What is Lordosis?
Lordosis is also known as Hyperlordosis or Swayback or Saddleback. It is an abnormal excessive front-to-back curvature of the lower back Lumbar Spine. Hyperlordosis is one of the most common causes of Lower Back Pain yet is a correctable condition if addressed properly.
What causes Lordosis?
Anything that causes the pelvis to rotate forward will move the body’s center of gravity forward. The body will compensate by moving the upper torso backward to reposition the center of gravity in a vertically balanced position. When that happens, the end result is an excessive front-to-back lumbar curve given other names Hyperlordosis, Swayback, or Saddleback. The resulting Postural Dysfunction of the lower back Lumbar Spine causes muscular imbalances as well as incorrect positioning of and in the Lumbar Spine. What this basically means is that Hyperlordosis is fundamentally a postural and developmental problem that develops over a period of time rather than a condition that happens overnight.
Does this mean that Foot Position has a lot to do with Lordosis?
Anything that causes the heels of the feet to be lifted higher than the balls of the feet can be a contributing cause to Lordosis. This means that Lordosis can be caused by wearing high heeled shoes that results in postural dysfunction of the lower back. The postural dysfunction in turn causes muscular imbalances where there are corresponding anterior and posterior hypertonic muscle groups in opposition to weak and inhibited muscle groups in the pelvis and lower torso. This results in a condition that is commonly known as “Lower Crossed Syndrome”.
What are the corresponding Hypertonic (Excessively Tight) Muscle Groups for Lower Crossed Syndrome?
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 corresponding Weak and Inhibited Muscle Groups for 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 Lordosis 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 does the improperly positioned Spine cause Lower Back Pain?
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?
The pain symptoms commonly experienced initially from the Improperly Positioned Spine are Facet Syndrome Pain Symptoms due to the Hyperextended Lumbar Spine that results in Facet Joint Compression, decreased Facet Joint movement, and irritation caused within the limited Facet ROM-Range of Motion in a Hyperextended state. Additional Pain symptoms over time would be a result of degeneration of Intervertebral Discs, and development of Osteophytes (Bone Spurs) that would have an effect upon nerve roots in the Lumbar area. In either case the pain could be localized, radiating, or Radicular-nerve root pain in nature.
How does Tissue Hypertonicity cause Lower Back Pain?
When Lordosis occurs, the hypertonic tissues experience excessive soft tissue loading and compression as well as reduced circulation due to the compressive state. The excessive tissue loading in turn causes reduced circulation that results in the inability to move waste products out of the muscles, ligaments, tendons, and other soft tissue, as well as impeding the flow of nutrients into cell structures. The result of this multiple cause and effect issue is significantly reduced circulation that not only results in lower back pain, but can also result in Ischemia (lack of Blood Flow) or Myofascial Pain Syndrome or Trigger Points.
What can be done to reverse and correct Lordosis?
As far as self-treatment goes, the first thing that the Hyperlordosis back pain sufferer should do is to alleviate as much as possible any condition that would position the heels higher than the balls of the feet while standing. The best approach to Hyperlordosis is to have a Diagnostic Pain Assessment conducted by a skilled Healthcare Professional prior to Hyperlordosis Treatment. The Assessment is a comprehensive compilation of information based upon Postural Analysis, Range of Motion Testing and other Special Tests that will be used to formulate the most effective treatment plan for this condition.
Stephen (Steve) Akamine has extensive experience as a specialist in the treatment of Acute and Chronic Myofascial Pain. Steve is one the very few Medical Massage Therapists in Honolulu and the State of Hawaii that conducts a Diagnostic Pain Assessment for Medical Massage Therapy. Steve strives to achieve minimum pain with maximum functionality beyond symptomatic pain relief for each and every one of his clients. “The goal of Medical Massage Therapy at Honolulu-Chronic-Pain-Management.com is to resolve Acute and Chronic soft tissue conditions that are related to musculoskeletal pain, lack of range of motion, ischemia (restriction in blood supply), biomechanical (mechanics of movement of living beings) dysfunction, nerve compression or entrapment, or injury or rehabilitation from surgery or some form of pathology (study and diagnosis of disease)”. You can find free tips and information about soft tissue treatment for Chronic Pain at his Chronic Pain Management Resource Center.