Lordosis (Swayback)

What is lordosis (swayback)?

Lordosis is the medical definition for the forward curved spine in your neck or lower back.

Your cervical spine (the medical name for the part of your spine in your neck) and lumbar spine (your lower back) are naturally curved a little forward, toward the front of your body. This naturally occurring lordosis helps you maintain your posture and absorb shock when you move.

Anything that makes those areas of your spine curve more than they should is called a lordotic curve.

Lordosis develops if your spine curves too much and pushes your posture out of its usual alignment. You might see lordosis that affects your lumbar spine called swayback. Remember, lordosis is normal in the cervical and lumbar spine. In the cervical spine, a 30- to 40-degree curve is normal. In the lumbar spine, a 40- to 60-degree curve is typical.

Your healthcare provider might recommend stretches and exercises to help improve your posture, but most people with lordosis don’t need any treatment. Children with lordosis usually grow out of it.

Lordosis vs scoliosis and kyphosis

Lordosis, scoliosis and kyphosis are all conditions that affect the curve of your spine. The difference between them all is which part of your spine is affected, and which direction they make it curve.

Lordosis is an increase in the curve toward the front of your body that’s naturally part of your cervical and lumbar spine.

Scoliosis causes your spine to curve and rotate to the side. It’s most common in kids and teens.

Kyphosis causes your thoracic spine (your upper back between your neck and the bottom of your ribs) to curve backward, away from the front of your body more than it naturally should. It makes people have hunched shoulders.

Who does lordosis affect?

Lordosis can affect anyone.

Some groups are more likely to develop lordosis, including:

• Adults older than 50.
• Kids going through growth spurts.
• People who are pregnant.

How does this condition affect my body?

Lordosis changes your posture. How it affects your body depends on where you have it.

• Cervical lordosis: Pushes your neck further forward than it should be or usually is. In very rare cases, this can affect your ability to use your neck and throat, including talking or swallowing.
• Lumbar lordosis (swayback): Pushes your hips and pelvis further forward than they should be. This can make you stand with your stomach pushed forward and your butt stuck out behind you. If you lie flat on your back, there will be more space underneath your back than usual. Rare severe cases of swayback can interfere with your ability to control your bladder or bowels.

If the curve in your spine is severe enough it might make it difficult (or impossible) to move your neck or back.

What are the symptoms of lordosis?

Many people don’t have any physical symptoms of lordosis. In fact, you might never know you have it until you’re diagnosed.

It’s usually easier for other people to notice changes in your posture, such as:

• Your head and neck leaning further forward than usual.
• Your hips pushed forward.
• Your butt sticking out.
• Extra space beneath your lower back when you’re lying down.

Lordosis that causes more severe curves can cause neck pain or low back pain and make it difficult to move the way you usually can.

What causes lordosis?

Most cases of lordosis are idiopathic — the medical definition for having no cause. They develop on their own. Swayback that affects kids usually has no cause. This can also be identified in people with increased thoracic kyphosis.

Some medical conditions can cause lordosis, including:

• Spondylolisthesis.
• Achondroplasia.
• Osteoporosis.
• Osteosarcoma.
• Muscular dystrophy.
• Kyphosis.
• Static encephalopathy.

People who are pregnant are more likely to develop swayback too.

How is lordosis diagnosed?

Your provider will diagnose lordosis with a physical exam.

They’ll look at your posture and check your spine for any unnatural curvature. They’ll check to see if the lordotic curve is flexible. If it moves with you when you bend your neck or low back you’ll be less likely to need treatments or surgery.

They might also screen you for scoliosis and kyphosis and other conditions that affect your back and spine.

What tests are done to diagnose lordosis?

If your provider notices signs of lordosis in your spine, you might need some imaging tests to help them know exactly what’s going on inside your body, including:

• X-rays.
• MRI.
• CT scan.

How is lordosis treated?

How lordosis is treated depends on where it is along your spine, and if it’s causing any symptoms.

Most people don’t need any treatment. If you have symptoms like neck or back pain, you’ll probably only need over-the-counter NSAIDs (like aspirin or ibuprofen) and stretching and strengthening to treat your symptoms. Talk to your provider before taking an NSAID for longer than 10 days.

You’ll likely need to visit your provider every few months to monitor the lordosis to make sure the curve hasn’t gotten more severe.

If the lordotic curve gets worse over time, or if it’s not flexible, your provider might suggest a few treatments, including:

• Physical therapy: Your provider might suggest exercises and stretches to strengthen the muscles around your spine. Exercises can’t reduce the curve or cure lordosis, but studies have found they’re the best way to reduce symptoms like pain in your neck or back. Strengthening your hamstrings, hips, abs and glutes (the muscles in your butt) can all improve your posture.
• Bracing: You’ll wear a customized brace to support your spine and stop it from curving any further. Your provider will tell you how often you should wear your brace, and for how long you’ll need to wear it. Most people need to wear their brace for at least 20 hours a day.
• Lordosis surgery: It’s rare to need lordosis surgery. If the lordotic curve is severe enough — or it keeps getting worse over time — your provider might recommend a spinal fusion to help straighten your spine and lessen the curve. You might also need bone grafting to help this heal. Your surgeon or provider will tell you which kind of surgery you’ll need and how long it will take you to recover.

How do I take care of myself?

You don’t have to stop exercising or playing sports with lordosis. In fact, staying active can help strengthen the muscles around your spine and help reduce some symptoms. If you need surgery to repair the curve in your spine, you might need to avoid certain physical activities while you’re recovering. Talk to your surgeon or provider about what to expect.

Visit your provider as often as they suggest to monitor any changes in your spine.

Following a healthy diet and exercise plan helps improve your overall health.

Talk to your provider if you notice any changes in your back, especially if you experience new symptoms like pain or a loss of feeling in your limbs.

How can I prevent lordosis?

You can’t prevent lordosis. It’s either idiopathic (it develops without a cause) or caused by another health condition. In either case, there’s nothing you can do to prevent it from developing. Staying flexible and strengthening your core is the best way to minimize your risks.

What can I expect if I have lordosis?

Lordosis shouldn’t have a big impact on your life. Most people don’t need treatment for it. Even if you do, you’ll likely only need over-the-counter medications or exercises to improve your posture.

Kids who have lordosis usually grow out of it as their spine grows and develops with the rest of their body.

When should I see my healthcare provider?

If you have back pain it is a good idea to talk to your healthcare provider.

Talk to your provider about how often you'll need follow-up visits. They’ll tell you how often they need to check the curve in your spine for any changes.

Visit your provider right away if you lose feeling in any of your hands or feet, or if you’re feeling tingling or shocks. These could be symptoms of other, more serious issues with your spinal cord.

What questions should I ask my doctor?

• Which type of lordosis do I have?
• Will I need treatment?
• How often do you need to check my spine?
• Am I at risk for any other issues with my back or spine?

A note from Cleveland Clinic

Most people don’t ever think about their bones until they have a reason to when something is wrong with them. Lordosis is no exception to this rule, especially because you might never have symptoms or notice that your spine is curving more than it should. Even if it can be scary to think something is changing your spine without you even feeling it, lordosis shouldn’t have a major impact on your life, or your ability to do the activities you love.

Talk to your provider about any changes you notice in your back or posture.