Swayback (Lordosis)
About swayback
The spine normally curves at the neck, the torso and the lower back area. This positions the head over the pelvis naturally. The curves also work as shock absorbers, distributing the stress that occurs during movement.
When the spine curves too far inward, the condition is called lordosis or swayback.
What causes swayback?
Lordosis can affect people of any age. Certain conditions can contribute, including achondroplasia, discitis, kyphosis, obesity, osteoporosis and spondylolisthesis.What are the symptoms of swayback?
Lordosis can cause pain that sometimes affects the ability to move. It is usually found in the lower back, where the inward curve can make the buttocks seem more prominent.
When lying on the back on a hard surface, someone with a large degree of lordosis will have a space beneath the lower back and the surface. If the curve is flexible (or reverses itself when the person bends forward), there is little need for medical concern. If the curve does not change when the person bends forward, the lordosis is fixed, and treatment may be needed.
How is swayback diagnosed?
To diagnose lordosis, a doctor may take the patient's medical history and perform a physical examination. The medical history will cover such issues as when the excessive curve became noticeable, if it is getting worse and whether the amount of the curve seems to change. During the examination, the patient will be asked to bend forward and to the side to see whether the curve is flexible or fixed, how much range of motion the patient has and if the spine is aligned properly. The doctor may feel the spine, checking for abnormalities.
The doctor may order a neurological assessment if the person is having pain, tingling, numbness, muscle spasms or weakness, sensations in the arms or legs or changes in bowel or bladder control. Other tests may be ordered, including X-rays.
How is swayback treated?
If the doctor decides conservative treatment is best, it may include:
- Drugs to relieve pain and swelling
- Physical therapy to build strength and flexibility and to increase range of motion
- Braces to control the growth of the curve, especially in children and teens
- Reducing excess body weight
If the curvature is severe and causing other symptoms, spinal instrumentation, artificial disc replacement and kyphoplasty are potential surgical treatments.
Key points
- The spine normally curves at the neck, the torso and the lower back area. When the spine curves too far inward, the condition is called lordosis or swayback.
- Lordosis can cause pain that sometimes affects the ability to move. It is usually found in the lower back.
- Lordosis can affect people of any age.
- Conservative treatment for the condition may include medication, physical therapy, braces and weight loss. Surgery may be needed if the curvature is severe and causing other symptoms.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
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