Lordosis of the lumbar spine treatment. Lumbar lordosis - how to be and what to do? What do diagnoses mean?

19.10.2019 -

(posterior curvature of the spine), lordosis is characterized by curvature of the cervical and lumbar sections of the spinal column, the convex part facing forward. This feature can be both physiological and pathological.

Physiological lordosis is a natural curve that provides normal work musculoskeletal system. Pathological lordosis is dangerous to health and its treatment is mandatory!

Development pathological lordosis in schoolchildren occurs due to failure to maintain normal posture while reading, doing homework and school work. In adults, pathological lordosis develops when spending a long time at the computer or watching TV.

Development primary cervical lordosis occurs due to complications - inflammation, tumors.

Secondary cervical lordosis formed against the background of birth injuries.

Read more about the types and causes of lordosis in.

Symptoms of hyperlordosis:

A low-set head that protrudes sharply forward.
Visually incorrect posture is a clear bend in the neck.
Pain in the affected area of the neck.
The appearance of pain when turning the head.
Limitation of head movement to the left and right due to unpleasant discomfort.

With straightened lordosis, restrictions in movements are revealed. There is a disturbance in blood flow, which disrupts the nutrition of the brain. This syndrome is dangerous fainting states and ischemic stroke.

Symptoms of straightening cervical lordosis:

Pain in the neck is severe.
Frequent fatigue and depressed mood.
Constant headaches, frequent dizziness.
Signs of skin numbness.
Feeling of darkening in the eyes.
Decreased appetite.
Trophic disturbances.

At an advanced stage of lordosis, disturbances are noted of cardio-vascular system, breathing, disturbances in heart rhythm.

Symptoms of lumbar hyperlordosis:

Lumbar pain. Aching, sharp.
Incorrect posture in the form of a curved lower back.
A protruded belly and excess weight aggravate the curvature.
Deviation of the entire body and pelvis backwards.
Knees spread apart.
Fatigue when walking and standing for long periods of time.

With smoothed lordosis, compression syndromes are observed. Soreness appears in various places around the spine, heart of the stomach, etc.

Symptoms of straightened lordosis in the lower back:

Pain and limitation of movement in the lumbar region.
Tiredness when walking and standing.
Feeling of numbness in the back and legs.
Change in gait.
Feeling of flat back when palpating.

If treatment is not prescribed on time, the disease is aggravated by the disorder internal organs- gastrointestinal upset, heart pain, metabolic disorders.

Treatment methods

When treating lordosis in cervical spine adhere to several rules:

Strengthening the muscular corset of the back, in particular in the cervical region.
Correct spine position.
Improving blood flow in the spine.
Identifying the cause of the disease and eliminating symptoms.

The first step in the treatment of lordosis is straightening the physiological curve. But we should not forget about the reason that became the impetus for the subsequent curvature of the spine.

Smoothed lordosis in the cervical spine is normalized with the help of:

Complex therapy- massage, manual therapy, application medicines and exercises. Therapeutic exercise is aimed at strengthening the muscle corset. Connection of massage and manual therapy is removed pain syndrome and muscle tension.
A course of reflexology also helps.
Physiotherapeutic procedures prescribed by a doctor depending on the degree of pathological lordosis.
Unloading the spine, giving the correct position.

How to treat lordosis lumbar region? Treatment of lordosis in the lumbar region takes a lot of time and effort. It is necessary to realize that, in addition to physical exercise the person will have to undergo massage sessions, physiotherapy and other drug treatments.

To determine the straightening of the lumbar lordosis, you should take a simple test. It is enough to press your back against the wall and stick your hand into the gap between the wall and your lower back. If the hand does not fit into this connector, then we can talk about straightening the lordosis.

In addition to the main treatment, there is spinal traction. However, this procedure is not indicated for everyone. carried out only by a specialist. The neurologist also prescribes additional drug treatment.

Drug therapy includes taking vitamins and mineral supplements to help strengthen the skeleton, normalize blood flow, and improve immunity. If you experience pain, your doctor will prescribe painkillers.

Recommended Exercises

With lumbar lordosis, it is important to regularly do special exercises. Let's look at the basic complex:

Standing against the wall, lean forward and reach your feet with your hands.
Standing against the wall, touch the wall with protruding parts (heels, buttocks, shoulder blades), arch your spine and try to touch the wall with your lower back.
In a standing position, bend forward and grab your shins with your hands. Make springy movements back and forth.
Do squats. Squat - exhale, etc. - inhale.
In a lying position, try to touch part of your lower back to the floor.
In a lying position, arms spread to the sides with palms facing the floor, raise your legs 90 degrees. You can lean on the floor. Next, try to throw your legs as far behind your head as possible. Movement without jerking!
Move from a lying position to a sitting position.
Lying down, pull your knees to your chest and return to standing position.
Raising and lowering straight legs up to 15 times.

Treatment at home

Treatment of lordosis at home is carried out using 3 methods:

Gymnastics.
Massage.
Application of an orthopedic bandage.

A bandage is a special device in the form of a corset. It fixes the curved parts of the spine and prevents further deformation. The size of the bandage is selected by the doctor. He also advises the patient about the wearing time.

Massage. Sessions can be carried out both at home (if you invite a specialist) and in massage rooms.

Gymnastics. All exercises consist of stretching and strengthening the muscles of the spine.

How to treat spinal lordosis in a child

The first stage of treatment for lordosis will be to establish the root cause of the disease. Based on this, the doctor will prescribe effective treatment. When lordosis is combined with osteochondrosis, treatment will be carried out to eliminate degenerative-dystrophic phenomena.

Treatment:

Exercise therapy is mandatory in strengthening the muscle corset.
The use of bandages for excess weight.
Drug treatment. Use of painkillers.
Spinal traction procedure.
Massage.

Pathological lordosis is a labor-intensive process. The fight against it is carried out thanks to the complex effects medical procedures.

See also video of exercises necessary for lordosis:

The human spine, when looking at it from the front, should be straight, the identified lateral curvatures will be a deviation from the norm, but in the anteroposterior direction, that is, when viewed from the side, you can notice 4 natural curves. These curves spinal column in the cervical and lumbar regions (lordosis), thoracic and sacral (kyphosis) are designed to compensate for the pressure exerted on the spine during vertical loads and protect it from injury. Let us dwell in more detail on lordosis in the lumbar spine.

Lordosis is a curvature of the spinal column with a convexity directed forward and a convexity directed backward. There are such bends:

physiological, i.e. natural,
pathological - deviating from the norm, recognized as a disease (pathology) - curvature of the spine.

It all depends on the amount of bending.

Natural lordosis forms in the cervical and lumbar spine during the first year of a person’s life, when he begins to sit, learns to stand and walk.

The normal angle of curvature of the spine in the lumbar region is 150-170 degrees.

Pathological forward curvature of the spine can form at any age due to various reasons(injuries, illnesses, during pregnancy, etc.) and is accompanied by pain, changes in posture and disturbances in the functioning of internal organs. Changes occur in the spine itself: the load on the vertebrae becomes uneven, the joints suffer, the mobility of the spine decreases, and conditions are created for the occurrence of hernias.

The earlier the pathology appears and the longer it remains unattended, the more pronounced its symptoms will be and the more serious the consequences.

So, when pathological lordosis appears in childhood or adolescence The chest is deformed, as a result of which the internal organs are compressed and their functions are disrupted.

What do diagnoses mean?

A healthy spine in the cervical and lumbar region has bends (lordosis) of a certain degree. In case of deviations from normal values we can talk about pathological lordosis, which can be of two types.

Lordosis in the lower back is smoothed (straightened)

If the curve in the lumbar spine is smoothed (or straightened), then this pathology is called “hypolordosis”. If there is insufficient curvature of the spine in the lower back, axial loads will not be sufficiently mitigated.

A healthy spinal column in such cases, due to the bending in the lumbar region, is compressed like a spring and reduces the pressure several times. If this does not happen, the vertical load on the intervertebral discs, which leads to their deformation, displacement, and the development of pain in the lower back.

The basis for diagnosing flattened lordosis in the lower back is usually where the doctor can see a decrease in the height of the intervertebral discs, a bringing together of the anterior parts of the lumbar vertebrae and a distance of the processes.

As a rule, hypolordosis occurs due to a sedentary lifestyle and lack of physical activity. When a person sits, the curves of the spine are smoothed out. When sitting for a long time (they overexert themselves) and gradually straighten the natural curve of the spine, they spoil their posture. The angle of curvature of the spinal column with hypolordosis is more than 170 degrees.

flat back;
rapid fatigue in sitting and standing positions;
pain in the lumbosacral region;
altered gait.

Increased lordosis in the lumbar region

The opposite situation, when the lumbar deflection of the spine is too pronounced, is called “hyperlordosis.” The bending angle with this diagnosis is approximately 145-150 degrees.

On x-rays of the lumbar spine, you can see that the anterior surfaces of the vertebrae fan out, and the spinous processes are practically connected to each other.

Hyperlordosis can be congenital, which is usually associated with hereditary predisposition and disturbances in the intrauterine development of the vertebrae before the birth of the child. Also, this diagnosis can be made to an adult - then we're talking about about acquired hyperlordosis.

Excess weight, smoking, alcohol abuse, endocrine diseases increase the risk of developing hyperlordosis.

External signs of hyperlordosis:

protruding buttocks and backward deviation of the pelvis;
protruding belly;
a large “arch” under the lower back when lying on your back.

Subjective symptoms of increased lordosis in the lumbar region include constant strong tension in the lower back and the appearance of pain when lying on the stomach.

Causes of pathology

Hyperlordosis and hypolordosis have a number of unpleasant consequences for the body, including: displacement of internal organs, acceleration of destruction of cartilage tissue of joints and bones. Therefore, it is important to know the factors that may contribute to the emergence and development of these pathologies.

Congenital pathologies of the curvature of the spine are associated with heredity and injuries received during childbirth.

Acquired lordosis usually develops by the age of 30, which is associated with physical inactivity, weakness of muscles and ligaments, long stay in a sitting position, first while studying at school, others educational institutions, and then at work in the absence of proper physical activity and care for one’s health.

weak back muscles;
pathological or congenital dislocation of the hip, immobility of the hip joint;
osteochondrosis, intervertebral hernia and others chronic diseases spine;
spinal column injuries;
malignant neoplasms in the spine itself or nearby organs;
tuberculosis;
pregnancy.

Hyperlordosis occurs in women during pregnancy as the fetus grows. A growing belly increases the natural curvature of the spinal column, and the back muscles are no longer able to hold the spine in its usual position. After childbirth, when the weight normalizes, the back gradually recovers, and the angle of bend in the lower back returns to its normal value.

Diagnostics

The diagnosis can be made by a surgeon or traumatologist. Preliminary diagnosis is carried out on the basis of examination and medical history, an assessment of the range of motion and muscle strength. In addition to this, neurological status is assessed.

X-rays can provide the most accurate picture of the condition of the spine. IN difficult cases when it comes to availability somatic diseases or neurological symptoms, other types of research are used, for example:

If you suspect the presence of inflammatory processes or tumors, use laboratory methods research.

Treatment of lumbar lordosis

Often such a diagnosis is not noticeable, does not cause inconvenience or pain, so patients delay treatment. But if the degree of deviation from the normal angle is too great, treatment should be started immediately. Indeed, with destructive changes in one area of the spine, the load is redistributed to others, which means pathological condition in the lower back threatens the appearance of problems in the cervical or thoracic regions in the near future.

Treatment will depend on the origin of the disease and the degree of curvature.

If the cause of hyperlordosis is an infection, then first you need to cure the underlying disease, remove the inflammation, and then its consequence in the form of curvature of the spine.

If the curvature of the spinal column has changed due to obesity, then weight loss measures are first taken, including a special diet and training programs.

In any case, if lordosis appears as a consequence of any disease, you first need to get rid of the disease, i.e. eliminate the cause, and gradually correct the consequences for the back.

If lordosis was detected on early stages, then it is not difficult to cure it.

Physical therapy exercises will strengthen the muscle corset, which will reduce lower back pain. Such classes can be carried out at home, without the use of special exercise equipment.

The best effect will be achieved by combining strength training with relaxation and stretching exercises.

In more complex cases, medications are added to the above measures: (, Tizanidine, Meprotan), painkillers,.

In case of congenital lordosis and in completely advanced cases, only surgery can help, after which rehabilitation measures and continuation of traditional treatment.

Spinal curvature is a problem that literally every person on the planet faces to one degree or another. Of course, the curvature can be so weak that it will simply be unnoticeable and will not cause any problems to the person.

However, there are also severe forms, which are considered pathological due to aesthetic disorders, as well as the complications they cause. One of such pathologies is lumbar lordosis; in this article we will talk about what kind of disease this is, what are the causes of its occurrence, types, symptoms, etc.

Everyone knows that the normal adult spine has several curves. IN thoracic region The spine curves backward, which is called thoracic kyphosis. At the same time, in the lumbar region, the spinal column bends forward or, otherwise, inward; in medicine this area is called lumbar lordosis. Due to the fact that the physiological curvature and the corresponding pathology have the same name, it is important to understand in which cases lumbar lordosis refers to a disease.

So, we are talking about the disease in cases where the deflection in the lower back, that is, the angle of curvature of the spinal column in the lumbar region, exceeds certain norms. In other words, a pathological curvature is diagnosed by a doctor when the angle of the bend changes too much.

Accordingly, pathological lumbar lordosis, which is discussed in this article, is a disease of the spine, characterized by curvature of the latter with the convex side in the forward direction. This pathological process is divided into types, has several stages of development, differing in the degree of the angle of curvature, and, accordingly, increasingly severe symptoms and complications. In addition, the curvature of the spinal column in the lumbar region is both congenital and acquired.

Kinds

To make a more accurate diagnosis, as well as classify the characteristics of the pathological process, in medicine, lordosis of the lumbar spine is conventionally divided into two main types:

Primary lordosis - in this case, the curvature of the spinal column is caused by various congenital pathologies and disorders in the development of the fetus or diseases that directly affect the structures of the spine.
Secondary - in this case, the occurrence of pathology is due to concomitant diseases that are indirectly related to the spine, as well as back injuries, poor posture and other similar factors.

There is also the term “increased lumbar lordosis,” but this should not mislead you. This formulation is only a clarification that speaks about the development of pathology. In other words, “strengthened” means there are deviations from the norm of physiological bending.

In addition, returning to the topic of the types and classification of the disease, there is also a division into two separate types of deviation:

Hypolordosis is an anomaly in which the curvature of the spinal column in the lumbar region is absent or its indicators are significantly lower than normal.
Hyperlordosis - in this case, on the contrary, we are talking about too much curvature of the spine in the forward direction, that is, the angle of bending exceeds the norm.

Of course, both types are deviations from the norm and are equated to diseases. Moreover, each case has its own characteristics, differing in symptoms and subsequently developing complications.

Causes

Due to the fact that lordosis can be either a congenital or an acquired disease, doctors identify many reasons for its development that correspond to these two features of the occurrence of pathology. Taking this fact into account, it is worth dividing possible reasons and factors for the development of the disease into two groups.

The formation of lumbar lordosis in children occurs for the following reasons:

Genetic, that is, hereditary predisposition - cases of the disease are recorded in the family medical history. This takes into account the presence of a pathological process not only in the mother or father (which is most likely), but also in grandparents or closest blood relatives.
Various anomalies of fetal development in the womb, including disturbances in the formation of vertebrae, intervertebral structures, muscle tissue and ligaments. In especially severe cases, the newborn may completely lack one or more vertebral segments.
Primary lordosis also develops if the child is injured during childbirth, which may be due to the negligence of the obstetrician or a difficult birth.

Among the causes of acquired pathology are the following:

The main reason for the development of lordosis is poor posture, which most often occurs in adolescence or young adulthood. Carrying a backpack or bag on one shoulder, stooping while walking, incorrect or uncomfortable position when sitting at a desk, etc., all these are factors in the occurrence of the disease.
The second most common cause is various injuries to the spinal column. Not only spinal fractures are taken into account, but also serious blows, bruises, and strains of the lower back muscles. Especially often, pathology develops as a result of falls from great heights or after serious accidents.
Heavy physical labor, in particular, constant lifting of heavy weights, as well as excessive stress on the spine due to moderate and severe forms of obesity.
Often the development of lumbar lordosis is caused by concomitant pathologies of the spine, the most common of which is. This also includes radiculitis, inflammatory processes, bone tuberculosis, development, etc.
Sedentary lifestyle.
Impaired metabolism and so on.
Often lordosis develops in pregnant women, especially when we are talking about several pregnancies over a short period of time or if the fetus was heavy and the woman is of a fragile constitution.

It is worth taking into account that only the most probable and common causes of the development of lordosis of the lumbar spine are listed above; in fact, there are much more of them.

Symptoms

The clinical picture of lordosis differs greatly depending on the degree of development of the pathological process, the causes of its occurrence, as well as the type, type of disease and other factors. With a slight curvature, invisible to the naked eye, the symptoms will be blurred or any manifestations will be completely absent.

At the same time, the more the pathology develops, the more pronounced the symptoms will be. In general clinical picture for this disease is as follows:

Main clinical sign so-called aesthetic deviations appear. When the spine is curved anteriorly in the lumbar region, the lower back bends more (or becomes flat, depending on the type of pathology), while the abdominal region protrudes, the man walks forward with his stomach, unnaturally bending back to maintain balance.
At the same time, the gait becomes less stable, the legs bend like a wheel, and walking becomes much more difficult.
The more pronounced the angle of curvature, the more intense the pain becomes. The pain is localized in the lower back and intensifies while walking, as well as with any physical activity. The nature of the pain is initially dull and aching, but then movements are accompanied by stronger and sharp pains, Sometimes . With time painful sensations spread to the buttocks area, may pull the legs.
Due to poor posture and constant pain there is deterioration general condition patient. Fatigue, sleep disturbances, systematic fatigue, and nervousness appear.

As mentioned earlier, the clinical picture is diverse and depends on a number of factors, but attention should be paid to any deviations from the norm, because in the early stages it is much easier to fight diseases.

Diagnostics

Of course, for a full diagnosis, it is better to consult a doctor who will write out the appropriate directions and help to not only easily identify lumbar lordosis, but also determine the degree of progression of the disease, its type, etc. To do this, it is necessary to undergo a number of diagnostic measures:

The first step is to take a medical history from your doctor and initial examination with palpation of the lumbar spine. The initial examination also includes functional diagnostic methods, in which the patient, with the help of a traumatologist, performs a number of actions to assess the severity of the disease.
- allows you to do x-rays of the spine in different projections to obtain a general picture of the course of the disease.
or – usually one of these methods replaces the other. The procedures allow you to obtain a detailed picture of lesions and deformations of bone tissue, but MRI is more preferable, as it provides the most detailed information.

Treatment

Treatment of lumbar lordosis requires integrated approach. In this case, it is better to consult a doctor initially, even when the disease is initial stages development. Only an experienced specialist will assess the scale of the problem and prescribe the most adequate treatment.

In general, treatment methods are as follows:

Drug therapy.
Physiotherapy.
Massages.
As a last resort it is required surgical intervention.

To fully understand the principle of treatment, we will consider each method of combating lordosis separately.

Drug treatment

Within drug therapy The doctor prescribes a number of drugs aimed at suppressing unpleasant symptoms, combating concomitant pathologies, and also to achieve maximum therapeutic effect. We are talking about drugs from the following groups:

Remember that everything medications for lumbar lordosis, they are prescribed strictly by the attending physician.

Physiotherapy

Accelerate recovery, as well as reduce pain and normalize metabolic processes in the affected area of the spine, physiotherapy allows:

Ultrasound.
And so on.

It is important to undergo physical therapy full course, this is the only way to achieve the maximum therapeutic effect.

Massage

Treatment through massage is another auxiliary method, without which treatment of spinal curvature is indispensable. Remember that massages must be performed by qualified specialists, and they also need to be completed in a course, repeating it several times.

Massages allow you to tone or relax muscles, eliminate pain, straighten the spine, “put back in place” the vertebrae, if required, etc.

Physiotherapy

Therapeutic gymnastics is also useful for healthy person as a preventive measure for lordosis. The patient needs it and they take care of it a long period, possible throughout your life.

Exercises for lordosis vary greatly depending on the stage of progression of the pathological process, the same applies to loads, so initially classes are conducted under the guidance of a rehabilitation physician. In severe cases, classes are carried out in a supine position; as success is achieved and the treatment takes effect, the set of exercises becomes more varied.

Operation

As mentioned earlier, surgical intervention is required only in extreme cases, when the disease threatens the patient’s life or is accompanied by serious complications. The operation involves straightening the spine through the installation of special metal structures, sometimes they replace vertebrae.

Lumbar lordosis is preserved - what does this mean?

This diagnosis indicates that, as a result of treatment or at the time of diagnosis, the curvature of the spinal column in the lumbar region is within normal limits. That is, it does not exceed 59 degrees.

If the patient feels normal and is not bothered by pain, treatment is not required. But if there are any complaints, additional diagnostics are carried out.

Complications

Lordosis causes a lot of trouble and is often accompanied by severe symptoms, but this pathology is even more dangerous because of its complications:

Severe cases of lordosis are accompanied by organ prolapse abdominal cavity, which causes disruptions in their work and various problems gastrointestinal tract, kidney dysfunction is noted, etc.
On late stages progression of the disease occurs in the lumbar spine, which is fraught with complications from nervous system. First of all, we are talking about numbness and tingling in the lower extremities, which is then replaced by loss of sensitivity, up to paralysis.
The disease also leads to damage genitourinary system, in women this is manifested by increased menstrual pain and delays, in men, impaired potency by prostatitis.

Prevention

It is better to prevent the development of the disease at all than to fight it and its consequences. To prevent lordosis, follow a number of simple recommendations.

- this is a physiological or pathological curvature of the spine, in which its convexity is directed anteriorly. Physiological lordosis is observed in all people in the lumbar and cervical spine. Pathological lordosis is usually located in the same sections, but differs from physiological lordosis in the degree of bending. In rare cases, pathological lordosis forms in the thoracic spine. It manifests itself as poor posture and back pain. Diagnosed based on examination data and X-ray results. Treatment can be either conservative or surgical.

ICD-10

M40.4 M40.5

General information

(from the Greek lordos - bent, stooped) - a physiological or pathological curvature of the spine in the anteroposterior direction with a convexity facing anteriorly. Physiological lordosis normally develops in the first year of life. Pathological lordosis can develop at any age due to congenital or acquired pathology of the vertebrae, hip joints, back muscles, buttocks and thighs. Accompanied by pain and poor posture. In severe cases, it can impede the functioning of internal organs. Treatment of lordosis is often conservative. With severe pathology and/or progression of pathological lordosis, surgery may be required.

Causes of lordosis

The cause of the development of primary pathological curvature can be processes such as malformations, tumors and inflammation in the vertebral area, spondylolisthesis, muscle torsion spasms and spinal injuries.

Secondary pathological lordosis can occur due to flexion contracture of the hip joint, ankylosis (immobility) of the hip joint, pathological or congenital dislocation of the hip. systemic diseases musculoskeletal system, cerebral spastic paresis lower limbs, polio with damage to the muscles of the pelvic region and lower extremities, as well as pregnancy. IN the latter case Lordosis is temporary and disappears after the birth of the child. In all of the above conditions, the center of gravity of the body shifts forward and, in order to maintain balance, the person bends at the waist.

Predisposing factors that increase the likelihood of developing lordosis and, under certain conditions, can cause this pathology also include poor posture, excess weight with fat deposits large quantity belly fat and rapid growth during childhood and adolescence.

In children and adolescents, secondary compensatory hyperlordosis is usually mobile in nature and can decrease or disappear when the cause that caused it is eliminated. Long-existing lordosis in adult patients becomes fixed, and the curvature of the spine in such cases does not change even after eliminating the provoking factors.

Pathanatomy

Normally, the human spine has 4 curvatures: two lordosis (lumbar and cervical) and two kyphosis (sacral and thoracic). All of them are located in the anteroposterior (saggital) direction. There should be no lateral curvatures (scoliosis) normally.

The first signs of physiological kyphosis and lordosis are detected immediately after birth. However, in infants they are weakly expressed. The curves become pronounced when the child begins to stand and walk, that is, by the end of the first year of life. And the final anatomical structure of the spine is formed by the age of 16-18, when the closure of bone growth zones occurs. However, pathological lordosis can occur in both children and adolescents and adults. The reason for its development in various cases is a change in the shape and size of the vertebrae, as well as other pathological processes in some parts of the musculoskeletal system.

With pathological lordosis, a number of characteristic changes are usually observed. The vertebrae move anteriorly, their bodies fan out. There is a vacuum in the anterior sections bone structure and expansion intervertebral discs. The spinous processes of the vertebrae adjacent to the affected part become denser and closer together. If pathological lordosis occurs in childhood or at a young age, deformation of the chest develops, accompanied by compression and dysfunction of the organs of the chest cavity. Deformities in other parts of the body may also occur. Moreover, the earlier lordosis appeared, the more pronounced the listed changes are.

Classification

In traumatology and orthopedics, lordosis is classified according to several criteria.

Taking into account localization:

Cervical spine.
Lumbar spine.

Taking into account the causes of occurrence:

Primary lordosis, which develops as a result of various pathological processes, arising directly in the spine.
Secondary lordosis, which is compensatory in nature and occurs because the body tries to adapt to maintaining balance in non-physiological conditions.

Given the shape:

Physiological lordosis.
Excessive pathological lordosis (hyperlordosis).
Straightening the bend (hypolordosis).

Taking into account the possibility of returning the body to its normal position:

Unfixed lordosis, in which the patient can straighten his back with a conscious effort.
Partially fixed lordosis, in which limited changes in the bending angle are possible.
Fixed lordosis, in which returning the body to its normal position is impossible.

Symptoms of lordosis

Common manifestations include changes in posture (usually when the normal curvature of one part of the spine is disturbed, a more or less pronounced curvature of other parts of the spine occurs), increased fatigue and pain in the affected part of the spine, which intensifies after physical activity or staying in an awkward position. There is a limitation when performing certain physical activities. With severe lordosis, diseases of the heart, lungs, kidneys, stomach and intestines can develop, caused by a violation of the normal relationship and compression of the corresponding organs.

Depending on the nature of the pathological changes, several variants of postural disturbance may be observed, accompanied by a decrease or increase in lordosis.

A round-concave back (kypholordotic posture) is accompanied by an increase in all curves. Lumbar lordosis and thoracic kyphosis are increased. The legs are in a position of slight hyperextension or slight flexion in knee joints. The shoulder blades stick out, the shoulders are adducted, the shoulder girdles are raised, the stomach protrudes forward. The head may also be slightly pushed forward.

Round back (kyphotic posture). There is a significant increase in thoracic kyphosis with a corresponding decrease in lumbar lordosis. With this type of posture, the center of mass of the body shifts posteriorly, so the person bends his legs slightly when standing and walking to even out this imbalance. There is a forward tilt of the head and a decrease in the angle of the pelvis. The shoulders are adducted, the shoulder girdles are raised, the shoulder blades stick out. The arms hang slightly in front of the body. The chest is sunken, the stomach protrudes forward.

Flat-concave back. There is a flattening of the cervical lordosis and a decrease in thoracic kyphosis. Lumbar lordosis is normal or increased. With this posture, the pelvis shifts the center of mass posteriorly, the knees are hyperextended or slightly bent. The head is lowered, the chin “looks” down. The shoulder blades stick out, the chest is sunken.

Flat back. All natural curves of the spine are reduced, the flattening of the lumbar lordosis is especially pronounced. The pelvic tilt angle is reduced. The shoulder blades stick out, the chest is shifted anteriorly, Bottom part the belly sticks out.

Most often, when speaking about pathological lordosis, they mean increased lumbar lordosis (lumbar hyperlordosis), in which kypholordotic posture is observed. It is this change in the shape of the spine that develops with most secondary pathological lordoses.

Taking into account the nature of the pathological process, several types of hyperlordosis are distinguished, which differ in symptoms and clinical course.

Fixed and non-fixed lumbar increased lordosis, which develops as a result of processes that cause a shift of the body's center of gravity anteriorly. May occur due to deformation chest due to spondylolisthesis, posterior dislocation and flexion contracture of the hip, as well as sharp curvature of the spine with the formation of a rib hump as a result of severe scoliosis or bone tuberculosis. The onset can be either acute or gradual. The nature of the course and clinical symptoms are determined by the degree of lordosis.

Extensor lumbar-hip rigidity. Develops in young patients with normal condition spine. Formed as a protective posture during various volumetric and adhesive processes in the area of the nerve roots. May occur with arachnoiditis spinal cord, radiculitis and some other diseases. Excessive lordosis in this case appears due to painless contracture of the lumbar and gluteal muscles. The beginning is gradual. A characteristic feature Such lordosis is a sliding gait. Usually proceeds favorably.

Fixed lumbar increased lordosis, which occurs as a result of volumetric processes in the lumbar spine. Most often, such lordosis develops with disc herniation. Typically, the first symptoms of lordosis appear in middle age. The onset can be either gradual or acute (with a breakthrough of the nucleus pulposus). Lordosis is accompanied by extensor contracture of the lumbar and gluteal muscles. When trying to overcome the contracture and return the body to a normal position, sharp pain occurs in the area hip joints. Symptoms of stretching are observed. Irradiation (spread of pain along the back of the thigh and lower leg) is rare. There are no disturbances in sensitivity or movement. The course of lordosis is usually unfavorable. Over time, decompensation develops, neurodystrophic changes occur in soft tissues. Characterized by severe, prolonged pain.

Due to disruption of the normal shape of the spine, with all types of lordosis, a pathological redistribution of the load on the bones, ligaments and muscles occurs. The ligaments are overstretched, the muscles are constantly in a state of increased tension. As a result, lethargy, weakness, and fatigue develop. With persistent, long-term lordosis, the following complications may occur:

Pathological mobility of the vertebrae.
Multiple scalene pseudospondylolisthesis (decreased stability of intervertebral discs).
Discs falling out.
Intervertebral hernia.
Psoit ( inflammatory process in the iliopsoas muscle).
Deforming arthrosis of the spinal joints.

Diagnostics

The diagnosis of pathological lordosis is made based on examination and radiographic data. During the examination, the doctor evaluates the patient’s natural body position and postural characteristics, and also conducts a number of special tests to determine whether the lordosis is fixed and whether it is accompanied by neurological disorders. In addition, the doctor palpates the back muscles and examines the organs of the chest cavity.

If you suspect pathological lordosis in mandatory X-rays of the spine are taken in frontal and lateral projections. In order to get an idea of the degree of lordosis, lateral radiographs are taken at maximum extension and flexion of the back. In this case, the radiologist uses measurements to assess the mobility of the spine in the anteroposterior plane (normal, decreased, increased). In addition, the doctor identifies violations of the structure and shape of the vertebrae, as well as their relative positions.

Treatment of lordosis

The pathology is treated by orthopedists and vertebrologists. The main goal of therapy is to eliminate the cause that caused the pathological lordosis. During the treatment, kinesitherapy rehabilitation and orthopedic procedures are also carried out. Patients are prescribed manual therapy, therapeutic massage and exercise therapy. Sometimes wearing posture correctors (bandages or corsets) is indicated. For primary pathological lordosis, it is carried out surgical treatment followed by rehabilitation.

Lumbar lordosis is a natural curve in the lower part of the spine, concave inward. Lordosis of the lumbar spine is considered normal only within certain limits, determined by the angle of curvature.

Some were unlucky to be born with such a pathology, and some acquired it as a result of an unhealthy lifestyle, excessive stress, illness, etc. Excessive bending in the lower back can cause pain and spinal diseases.

Lordosis often affects the fair sex in adulthood (from about 30 years old) and is a consequence of bearing a child.

There are some parameters that characterize lumbar lordosis. With their help, make a conditional division into types.

Depending on the root cause of the pathology: Primary lumbar lordosis - when the unnatural curve is caused by benign or malignant formations
inside the body, congenital pathologies of the vertebrae; Secondary – when the disorder is caused by mechanical damage

spinal column.

Depending on when the disease appeared: Congenital lordosis - the disorder manifests itself in childhood
, but it is believed that abnormal changes were already present at birth;

Acquired lordosis - pathology develops under the influence of any factors (trauma, tumor, disease).

Depending on the type of deviation:
Hypolordosis - the lumbar curve is either absent or much less than normal;

Causes

Since lumbar lordosis can be either congenital or acquired, there are many reasons for its appearance. Factors should be divided into two groups: for congenital pathology and acquired. If lumbar lordosis has bothered a person since birth, the following factors contribute to this:

The pathology bothered the parents or one of them;
There were any malnutrition of the fetus in the womb;
Injuries to the pregnant mother;
Incorrect delivery, which led to injury to the baby.

If the pathology appeared in adulthood or adolescence:

In pregnant women, the curve in the lower back increases; this pathological process is associated with increased load. After childbirth, after a certain time, the disease goes away on its own;
A complication of flat feet is an increased bend in the lower back;
Osteochondrosis and all its complications, including Schmorl's hernia (a vertebra may collapse) can lead to lumbar hyperlordosis;
Mechanical damage to the structure of the spinal column;
Severe sprains or tears along the spinal extensor muscles;
Various types of inflammation of the spine;
Radiculitis and its complications;
Sedentary lifestyle, constant sitting;
Overload from heavy sports with spasms of the lower back muscles;
Impaired metabolism;
Abuse of nicotine and alcohol.

Symptoms

Symptoms for this pathology vary. It all depends on the patient’s lifestyle, the degree of progression of the pathology, the cause that caused it, etc. The lower back bends excessively or is excessively leveled. Manifestations during minor violation will be minimal, a person may not even understand what it is. There may be almost no discomfort, except perhaps fatigue. The pathology will manifest itself a little later.

Please read the information carefully:

As the angle of bending increases, pain occurs, which intensifies with voluntary and involuntary arching of the back. A person’s gait changes, his posture deteriorates, his stomach moves forward and his buttocks move backward.

With hypolordosis, the picture is somewhat different: the lower back becomes flat, the back is rounded, and the pain is concentrated in the lower back itself.

In both cases, the pathology is dangerous and you need to see a doctor to get quality treatment. Besides the fact that a person is overcome painful sensations, the risk of many diseases increases. Here are some manifestations:

Loss of sensation in the legs, numbness;
It is difficult for a person to walk for a long time, pain quickly arises when moving;
Disruption of the pelvic organs;
In men, potency may be impaired;
Disturbances in the digestive system.

Diagnostics

Knowing what lordosis in the lower back is, you can understand for yourself whether you have it or not. This method of self-diagnosis can only be applied to hyperlordosis - when the lower back is too concave.

You can simply stand point-blank against the wall, straighten your back and check whether your hand can fit between your lower back and the wall. If so, you should contact a traumatologist.

The traumatologist conducts an initial examination, probes some problem areas, and does a complete interview of the patient. It is important to independently notice all manifestations of pathology; this will be very important for making a diagnosis and future course of treatment.

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As with many spinal pathologies, there are several types of diagnostics for low back pain:

Radiography is a simple and accessible examination method that gives general information about pathology, but sometimes they are not enough;
Computed tomography is an excellent examination method; it provides a very detailed image of bone tissue, but does not affect soft tissue lesions and is contraindicated for pregnant women;
Magnetic – resonance tomography– most effective method diagnostics, allowing you to find out everything about the disturbing pathology, find out all the little things and details without harm to health or pain.

Treatment

Proper treatment of lumbar lordosis should be diverse; it is necessary to influence the pathology from all sides. Any disease of the spine requires complex treatment to achieve a therapeutic effect.

In case of lumbar lordosis, treatment should be carried out by a highly qualified specialist. Since osteochondrosis often occurs with this pathology, the specialist may be a vertebrologist or neurologist. If the cause of the pathology is not defects of the spine itself, but other dangerous diseases, for example violations digestive tract– the help of a gastroenterologist is needed.

If there are metastases, the help of an oncologist is needed; here it is necessary to act very quickly. This pathology is incredibly dangerous.

The most common option is osteochondrosis and its complications. Let's consider treatment under such circumstances