What is lordosis and does it have anything to do with my back pain?

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If you look at a “textbook normal” image of a spine from the front and the side you should be able to note a few things. From the front you should see the spine more or less straight and from the side you should see flowing curves. The word lordosis simply describes the spine’s normal curvature in two areas: the neck and lower back.

The word comes from lordos, meaning “bent backward”. The neck and lower back have lordotic curves, considered secondary curves since we are not born with them but develop them later through movement, muscle use, and neurological adaptations. Our body naturally develops these curves, although it can happen that if a baby does not crawl or spend much time on their tummy exploring their environment we have difficulty in developing the proper flowing curvatures of the spine.

Our habits/environment as well as our genetics can influence these curves and sometimes certain areas may be more erect (loss of lordosis), be more curved (increased lordosis), or have curve where there should not be one (scoliosis). There are other words we give to other areas and deviations but for today let’s focus on lordosis.

Can the degree of lordosis significantly impact lower back pain?

Yes, but there needs to be context given here. The natural inward curve of the lower spine (lumbar lordosis) is important for proper spinal alignment, weight distribution, and mobility. Both excessive and insufficient lordosis can contribute to how the spine handles movement and load absorption/distribution. Does that mean everyone who has a loss of lordosis will have similar lower back pain? No, pain is influenced by too many factors to say that. Just because we see an anomaly in someone does not mean that always causes symptoms.

So, should we try to improve the current state of someone’s spine if we notice deviations from normal? Maybe, maybe not. Let’s give context. If someone presents with a loss of lordosis / a flattening of the curve but on evaluation, their spine seems to move quite well and they do not present with any symptoms or significant limitations it may be irresponsible to judge that that person should undergo an extreme rehab program to improve their spine curve.

If someone presents an abnormal curvature and they also have pain, spinal restrictions, and limitations to their ability to perform their day-to-day activities comfortably we may want to consider the state of their curvatures in the context of their current symptoms, habits, and routines, but never alone.

Hyperlordosis (Excessive Lordosis)


  • Genetics
  • Overweight
  • Pregnancy
  • Spondylolisthesis (slippage of a vertebra)

Hypolordosis (Reduced Lordosis)


  • Genetics
  • Degeneration
  • Spinal surgery such as spinal fusion
  • Lack of sufficient movement and play as an infant
  • Spinal restrictions due to trauma or chronic stress


  • Altered Load Distribution: A flattened lumbar curve can disrupt the natural load distribution along the spine, leading to increased stress on the lower back.
  • Reduced Shock Absorption: The spine’s ability to absorb shocks and impacts is diminished, which can result in discomfort and injury.
  • Muscle and Ligament Strain: The muscles and ligaments in the lower back may become overstretched and fatigued, contributing to pain and stiffness.

Will this cause problems for everyone?

No because not everyone will have the same level of sensitivity to pain and not everyone has the same habits. That means not everyone will subject their body to the same stressors. A teenager who grows up with a scoliosis but remains active, has a healthy diet, and seeks manual therapy for minor issues likely won’t deal with too many issues. On the flip side if that same person was so active, smokes 1 pack of cigarettes a week, and sits at a desk for long periods of time. Their chances of dealing with painful dysfunctions throughout life goes up dramatically.

Maintaining a Healthy Lordosis:

To lower risk of pain associated with abnormal lordosis, consider the following strategies:

  1. Weight Management: Maintain a healthy weight to reduce excess pressure on the spine.
  2. Maintain a routine of flexibility and mobility training.
  3. Strength training is another strategy that can improve mobility and tone throughout the body.
  4. Diet: Diet will influence how we feel and how inflamed we are. Eating a well-balanced diet, tailored to your needs, will help immensely.
  5. Chiropractic Care: Regular chiropractic adjustments can help maintain spinal health, correct imbalances, and guide helpful exercises.

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