Our spine is normally curved, in order to reduce shock and distribute weight evenly along the length of the back. However, in hyperlordosis (sometimes simply called lordosis and commonly known as “swayback”) the natural lordotic curves in the spine become overly pronounced, causing pain and sometimes spasms in the lumbar muscles. Though hyperlordosis most often occurs in the lumbar region of the back, it can also appear in the cervical spine.
There are a few different causes of lordosis. It can be congenital, occurring during fetal development when a significant difference develops between the thickness of the front and back parts of the cervical discs. The condition often worsens at puberty and is not obvious until the person reaches their early 20s. Pregnant women often experience this condition, as the weight of the baby pulls on the lower back. Spondylolisthesis, where one vertebra slips over another, can also contribute to this disorder. Hyperlordosis can occur in older adults due to arthritis or spinal degeneration, though in most adults it is perhaps most often due to an imbalance in muscle strength and length in the lumbar and hip regions.
Chiropractic care may help reduce lower back pain from hyperlordosis, and your chiropractor may use spinal manipulation to reduce pain and help restore motion. But unless the condition is severe enough to require surgery (which usually involves spinal fusion), stretching and specific rehab exercises are the most common treatment to correct hyperlordosis.
Hyperlordosis due to muscle imbalance involves four sets of muscles, two sets of which are too tight and two sets which are weak and need tightening: the trunk extensors and hip flexors (particularly the iliopsoas muscles) need stretching, and the abdominal muscles and hip extensors (primarily the hamstrings and gluteus maximus) need strengthening. The following exercises are helpful in stretching or strengthening the appropriate muscle groups:
To stretch the hip flexors: Get down on one knee, with your hips over the knee on the floor and your other leg in front of you with the knee centered over the foot. Then gently move your hips forward until you feel a stretch extending from your inner hip to your thigh. Hold the position for about 30 seconds and repeat three to five times. Repeat the stretch with the alternate knee on the floor.
To stretch the lower back: Lie on your back and bring your knees up to your chest. Wrap your arms around your knees, pull them in toward your back as far as you can and hold the position for 30 seconds. Repeat three to five times.
To strengthen the abdomen: Do these abdominal crunches by lying on the floor with your knees bent and feet flat on the floor. Then, with your hands on your thighs, lift your head and upper shoulders slightly off the floor. Repeat for as many reps as is comfortable, then rest for a minute and repeat the same number of reps twice (three sets of 10 reps, for example).
To strengthen the gluteus maximus: Lie on your back with your feet flat on the floor and your hands stretched out toward your feet. Gradually lift your hips off the floor until the line between your knees and shoulders is straight. Hold for 10 seconds and repeat 10 times.