Lordosis

In this condition, the spine curves inward more than usual, giving children an exaggerated posture known as “swayback,” with the pelvis tilted forward and buttocks pushed back. 

About lordosis

The spine is made up of small, stacked bones called vertebrae separated by soft, shock-absorbing spinal discs. A healthy spine has three gentle, natural curves which act as everyday shock absorbers, but a child with lordosis will have a more extreme inward curve. This condition typically occurs in the lower back (known as lumber lordosis), making it difficult for a child to press down their lower back when they are laying down. In rare cases, lordosis can develop in the neck (known as cervical lordosis), causing the head to jut forward.

Experts in lordosis

At the AIM Spine Center at Children’s Wisconsin, our pediatric spine experts work together to provide outstanding and compassionate care for even the most complex spinal disorders and spine trauma in infants, children and teens. If your child has already been diagnosed at another center, we invite you to get a second opinion for lordosis at the AIM Spine Center. 

What causes lordosis?

This condition tends to develop during adolescence, though children can also be born with it. Doctors aren’t always sure what causes lordosis, but posture problems, being overweight, or a history of spinal trauma, back surgery, hip problems or neuromuscular conditions (such as muscular dystrophy or cerebral palsy) can increase a child’s risk of developing lordosis.

Why is lordosis a concern?

This condition often is not a concern and might affect only a child’s posture. In rare, more severe cases, lordosis can cause pain, nerve issues and problems with bladder control. These more severe complications can affect a child’s quality of life, disrupting sleep, school, sports and other activities. 

What are the symptoms of lordosis?

Signs and symptoms could include:

• “Swayback” posture with prominent buttocks
• Visible curve in the lower back when viewed from the side

In more severe cases, lordosis can cause:

• Pain in the back or legs
• Leg numbness or tingling
• Leg weakness
• Bladder control problems

Always consult your child’s doctor if you have concerns or notice anything new.

How is lordosis diagnosed?

Some signs of lordosis will be detectible during a physical examination. The doctor might use the following imaging tools to assess your child’s spine:

• EOS scanner – Children’s was one of the first pediatric hospitals in the nation to have this scanner, which provides detailed, 3D images and limits radiation exposure.
• CT scan – More detailed than an X-ray, a CT scan uses a combination of X-rays and computer technology to produce cross-sectional, detailed images of parts of the body, including the bones, muscles, fat and organs.
• MRI– Uses a magnet, radio waves and a computer to create very detailed, 3D still and moving images.

Treatment for lordosis

The severity of this condition varies, and more mild cases might not require treatment at all. Children’s spinal specialists will recommend the best treatment for your child based on:

• Your child’s age, overall health and medical history
• Extent of the disease
• Your child’s tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

If lordosis is causing pain or other problematic symptoms, treatment could include:

Medical management – Anti-inflammatory medications can relieve children’s pain.

Bracing – If your child’s spine is still growing, your child’s doctor might recommend a back brace to keep the curve from getting worse. 

Physical therapy – If poor posture is contributing to your child’s lordosis, exercises can help strengthen your child’s core. Our physical therapy program offers experts trained the Schroth method for treating spinal curvature and a rehabilitation space designed for spinal conditions.

Surgical repair – Surgery usually isn’t required to treat lordosis. But in very care cases, if your child’s spinal curve is large or is causing significant problems, your child’s doctor might recommend surgery if more conservative treatments don’t help. Spinal fusion surgery involves fusing segments of the spine together with metal rods and screws to correct the rounding and prevent the curve from getting worse. Your child’s spinal care team will advise you on the best options for your child.

Long-term outlook after lordosis 

Early intervention for lordosis leads to the best outcomes, and your child should be monitored by a spine specialist to make sure that the curve doesn’t get worse or cause problems. In most cases, this condition doesn’t interfere with a child’s regular activities. A healthy weight, good posture habits and exercises to strengthen the core muscles can help prevent pain and other lordosis symptoms.