What is lordosis?

Healthy spines curve naturally from front to back. The lower back (lumbar spine) has a slight forward curve and the upper back (thoracic spine) has a gentle backward curve. These curves absorb shock from everyday activities like walking, jumping, and running.

Lordosis is an exaggerated inward curve of the spine that typically affects the lower back, a condition called lumbar lordosis. Less often, children develop a pronounced inward curve of the neck, cervical lordosis.

Lordosis can affect people of all ages. In rare cases, extreme forward curvature of the spine can become painful and affect movement.

What are lordosis symptoms?

Children with lordosis have a swayback appearance. Their posture may seem exaggerated. Their buttocks may sway further out to the back than normal and their stomachs sway out in front. When a child with lumbar lordosis lays on their back, it may be difficult or impossible for them to press their lower back into the floor.

In rare cases, children with severe lordosis may have pain, numbness, tingling, or weakness in one or both of their legs. They may also lose control of their bladder. If your child has these symptoms, they should be seen by a spine specialist as soon as possible.

What causes lordosis?

In many cases, doctors don’t know the cause of lordosis. While lordosis tends to develop during adolescence, some children are born with a higher risk of developing the condition. Lordosis is often associated with one of the following:

  • Posture: The lumbar spine relies on the muscles around the stomach and lower back (abdominal muscles) for support. Children with weak abdominal muscles tend to be more prone to lordosis.
  • Overweight: Extra weight in the belly puts strain on the lower back and pulls it forward, increasing the risk for lordosis.
  • Trauma: Sports injuries, accidents, or serious falls can cause spondylolysis, a type of spinal fracture. This can weaken the spine and cause the affected vertebrae to curve at a more extreme angle.
  • Surgery: Selective dorsal rhizotomy, a minimally invasive surgery that may be used to reduce leg spasticity in some patients with cerebral palsy, can lead to lordosis.
  • Neuromuscular conditions: Children with conditions that impair nerve and muscle function may also develop lordosis. Such conditions include muscular dystrophy, cerebral palsy, and several others.
  • Hip problems: Some children with developmental dysplasia of the hip also develop lordosis.

How we care for lordosis at Boston Children’s Hospital

The Spine Division at Boston Children’s Hospital is the largest and busiest pediatric spine center in the United States. Each year, we treat thousands of patients with spine conditions that range from simple to complex. Whenever possible, we provide non-surgical treatment for lordosis. In the rare cases that require surgery, we are a center of excellence in surgical procedures of the spine. When appropriate, our Spine and Sports Program works with young athletes with lordosis that is the result of a sports injury, with a focus on recovery and safe return to play.