Cervical Lordosis Treatment

Cervical Lordosis Treatment

Cervical Lordosis refers to the natural curve of the spine in the neck, known as the cervical spine. From top to bottom, a healthy spine forms an “S” shape, with a healthy cervical spine forming a gentle “C” at the top. This curve not only helps the spine maintain stability and structure, but also helps absorb shocks, supports the weight of the head by keeping it aligned over the body, and allows the neck to move and bend normally.

When this curve is exaggerated in one way or another, it can affect the tendons, ligaments, muscles, bones, nerves, and spinal cord in the neck. As such, you should address the condition to prevent injury and further complications.

The term “cervical lordosis” normally applies to cases in which there is an abnormal, excessive inward curve (hyperlordosis) or a definite lack of curve (hypolordosis). Less common are the cases in which the curve is increasing in the wrong direction. This condition is called reverse cervical lordosis. Also, these cases involve a curve to the right or left.

Understanding Lordosis and Its Relation to Scoliosis

Understanding cervical lordosis and its potential straightening is crucial for identifying the appropriate treatment. Cervical lordosis refers to the natural inward curve of the cervical spine (neck region). This curve is essential for balancing the head’s weight, distributing forces evenly across the vertebrae, and minimizing muscle strain. When this natural curve is lost or straightened, it can lead to discomfort and various symptoms.  Lordosis is not limited to the cervical spine. It also refers to the inward curve found in the lumbar spine (the lower back). While a certain degree of lordosis is normal and necessary for distributing mechanical stress during movement, excessive lordosis can be problematic.

Normal vs. Excessive Lordosis

• Normal Lordosis: Found within proper limits in the cervical and lumbar regions, helping to position the head over the pelvis.
• Excessive Lordosis: An exaggerated curve that may cause complications such as neck pain, back pain, and even neurological symptoms like weakness or numbness in the limbs.

Potential Complications

Excessive lordotic curves can lead to a variety of issues, including:

• Neck and Back Pain: Constant strain on muscles and ligaments.
• Neurological Symptoms: Weakness or numbness in the arms or legs depending on the affected region.
• Postural Problems: Difficulty in maintaining proper posture and balance.

What is Straightening of the Cervical Lordosis?

If you read a handful of neck X-ray reports, you’ll likely see that the radiologist has said on a few that there is “straightening of the normal cervical lordosis.” To understand what this is, you have to understand how the spine is constructed.

Your neck, upper back, and low back all have counterbalanced curves. One goes one way, and the adjoining curve goes the opposite way. When the curve points toward the front, it’s called lordosis. When it points toward the back, it’s called kyphosis. These curves balance the force of the head and allow you to stand with minimal muscle energy. They also equally distribute the forces between the front of an individual vertebra, where the disc is located, and the back of the vertebra, where the facet joints live.

When the normal curve is lost, there are a number of terms used to describe it by the radiologist:

• Straightening of the normal cervical lordosis
• Loss of cervical lordosis
• Straightening of the cervical lordosis

Relation to Scoliosis

Scoliosis patients often exhibit excessive lordosis, particularly in the lumbar spine. This is because the abnormal sideways curvature of the spine seen in scoliosis can exacerbate the natural lordotic curves, leading to further complications. Therefore, it is crucial to monitor and treat lordosis in individuals diagnosed with scoliosis to prevent worsening of symptoms and additional spinal issues.

By understanding both cervical and lumbar lordosis, and recognizing its potential complications and relationship with scoliosis, you can take proactive steps in managing and treating these conditions effectively.  Normal spinal contours are critical for the correct movement and function of the spine. In the spine affected by hyperlordosis, the vertebrae in the lumbar region exhibit a pronounced curve, creating what is commonly described as a swayback appearance. This excessive curvature is often referred to as hollow back, sway back, or saddle back—a term that originates from a similar condition observed in horses. The primary cause of hyperlordosis is often an anterior pelvic tilt, where the pelvis tilts forward, resting on top of the femurs (thigh bones).

To identify hyperlordosis, one simple method is to lie on your back on a hard surface. Observe if there is a noticeable space beneath the lower back and the surface, which indicates a significant degree of lordosis. This condition may become more pronounced during puberty and might not be fully apparent until the early or mid-20s. Understanding these aspects is crucial for recognizing and addressing hyperlordosis effectively.

At the Southwest Scoliosis and Spine Institute, our expertly trained doctors can help patients with Lordosis or Hyperlordosis get back to the life they want to live. Come in for a consultation with one of our spine specialists, so they can help stop the pain and get you back to enjoying life.

Understanding the Natural Curvatures of the Spine and Their Functions

The human spine exhibits three primary natural curvatures: cervical, thoracic, and lumbar. Each curve plays an essential role in maintaining overall body function and posture.

Cervical Curve

Located in the neck region, the cervical curve supports the head’s weight and allows for its wide range of motion. This curvature also helps in absorbing shock, providing a cushioning effect for impacts that occur during activities like walking or running.

Thoracic Curve

Found in the upper back, the thoracic curve helps to stabilize the body’s structure and supports the rib cage. This curve is vital for protecting internal organs, including the heart and lungs. Additionally, it contributes to a balanced and upright posture.

Lumbar Curve

Situated in the lower back, the lumbar curve is crucial for bearing the body’s weight, especially during motion and lifting activities. This region of the spine allows for greater flexibility and mobility, enabling actions such as bending and twisting.

Key Functions of Spinal Curvatures

• Shock Absorption: The natural curves act like a spring, helping the spine absorb impact and reduce stress on individual vertebrae.
• Stability and Alignment: These curvatures align and stabilize the spine, maintaining the body’s structure and balance.
• Mobility and Flexibility: The curves enable a range of motions, allowing the body to move and bend easily without compromising stability.

Is this Condition Serious?

Most cases of cervical lordosis have minor symptoms and do not pose an immediate threat to the patient’s health. However, if steps aren’t taken to address the condition, it will almost certainly worsen over time. This eventually leads to pain and long-term discomfort.

Other risks include:

Increased vulnerability to injury –
An abnormal curve means the neck can’t distribute mechanical stress due to muscle weakness and instability. This makes you more vulnerable to spinal injuries resulting from impacts such as in a car accident or fall.
When you lose the normal neck curve, the weight of the head is no longer balanced by the opposing curve (kyphosis) in the upper back. This imbalance forces the muscles at the back of the neck to work harder to keep the head upright.
This added muscle strain leads to overload where those muscles attach to the skull, often resulting in headache pain. Additionally, the extra weight transferred to the discs between the vertebrae can accelerate wear-and-tear, leading to disc degeneration.

By understanding these mechanics, it’s clear how critical maintaining the natural curve of your neck is for overall spinal health.

Disc degeneration and weakness –
The abnormal curve causes spinal tension, resulting in increased pressure on the spine’s discs, which contributes to the degeneration of the vertebrae and discs. This can lead to a bulging or herniated disc, as well as conditions like cervical spinal stenosis and cervical myelopathy.

Changes to posture and appearance –
While it may not be painful or uncomfortable, the misalignment of the spine due to lordosis can cause obvious changes to your physical appearance. This includes forwarding head posture and an overall asymmetrical appearance.

Common Causes of Cervical Lordosis

These include traumatic injury, poor posture, obesity, osteoporosis, and conditions like degenerative disc disease and spondylolisthesis. Osteoporosis, in particular, affects bone density and sometimes causes vertebrae to lose strength, thus compromising the structural integrity of the spine. This weakening of the vertebrae can lead to spinal deformities, including lordosis. Lordosis can also occur as a result of inherited conditions like achondroplasia (dwarfism) or certain neuromuscular disorders.

If the curve of the spine is only mildly exaggerated and there isn’t any pain or other symptoms, medical treatment may not be necessary. When the curve is noticeable enough that it causes problems, the treatment option often depends on the severity and the cause. For example, lordosis caused by muscle weakness or being overweight often improves with simple interventions like weight management and exercises that strengthen the neck.

More conservative measures may include:

• Medical Therapy: Pain relievers or anti-inflammatories to reduce swelling.
• Physical Therapy: Daily sessions to increase strength and range of motion.
• Braces: Used to control the growth of spinal curvature, particularly in children and teenagers.
• Weight Loss: Can significantly improve posture, thereby reducing the strain on the spine.

Incorporating these treatments can provide a comprehensive approach to managing lordosis, ensuring that each aspect of the condition is addressed effectively.

How Does Straightening of the Cervical Lordosis Happen?

Straightening of the cervical lordosis can occur due to various factors, impacting the natural curve of the neck. One of the most common reasons is injury from car accidents, which can damage the neck ligaments. However, there are several everyday activities and conditions that contribute to this issue as well and some are the following.

Prolonged Poor Posture:

• Continually looking down at devices, like smartphones or computers, places undue stress on the neck.

Muscular Imbalances:

• Tightness in the chest muscles can pull the shoulders forward, affecting neck alignment.
• Sitting for extended periods can tighten the psoas muscle, altering posture and neck curve.

Age-Related Changes:

• Natural aging can lead to degenerative changes in the spine, affecting the cervical curvature.

By understanding these contributing factors, one can take steps to maintain proper neck posture and mitigate the effects of straightening of the cervical lordosis.

How to Identify if You Have Lordosis

Identifying lordosis, a condition where the spine curves excessively inward, can be done through a simple self-check at home. Here’s how:

Steps to Check for Lordosis

1. Find a Flat Surface: First, lie down on a flat, hard surface like the floor or a firm mattress.
2. Observe the Lower Back and Neck: Pay close attention to the space between your lower back and the surface. A normal spine will have a slight curve, but watch for abnormal gaps.
3. Check for Rigidity: Now, slowly bend forward. If the curve in your lower back stays rigid and doesn’t change significantly, this might indicate a more severe form of lordosis.

What to Look For

• Extreme Curvature: An exaggerated inward curve while lying down.
• Persistent Curve: The curvature does not reverse or become less pronounced when bending forward.

Next Steps

If you notice a pronounced, rigid curvature, it’s a good idea to consult a healthcare professional. While some forms of lordosis are mild and not a cause for concern, an extreme curvature may require medical attention.

By following these steps, you can get a better sense of whether you might have lordosis and decide if you need further evaluation.

Symptoms of Lordosis

When discussing the symptoms associated with lordosis, it’s important to recognize the specific impacts that this spinal condition can have on both movement and general health. Lordosis refers to an excessive inward curve of the spine, typically in the lower back, and this curvature can manifest in various physical symptoms.

Primary Symptoms:

• Lower Back Pain: Individuals with lordosis often experience moderate to severe lower back pain. This pain is directly linked to the abnormal curvature and can significantly affect daily activities.
• Impaired Movement: The unnatural curve can restrict normal movement, making physical activities more challenging and painful.

Additionally, the nature of the spinal curve plays a crucial role in the severity of the symptoms:

• If the curve is flexible (it reverses when the person bends forward), the symptoms may be less severe, and the condition might not require immediate treatment.
• Conversely, if the curve is fixed (it does not change when bending forward), this indicates a more severe form of lordosis that likely needs medical intervention to prevent further complications.

Extended Symptoms:

• Pain in the Neck: This may extend to the shoulders and upper back, further complicating the discomfort.
• Muscle Spasms and Tightness: These symptoms are common and contribute to the discomfort and limited mobility experienced by those affected.
• Limited Mobility: The stiffness and pain can restrict the motion range, making everyday tasks difficult.

Symptoms Indicative of Nerve Pressure:

In some cases, lordosis can exert pressure on the nerves in the cervical spine, leading to more severe neurological symptoms:

• Numbness, Tingling, and Electric-Shock-Type Pains: These sensations can occur in the arms, legs, and feet.
• Muscle Weakness: Affected individuals may experience a decrease in muscle strength, impacting their ability to perform physical tasks.
• Difficulty Controlling Muscles: This includes challenges with coordination and movement precision.
• Difficulty Controlling Bladder Function: This symptom, although less common, is particularly serious and warrants immediate medical attention.

Understanding these symptoms is crucial for recognizing lordosis and seeking appropriate treatment. Whether the symptoms are mild or severe, a proper diagnosis can help manage the condition effectively and improve quality of life.

Other, more serious symptoms:

Other more serious symptoms can also occur as a result of pressure on the nerves in the cervical spine, including things such as:  Numbness, tingling, and electric-shock-type pains in the arms, legs, and feet can be alarming symptoms that signal the need for a closer look at your neurological health. These sensations, along with muscle weakness and difficulty controlling muscles, are key indicators of a spinal condition.

In addition to the symptoms already mentioned, it’s important for doctors to look for other potential signs that could point towards a neurological issue, such as:

• Pain that varies in intensity and location
• Muscle spasms or general weakness that disrupts daily activities
• Sensations that feel unusual or out of the ordinary in the arms or legs

Furthermore, changes in bowel or bladder control can also signify neurological complications. These symptoms can be subtle at first, so it’s crucial to monitor any changes and discuss them with a healthcare provider.

If you experience any of these symptoms, it’s important to make an appointment with us as soon as possible. The reason to make an appointment sooner rather than later is Lordosis can lead to serious nerve damage. Early intervention is key to managing symptoms effectively and preventing further deterioration of nerve function.

Cervical Lordosis in Children

Usually, when cervical lordosis occurs in children, it does not have a cause. Called benign juvenile lordosis, this condition is typically the result of muscle weakness or tightness in the hips. In most cases, this condition corrects itself as the child gets older. If not, doctors may prescribe specific exercises to improve muscle tension and build strength in the hips.

Certain rare conditions can lead to lordosis in children, including:

• Cerebral palsy
• Myelomeningocele is a condition in which the spinal cord protrudes through a gap in the bones of the back.
• Muscular dystrophy
• Spinal muscular atrophy
• Arthrogryposis is a condition that causes stiffness and prevents a normal range of motion in joints.

If you think that your child is having an abnormal curve to his neck and it occurs due to cervical lordosis, you should talk to one of our doctors who is an expert in treating complex spine conditions. Our doctors are orthopedic spine specialists who have specialized training to detect lordosis and provide the best course of treatment.

How to Diagnose Cervical Lordosis?

At the Southwest Scoliosis and Spine Institute, doctors Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Y. Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD begin every exam with a thorough physical assessment. Diagnostic testing includes bend tests. These tests allow doctors to detect any loss of flexibility, gauge the range of motion, and check on the alignment of the spine. These observations help to determine any problems associated with cervical lordosis or similar conditions.

During the physical examination, our doctors will ask the patient to bend forward and to the side. This is to observe whether the curve is flexible or fixed and to assess the proper alignment of the spine. They may also palpate, or feel, the spine to check for any abnormalities. If there are concerns about the patient’s neurological function, doctors will require further assessments. These include checking for symptoms such as:

• Pain
• Tingling
• Numbness
• Muscle spasms or weakness
• Sensations in the arms or legs
• Changes in bowel or bladder control

Our doctors will also review the patient’s medical and family history to help identify any risk factors. Factors such as age, weight, and height are also taken into consideration as they can significantly affect the diagnosis and progression of lordosis. Our orthopedic spine specialists will also take the time to address symptoms and concerns, as well as answer any questions you may have and discuss the treatment options.

Additionally, the range of movement will be evaluated, and an examination of spinal alignment will be conducted to check for any abnormalities.  These radiological imaging techniques will also reveal any spinal or cervical issues that were not present during the physical exam.

Further Testing

If the clinician suspects cervical lordosis, they will order tests, including X-ray imaging using our advanced EOS X-ray system. Located right in our office, it allows us to take full-body images from the front, back, and sides. Using these images, our doctors are able to build a 3D model of the patient’s spine so they can accurately measure the extent of any abnormal curvature.

Importance of X-Rays for Assessing a Lordotic Spine

PA (Posterior/Anterior) and Lateral X-rays: These specific types of X-rays are crucial as they reveal the entire length of the spine. Spinal flexibility is further evaluated using side bending AP (Anterior/Posterior) X-rays, providing comprehensive insights into the spine’s condition.

Cobb Angle Method: To measure the lordotic curve in degrees, the Cobb Angle Method is often employed using a standard full-length AP X-ray. This precise measurement technique helps in determining the severity of the curvature.

Doctors may request additional imaging to determine if there is any compression of the nerves or spinal cord. These tests may include magnetic resonance imaging (MRI) or computed tomography (CT) scans, especially if the spinal cord is suspected of having been compromised.  By incorporating these detailed imaging techniques, we ensure a thorough assessment, allowing for accurate diagnostics and effective treatment planning.

Early Detection

Just as with other spinal conditions like lumbar lordosis, early detection plays a pivotal role in the management and treatment of cervical lordosis. Recognizing these issues early on allows for more effective intervention strategies, which can significantly alleviate symptoms and improve the patient’s quality of life. Timely treatment can prevent the progression of the condition, reducing the risk of complications and the need for more invasive procedures.

Our in-house capabilities not only expedite the diagnosis process but also ensure that each patient receives a tailored treatment plan based on precise, comprehensive data.

Non-Surgical Treatment of Cervical Lordosis to Straighten or Reduce the Curve & Pain:

• Medications (NSAIDs) to reduce pain and inflammation. These can help alleviate discomfort and minimize swelling, making daily activities more manageable.
• Physical therapy to build strength and increase range of motion. Engaging in daily sessions can significantly improve muscle tone and flexibility, contributing to better posture and reduced pain.
• Braces control the growth of spinal curvature, particularly effective for children and teenagers. Bracing helps in preventing further curvature and supports the spine during growth spurts. In adolescents, whose spines have not completely stopped growing, the option of braces is also a good treatment. This helps to control the progression of the curvature. Bracing is typically not effective in adults as their spines have finished growing and are not as flexible. 
• Weight loss programs to reduce load and improve posture. Shedding excess weight can lessen the strain on your spine, leading to better alignment and reduced discomfort.
• Nutritional supplements to improve bone health (vitamin D, calcium). Ensuring adequate intake of these nutrients can strengthen bones, providing better support for the spine and overall skeletal structure.

By incorporating these treatment methods, individuals can manage the symptoms associated with the straightening of cervical lordosis effectively. Understanding the underlying anatomical and functional aspects aids in selecting the most appropriate non-surgical interventions.

Surgical Options for Treating Lordosis

In cases where there is severe curvature – especially where there are symptoms of nerve compression, doctors may recommend surgery. The type(s) of surgery recommended depends on the age and overall health of the patient, as well as the cause of the curve in the first place. However, if non-surgical means of care fail, doctors may recommend surgical intervention. Patients should consider that the decision to move forward with surgery is not taken lightly and involves a thorough evaluation by a specialist. This ensures that all non-surgical options have been exhausted and that surgery is indeed the best course of action.

Specifically, the surgical options include spinal instrumentation, which involves the use of rods and screws to correct spinal alignment. Another option is artificial disc replacement, which replaces damaged spinal discs with artificial ones. Additionally, for those suffering from spinal compression fractures, doctors may consider a minimally invasive procedure that restores vertebral height. These treatments are typically reserved for the most severe cases where other therapies have not resulted in adequate improvement.

When conservative treatments such as physical therapy or medication aren’t enough to manage lordosis, surgical intervention may become necessary. Here are the specific surgical options available to address this spinal condition:

Spinal Instrumentation

This approach involves placing rods, screws, and other devices into the spine to correct its alignment. These instruments stabilize the spine during the healing process, promoting proper posture and reducing curvature over time.

Artificial Disc Replacement

Artificial disc replacement aims to remove the damaged intervertebral disc and replace it with a synthetic one. This method helps maintain spine mobility and flexibility while alleviating pain and other symptoms associated with lordosis.

Kyphoplasty

Kyphoplasty is a minimally invasive surgery primarily used when vertebral compression fractures contribute to lordosis. During this procedure, a balloon is inserted into the vertebra to create space, which is then filled with bone cement. This helps to restore the spine’s normal shape and relieve pain.

Why Surgery?

While surgical treatments can be more invasive, they are sometimes the most effective way to correct severe spinal deformities and provide long-term relief. A healthy spine is crucial for overall well-being, and these surgical options offer viable solutions when other methods fall short.

Have you been struggling with lordosis? Speak with your healthcare provider to explore whether these surgical options are right for you.

Prognosis for Patients with Lordosis and Scoliosis with Proper Care

The prognosis for patients with lordosis and scoliosis can be quite positive with the right treatment and care. By adhering to medical advice and maintaining regular check-ups, most individuals can manage the symptoms effectively.

Key Factors for a Favorable Outcome:

• Early Diagnosis: Early detection through regular screenings can lead to more effective management.
• Customized Treatment Plans: Tailored therapies, including physical therapy, bracing, or surgery, if necessary, can greatly improve quality of life.
• Consistent Monitoring: Regular follow-ups with healthcare providers ensure that any changes in the condition are promptly addressed.

Management Strategies:

Physical Therapy:

• Focuses on strengthening and flexibility exercises.
• Helps in maintaining a good posture.

Bracing:

• Often recommended for growing children.
• Prevents further curvature of the spine.

Surgical Interventions:

• Considered in severe cases.
• Aims to correct the spinal curvature and prevent complications.

With a comprehensive care plan, many patients see improvements in their symptoms, leading to a more active and comfortable life.

Preventative Medicine

Preventative medicine is often talked about because it works. Adults and parents of children who think they or their child might have Cervical Lordosis really need to be proactive and be examined before this nasty condition gets worse and excruciating pain sets in. There are non-surgical treatments that can definitely help.

Non-surgical treatment is often preferred because it is non-invasive, reducing the risk of complications. Conditions like lordosis are mechanical disorders best treated through mechanical means. This approach aims to provide comprehensive care that supports a healthy, active lifestyle without the need for surgery.

Surgical interventions, while sometimes recommended, can introduce additional abnormalities that were not present before the invasive procedure. Therefore, it is crucial to proceed with caution when considering surgery for postural corrections.

Why Choose the Southwest Scoliosis and Spine Institute?

The following are just a few of the many reasons why patients might choose us.

• Expertise in the spine: The team of specialists at Southwest Scoliosis and Spine Institute is comprised of spine experts.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
• Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
• Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  We ensure that patients receive complete, seamless care for their spinal conditions.
• Dedicated facilities: Southwest Scoliosis and Spine Institute is dedicated to providing patients with a safe and comfortable environment.

Finally, surgeries to correct idiopathic scoliosis are complex and multi-step procedures.  Our Southwest Scoliosis and Spine Institute surgeons, with offices in  Dallas, Plano, and Frisco, Texas, are specially trained and have years of experience performing these types of spine surgeries. We have seen over 100,000 patients and have performed over 16,000 operations.  If you or your loved one is experiencing back pain, we strongly urge you to call us for an appointment, and we will see you in less than 24 hours.

For peace of mind and good health in the future, call the Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas. 

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