Lumbar Hypolordosis

Hypolordosis (flatback) of the lumbar spine is when your low back has too little of a curve from what is considered a normal.

The word is of Greek origin where “hypo” means “under” and “lordosis” means “bending backwards”.

The lumbar lordotic curve starts at the first lumbar vertebra and ends at the top of the sacrum.

The lumbar curve is not a true arc. The shape of the body of the vertebrae and their shared discs is what determines the general shape of the curvature. Because the bodies of the vertebrae and the discs are somewhat thicker in the front helps to determine the backward curve or lordosis of the lumbar spine.

There is a greater degree of angulation in the lower lumbar and a lesser degree in the upper lumbar. If there was a true arc the transition from one spinal area to the other (lumbar to thoracic) that would require a greater angulation at the transitional zone. This would place extreme stress on the transition area which would result in disc and facet joint injury and premature degeneration.

Therefore, the transition must be a gradual one.

What Happens With Hypolordosis?

When there is a hypolordosis, or a lesser curve, there is added stress on the anterior (front) structures, normally the discs and the bodies of the vertebrae. This added stress will create compressive forces on the disc and the vertebra which will cause reactive bone changes creating osteophytes or bone spurs.

This flat back elongates the posterior back muscles, shortens the hamstrings, lengthens or pulls on the anterior hip flexor muscles...all which will cause a posterior pelvic tilt.

As the body attempts to remain in balance there is reactive muscle contractions and relaxations throughout the entire body.

What will happen is a systemic neuro-musculo-skeletal reaction that will render you susceptible to not only chronic recurrent strain but the development of trigger points, joint irritation/inflammation, disc degeneration, abnormal neuro-muscular function, compression fractures of the vertebrae, headaches, etc.

Correcting Flatback

The basic corrective approach to hypolordosis is the same corrective actions that would be applied to any abnormal posture. A total, complete and thorough analysis from the foundation (feet) all the way to the top (head) should be conducted.

This will include identifying and correcting all structural and functional deficits that are correctable. The feet need to be evaluated for droped arches (pes planus), pronation, supination, Morton's foot, ligament laxity, muscular imbalances and flexibility. Attention and recommendation should be given to proper footwear as well.

The muscles throughout the body should be assessed for strength, endurance and flexibility. Trigger points need to be searched for, located and treated appropriately.

Proper posture should be developed and maintained.

If you are overweight or obese this will create unnecessary stresses and strains not only on your low back but throughout your entire body.

All habits and lifestyle activities must be considered as a contributing and causing factors.

A regular physical fitness program should be incorporated into each day with special emphasis on a brisk daily walk of ideally 60 minutes.

Jogging on Treadmill

As always, you are responsible for your health and well-being and your actions or lack of will ultimately determine your level of health.

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