by Stephen Akamine

What is Lordosis?

Lordosis is an abnormal excessive front-to-back curvature of the lower back Lumbar Spine. It is also known as Hyperlordosis or Swayback or Saddleback. Lower Back Pain is a common symptom of Lordosis, and is a correctable condition if addressed properly before any permanent damage is dome to the Lumbar Spine.

What is the cause of Lordosis?

If the pelvis rotates forward as a result of some kind of condition, the center of gravity of the body will move forward as well. The upper torso will then move backward to reposition the center of gravity so that it is vertically balanced. An excessive front-to-back lumbar curve is the end result given other names such as Hyperlordosis, Swayback, or Saddleback. This Postural Dysfunction of the lower back Lumbar Spine causes muscular imbalances as well as incorrect Lumbar Spine positioning. Hyperlordosis doesn't happen overnight, but develops over a period of time, and is fundamentally a postural and developmental problem.

How is Lordosis associated with Foot Positioning?

Lordosis is caused by anything that positions the heels of the feet higher than the balls of the feet. Wearing high heeled shoes results in postural dysfunction of the lower back, and that is a primary cause of Lordosis. Muscular imbalances are then caused by the postural dysfunction where there are corresponding anterior and posterior hypertonic muscle groups in opposition to weak and inhibited muscle groups in the pelvis and lower torso. Lower Crossed Syndrome is a condition that is commonly caused by the result of those imbalances.

What Muscle Groups corresponding with Lower Crossed Syndrome are Hypertonic (Excessively Tight)?

The anterior hypertonic muscle groups directly related to Hyperlordosis Lower Crossed Syndrome are the Hip Flexors (Psoas Muscles) and the upper anterior thigh muscles (Rectus Femoris and Sartorius). The posterior hypertonic muscle groups directly related to Hyperlordosis Lower Crossed Syndrome are the muscles of the Lumbar Spine (Erector Spinae, Multifidi, Quadratus Lumborum, Rotatores).

What are the Weak and Inhibited Muscle Groups that correspond with Lower Crossed Syndrome?

The anterior weak and inhibited muscle group directly related to Hyperlordosis is the abdominal Muscles (Rectus Abdominus). The posterior weak and inhibited muscle groups directly related to Lordosis is the buttocks muscles (Gluteus Maximus) and the posterior upper leg muscles (also known as the Hamstrings or Biceps Femoris).

How does Hyperlordosis cause Lower Back Pain?

With the spine positioned in an excessive lordotic curve, a primary dysfunctional source of pain and a secondary dysfunctional source of pain is created. The primary source of pain is the improperly positioned lumbar spine. The secondary source of pain is the abnormal tissue hypertonicity that is created.

How is Lower Back Pain caused by an improperly positioned Spine?

The improperly positioned lumbar spine due to Hyperlordosis results in unbalanced, uneven, and abnormal weight bearing loads upon the Lumbar Vertebrae and the Intervertebral Discs, which could result in nerve impingement and/or Sciatica. The excessive curve also results in incorrect Lumbar Facet Joint movement i.e. reduced Lumbar Facet Joint movement and /or Lumbar Facet Joint Compression which can turn into Lumbar Facet Syndrome. That Facet Syndrome could be a stuck open or closed Facet Joint or a Facet Joint that sticks or binds. This could also cause Facet Arthritis.

So what kind of Pain Symptoms are experienced directly as a result of the Improperly Positioned Spine?

Facet Syndrome Pain Symptoms due to the improperly Hyperextended Lumbar Spine are the result of Facet Joint Compression, decreased Facet Joint movement, and irritation caused within the limited Facet ROM-Range of Motion in a Hyperextended state. The development of Osteophytes (Bone Spurs) and degeneration of Intervertebral Discs would result in additional pain symptoms over time, and would have an effect upon nerve roots in the Lumbar area. Pain could be localized, radiating, or Radicular-nerve root pain in nature.

How does Tissue Hypertonicity cause Lower Back Pain?

Excessive soft tissue loading, compression and reduced circulation occur due to Lordosis. The tissues become hypertonic due to the compressive state. This in turn causes reduced circulation, resulting in the inability to move waste products out of the muscles, ligaments, tendons, and other soft tissue, as well as causing an impediment to the flow of nutrients into cell structures. This multiple cause and effect issue then results in significantly reduced circulation that causes lower back pain, and results in Ischemia (lack of Blood Flow), Myofascial Pain Syndrome or Trigger Points.

What can be done about Lordosis?

The first thing that should be done is to alleviate as much as possible any condition that positions the heels higher than the balls of the feet while standing. The best Hyperlordosis approach to treatment is a Diagnostic Pain Assessment conducted by a skilled Medical Massage Therapist or other Healthcare Professional prior to Hyperlordosis Treatment. Comprehensive compilation of information based upon Postural Analysis, Range of Motion Testing and other Special Tests will be used in the Assessment to formulate the most effective treatment plan for this condition.

About the Author:
Stephen Akamine has suffered from Chronic Pain for 17 years. He is a Licensed Medical Massage Therapist in the State of Hawaii and an outspoken advocate for relieving the suffering of Chronic Myofascial Pain patients. You can find Facet Joint Pain information and information about soft tissue treatment for pain at his Online Resource Center.