Swayback, or lordosis, is an abnormal curvature of the spine that affects posture and can cause pain. It can be caused by pregnancy, obesity, tight muscles, or certain bone and spine disorders. Treatment includes physical therapy, stretching, weight loss, and in severe cases, surgery.
In humans, the spine is naturally curved. The neck and lower back curve inward, while the upper back curves outward. When a person’s spine curves inward more than normal, it is called a swayback. Also known as lordosis, the problem typically affects the lumbar vertebrae in the curve in the lower back.
The most obvious impact of a swayback is its effect on posture. A person with lordosis will be arched forward, with the pelvis tilted forward and the buttocks appearing more prominent. If the curvature is extreme, it can affect the person’s mobility. Pain is also a common symptom, as the abnormal curvature puts pressure on the surrounding ligaments and muscles.
There are several possible conditions that can cause a swayback. Pregnant women often have this problem as they try to compensate for the extra weight they carry; obesity can also have the same effect. Tight or shortened back or hamstring muscles can cause the spine to curve excessively. Certain bone and spine disorders, such as achondroplasia, dwarfism, discitis, and osteoporosis, can lead to a wobble. Kyphosis, in which the upper back curves outward excessively, can sometimes be accompanied by lordosis.
When diagnosing lordosis, a doctor typically begins with a medical history, including when the problem started, how far it has progressed, and possible contributing factors. He will also usually perform a physical exam to establish the patient’s range of motion and determine whether the curve is flexible, where it reverses when the person leans forward, or fixed, where it does not. Any neurological symptoms such as pain, numbness, or tingling sensations will be looked at. Your doctor may feel your spine or in some cases use X-rays and other tests to see the extent of the curve and look for abnormalities.
Treatment for a swayback normally includes physical therapy. Exercises are typically used to strengthen the muscles that support the spine. Stretching and lengthening of the back and hamstrings may also be necessary to increase flexibility.
In addition to physical therapy, other treatments may also be used. In youths where a swayback is developing, a brace may be advised to limit curve rise. For obese patients, diet and exercise to reduce weight can help. Pain medications can be used in conjunction with any of these treatments to limit discomfort. In severe cases, surgery may be required.
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