Forward curves in the cervical (neck) and lumbar (lower back) regions - called lordosis.
Backward curves in the thoracic (upper back) and sacral regions - called kyphosis.
These are known as physiological (normal) spinal curves and begin to form during the first year of life.
Pathological lordosis occurs when the natural curve becomes excessively pronounced (hyperlordosis) or abnormally flattened (hypolordosis). It may be congenital or acquired and can eventually lead to pain, posture problems, and dysfunction of internal organs.
Causes of Lordosis
Primary Lordosis
Primary pathological lordosis develops due to disorders affecting the spine itself, including:
Congenital spinal abnormalities
Inflammatory diseases of the vertebrae
Tumors
Muscular torsion spasms
Spondylolisthesis
Spinal injuries
Secondary Lordosis
Secondary lordosis develops as a compensatory mechanism caused by:
Limited mobility of the hip joint
Congenital or pathological hip dislocation
Systemic musculoskeletal disorders
Poliomyelitis affecting the pelvic and lower-limb muscles
Pregnancy
Cerebral spastic paresis of the lower extremities
During pregnancy, increased lumbar lordosis is usually temporary and resolves after childbirth as the body's center of gravity returns to normal.
Risk Factors
The following factors increase the likelihood of developing lordosis:
Poor posture
Excess body weight
Rapid growth during adolescence
In children, compensatory hyperlordosis is often reversible once the underlying cause is corrected. In adults, fixed spinal deformities are generally permanent, although correction may still be possible when muscle weakness is the primary cause.
Symptoms of Lordosis
Common symptoms include:
Poor posture
Fatigue
Back pain after physical activity
Pain when maintaining certain positions
Limited mobility
Excessive forward head posture
Protruding abdomen
Severe pathological lordosis may affect:
The heart
The lungs
The kidneys
The gastrointestinal tract
This occurs because spasms of the deep spinal and pelvic muscles can impair circulation and organ function.
Postural Variations Associated with Lordosis
Round-Concave Back (Kypholordotic Posture)
Characteristics:
Increased thoracic kyphosis
Increased lumbar lordosis
Protruding shoulder blades
Rounded shoulders
Protruding abdomen
Forward head posture
Round Back (Kyphotic Posture)
Characteristics:
Markedly increased thoracic kyphosis
Reduced lumbar lordosis
Forward head position
Protruding abdomen
Sunken chest
Flat-Concave Back
Characteristics:
Flattened cervical lordosis
Reduced thoracic kyphosis
Normal or slightly increased lumbar lordosis
Flat Back
Characteristics:
Reduced physiological spinal curves
Flattened lumbar region
Protruding shoulder blades
Forward-displaced chest
Protruding abdomen
Types of Lordosis
By Location
Cervical lordosis
Lumbar lordosis
By Cause
Primary lordosis
Secondary lordosis
By Shape
Physiological (normal) lordosis
Hyperlordosis (excessive curvature)
Hypolordosis (flattened curvature)
By Mobility
Non-fixed (correctable)
Partially fixed
Fixed
Lordosis in Children
Common causes include:
Injuries
Hereditary spinal disorders
Prolonged static postures
Low physical activity
Weak musculature
Typical signs:
Excessive arching of the back
Sunken chest
Prominent shoulder blades
Protruding abdomen
Abnormal gait
If left untreated, childhood lordosis may contribute to:
Disc protrusions
Herniated discs
Chronic back pain later in life
Lordosis in Adults
Common contributing factors include:
Back and hip injuries
Bone diseases
Muscle weakness
Obesity
Nutritional deficiencies
Sedentary lifestyle
People who spend long hours sitting are particularly at risk.
Possible Complications
Without treatment, lordosis may lead to:
Herniated intervertebral discs
Vertebral displacement
Excessive vertebral mobility
Degenerative changes in spinal joints
Inflammation of the iliopsoas muscle
Patients may also experience chronic fatigue, persistent pain, and sleep disturbances.
Diagnosis
Diagnosis typically involves:
Physical examination and medical history
Myofascial assessment
Functional muscle testing
X-rays
MRI or CT scans
X-rays are usually taken in multiple positions to assess the degree of curvature and structural changes in the spine.
Treatment of Lordosis
Treatment should be comprehensive and focus primarily on correcting muscular imbalances and weakness.
Common treatment methods include:
Therapeutic exercise
Kinesitherapy
Physiotherapy
Therapeutic massage
Swimming and aquatic exercise
The success of treatment largely depends on consistency and adherence to medical recommendations.
Bubnovsky Method Exercises
The Bubnovsky method is based on:
Decompression exercises
Strength training without axial spinal loading
Stretching exercises
Flexibility development
Strengthening of the muscular support system
Programs are individually designed following a detailed assessment. Swimming and massage are often recommended as complementary therapies.
Straightened (Flattened) Lordosis
Hypolordosis is a condition in which the natural spinal curve becomes reduced or completely absent.
Common symptoms include:
Flat lower back
Shortened stride
Altered gait
Lower back pain
Difficulty bending forward or backward
Digestive disturbances caused by changes in abdominal organ positioning
A flattened lordotic curve increases stress on the vertebrae and intervertebral discs and may contribute to the early development of disc herniations. Prevention
To maintain a healthy spine, specialists recommend: