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Hyperlordosis

(Saddle Back)

Definition

Hyperlordosis is an excessive inward curve of the lower spine. It is sometimes called saddle back.

Early treatment can improve outcomes.

Hyperlordosis
Lordosis

The shadowed spine to the left shows ideal lordosis.

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Causes

The exact cause is not known.

Risk Factors

Things that may raise the risk of this problem are:

  • Poor posture
  • Obesity
  • Trauma to the spine
  • Prior back surgery
  • Neuromuscular problems, such as cerebral palsy
  • Hip disorders
  • Achondroplasia —a genetic bone disorder that is the most common type of dwarfism
  • Having other structural problems of the spine, such as spondylolisthesis
  • Hyperkyphosis —an exaggerated outward curve of the thoracic spine
  • Problems that weaken the bones, such as osteoporosis

Symptoms

Most people do not have symptoms. Those who do may have back pain.

Diagnosis

This problem may be diagnosed during a routine exam or spinal check at school.

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the spine. This is often enough to make the diagnosis.

Images may be taken of the spine. This can be done with:

Treatment

Any underlying causes will need to be treated.

The goal of treatment is to stop the curve from getting worse. Choices are:

  • Observing a mild curve for any changes
  • Over the counter pain relievers
  • Physical therapy to learn exercises that improve posture and ease back pain
  • A back brace to keep the spine in line

Surgery may be needed by people with severe symptoms and those who are not helped by other methods. The goal of surgery is to correct the curve. This is done with a metal rod, hooks, or screws.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

North American Spine Society
http://www.spine.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Acute low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-low-back-pain. Accessed February 1, 2021.

Hresko MT. Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med. 2013 Feb 28;368(9):834-841.

Lordosis. Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions-and-treatments/conditions/l/lordosis. Accessed February 1, 2021.

Spine basics. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00575. Accessed February 1, 2021.

Swayback (Lordosis). Cedars Sinai Health System website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html. Accessed February 1, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS  Last Updated: 2/1/2021