues and also referred pain into a wider area than the back.
These are the bones in the lower back and sit on top and below each disc. There are 5 lumbar vertebrae in the lumbar region and they increase in size and thickness from lumbar 1 to lumbar 5. The lordotic curve helps the spine to bear weight properly and carry load. Each vertebrae connects with the next via facet joints which have small holes for the lumbar nerve roots to exit the spine. If your vertebrae are over extended from hyperlordosis then this will cause compression of the bony surfaces which will lead to aggravation and pain in your spine.
Nerve roots exit our facet joints of the lumbar spine and then form in to the main body of the nerve which runs off down the legs. Over extension with hyperlordosis can negatively impact the environment that roots have to exit the spine which may result in slight compression or trapping of nerves – which results in pain and in worse cases reduced function in certain body parts.
Your back has many muscles of different size which help your back to function and provide support for the spinal column. Put simply you have flexors, extensors and the oblique muscles which live in the lumbar region. As discussed, imbalance of the spinal, abdominal and gluteal muscles can all influence how your spine behaves and how it is positioned. If you are placed in to extreme extension causing the spine to change – this means the extensors are becoming overworked and the flexors aren’t doing enough to neutralise your spinal position.
Symptoms of Hyperlordosis
The first and most noticeable symptom you will have with hyerlordosis is shape of the spine and how this affects your posture. Your stomach will be pushed forward and your bottom and pelvis will extend further out at the back. As a result of this you will most likely feel some stiffness in the lower back.
Pain levels in hyperlordosis are not typically as high as something like lumbago but pain can definitely still be a factor due to the fact that the spine is curved more than it is intended to be and this causes discomfort to the tissues that are being over compressed.
Tightness in the muscles that sit around the abdomen, back and glutes can often be a major symptom and also as mentioned previously be due to the cause of prolonged periods of sustained extension of the lower back – this has the subsequent effect on how your muscles control your body and function.
Recommended Treatment and Rehabilitation for Hyperlordosis
Treatment options in the short term for hyperlordosis are very similar to when managing lumbago and mechanical lower back pain type issues. Go to treatment options for this type of problem would start with the basics of heat, pain relief and relative rest.
Testing your own lordosis is a simple and easy test. If you are dealing with a hyperlordosis and you are trying to correct the symptoms or manage it, there is a simple test you can perform to see if you have a normal lordosis or if you have a larger one.
- Simply stand against a wall with your feet just off the wall.
- Rest your head, shoulders and back against the wall with a space for you to be able to pass your hand behind your lower back.
- If you can fit one hand behind your back – you have a normal lordosis, if you can get both behind, it means you have a hyperlordosis.
If you have developed any pain or extreme stiffness which you feel you can’t manage by yourself – seek the help of a physiotherapist or healthcare professional. They may be able to provide some acute treatment and specific exercises to help you reduce your symptoms.
Rehabilitation for this type of issue and being active in trying to recover your issue really starts with identifying cause and changing what is influencing the problem.
Look at your seating habits, analyse them and see what could need changing. A great place to start is the workplace and how you sit. Ensure your seat is of a good standard and has been setup correctly to fit your body – if you can’t get a good seat then purchase a lumbar support or use a rolled up towel to help improve your seating position
Another issue to address is also working habits – if you work on your feet – how do you stand or hold yourself, are you placing yourself in too much extension and how long are you doing this for. At home you should check the same things and look at what you are doing with your lower back when in standing and in sitting. Avoid locking your back in to full extension for long periods.
Comfortable shoes without excessive heel raises. If you do wear high heels, only wear them for short periods, especially for work and if you have to spend long hours on your feet, supportive footwear with good shock absorption is key.
Regular back mobility exercises will help to keep your back moving in a normal way and will offset any bad postural habits that you are acquiring through daily routine. Aside from back mobility specific to the lower back it is always recommended that you engage in a regular exercise programme – strength training with weights, Pilates and yoga help to improve the body’s resilience and also keep it balanced and equal.
To summarise – hyperlordosis is a term used to describe excessive curvature or extension of the lumbar region of the spine.
It can happen due to habit and poor postural positioning performed over long periods of time and also due to excessive weight gain and medical conditions.
This is sometimes painful but can result more commonly in stiffness, tightness and restricted movement of the lower back.
It’s easy to check with a simple self-test and it’s also easy to manage through changes to your lifestyle and habit.