Kyphosis – Lordosis Treatment
Lordosis refers to the natural arch in the low back. This natural curve is necessary to structurally disperse weight and absorb shock throughout the spine. In hyper-lordotic spines this curve is exaggerated. Typically, a hyper lordosis is not problematic and causes no pain. However, severe lordotic curves may become problematic and should be monitored by a qualified physician. In contrast, lack of lordosis (hypolordotic or flat back syndrome) in the lumbar spine can also be a problem, since the spine and the discs will be subjected to excessive stress without the natural shock absorption mechanism of the lordotic curve.
Causes of Hyper-Lordosis
The lumbar spine can be pulled into a hyper-lordosis by tight hip flexor muscles pulling the pelvis forward into an anterior pelvic tilt. This anterior pelvic tilt in turn causes the lumbar spine to arch excessively as a compensation so that the torso can function in an upright position in standing. Tight hip flexor muscles can be the result of hypertonicity caused by other problems in the low back such as bulging discs aggravating nerves that affect the hip flexor muscles. Tight hip flexors can also be the result of over training the muscles with exercises such as sit ups. Those who repeatedly over work their hip flexors can create a hype-lordosis due to a self-induced muscle imbalance. Other people with particular body types are prone to developing a hyper-lordotic lumbar spine as part of their natural growth and development.
Most cases of hyper-lordosis are nothing to be concerned about. Mild to moderate lordotic curves are not uncommon and most patients will never experience any associated pain or discomfort.
Most cases of hyper lordosis are treatable with physical therapy. Physical therapy treatment consists of soft tissue work (deep massage and manual stretching), a home stretching program, postural awareness and therapeutic exercises designed to address muscle imbalances and increase core strength and improve postural muscle function.
Kyphosis refers to the natural curvature of the thoracic spine (the mid back). However, in a hyper-kyphotic spine (excessive mid back curve), the curve is exaggerated and may produce a apparent physical deformity. Hyper-kyphosis will often coexists along with other postural problems, such as scoliosis or hyper-lordosis.
Most patients have only mild to moderate hyper-kyphoses. Many patients are not even aware of their irregular curve, as it creates no pain and only minor physical change. Most patients simply feel they have poor posture. Other patients are aware of the condition due to the abnormal profile it creates in their spine. Patients with moderate to severe hyper-kyphosis will frequently display a protrusion of the middle spine, forming a large mound or hump. This problem has been referred to by many less than complementary titles in previous medical literature including Hunchback, Roundback and Humpback to name a few.
Most patients have only minor kyphotic problems. Mild to moderate kyphoses are usually symptom free, even though they are often blamed for many undiagnosed back pain conditions. Kyphotic curves, like many harmless spinal abnormalities, are often blamed for unrelated back pain. Most chronic cases of serious back pain are coincidental to any mildly abnormal kyphosis.
Drastically exaggerated kyphotic curves are rare. These conditions can be painful and may produce other health concerns. Some unusually advanced kyphotic curvatures can actually be dangerous if allowed to progress unchecked. In such cases, treatment is strongly advised.
Causes of Kyphosis
A thoracic hyper-kyphosis is typically a structural compensation for a hyper-lordosis in the lumbar spine (an excessive amount of arch in the low back).
The condition can come from a variety of other causes as well:
- * Congenital conditions can make a person susceptible to developing hyper-kyphotic curves as they grow.
- * Osteoarthritis can contribute to the condition by changing normal spinal anatomy.
- * Osteoporosis is a prime contributor to hyper-kyphosis in seniors.
- * Spinal Injuries such as compression fractures in the thoracic spine can create a hyper-kyphotic condition.
- * Lumbar spine fusion surgeries can adversely alter spinal mechanics influencing the surrounding vertebral levels. This can indirectly result in a hyper-kyphosis.
- * Poor posture is a significant cause of certain forms of thoracic kyphosis
Most kyphotic curves are harmless, even when they are visually apparent. Pain and other symptoms are rare with mild to moderate kyphotic curvature. The most effective treatment for a symptomatic hyper-kyphosis is physical therapy. Physical therapy helps to improve posture and correct dysfunctional spinal mechanics. Physical therapy treatment generally consists of soft tissue work (deep massage and manual stretching), a home stretching program, postural awareness training and therapeutic exercises to address muscles imbalances and increase core strength and improve postural muscle function. If a lumbar lordosis is present then it should be addressed as well.