Low Back Pain Related to Hyperlordosis: Difference between revisions
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The lumbar spine has an inward curvature or lordosis. A normal lumbar lordosis is characterized by a lumbosacral angle of 140°<ref name="1">Bewegingsleer, de romp en wervelkolom. I.A. Kapandji. 2009, p76-77, Bohn Stafleu van Loghum.</ref>. However, when the curvature of the lumbar spine is very pronounced, we talk about hyperlordosis or swayback. In case of hyperlordosis the lumbosacral angle increases and the lumbar index (the chord of the lumbar lordosis) also increases<ref name="1">Bewegingsleer, de romp en wervelkolom. I.A. Kapandji. 2009, p76-77, Bohn Stafleu van Loghum.</ref>. The causes of a hyperlordosis vary: [[Congenital Spine Deformities|congenital spine deformities]], an anterior tilt of the hip, short back muscles and thigh and hamstrings that are too weak. | The lumbar spine has an inward curvature or lordosis. A normal lumbar lordosis is characterized by a lumbosacral angle of 140°<ref name="1">Bewegingsleer, de romp en wervelkolom. I.A. Kapandji. 2009, p76-77, Bohn Stafleu van Loghum.</ref>. However, when the curvature of the lumbar spine is very pronounced, we talk about hyperlordosis or swayback. In case of hyperlordosis the lumbosacral angle increases and the lumbar index (the chord of the lumbar lordosis) also increases<ref name="1">Bewegingsleer, de romp en wervelkolom. I.A. Kapandji. 2009, p76-77, Bohn Stafleu van Loghum.</ref>. The causes of a hyperlordosis vary: [[Congenital Spine Deformities|congenital spine deformities]], an anterior tilt of the hip, short back muscles and thigh and hamstrings that are too weak. | ||
[[Image:Increased lordosis.png]] | |||
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== Epidemiology /Etiology == | == Epidemiology /Etiology == | ||
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])<br> == | ||
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== References == | == References == | ||
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[[Category:Lumbar]] [[Category: | [[Category:Lumbar]] [[Category:Low_Back_Pain]] [[Category:Musculoskeletal/Orthopaedics|Orthopaedics]] | ||
Revision as of 23:23, 25 November 2015
Original Editors - Leen Meylemans
Top Contributors - Lise Buelens, Leen Meylemans, Claudia Karina, Loes Verspecht, Gertjan Peeters, Lucinda hampton, Cameron Mostinckx, Rishika Babburu, Admin, Kim Jackson, Geubels Kaat, Evan Thomas and Oyemi Sillo
Is there a relationship between low back pain (LBP) and hyperlordosis?[edit | edit source]
Is there a relationship between low back pain (LBP) and hyperlordosis?
A 2004 studyCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title and a 2003 studyCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title found that there is no significant difference in lumbar lordosis between people with LBP and people without LBP. A 1999 studyCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title concluded that there were no statistically significant differences in thoracic kyphosis, lumbar lordosis and sacral inclination between people with acute LBP, people with chronic LBP and a control group. Also a 2 other studiesCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title found no statistical difference in sacral inclination angle, lumbosacral angle, sacral horizontal angle and total and segmental lordosis angles between acute LBP patients and chronic LBP patients. Another studyCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title concluded that there is a relationship between LBP en muscle weakness, but they also concluded that structural factors – such as the size of the lumbar lordosis and the pelvic tilt – are not associated with LBP. Also Kim HJ et al.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title concluded that an imbalance in trunk muscle strength can influence the lumbar lordosis. Furthermore this study also found that it is generally assumed that these muscles affect the shape of the lumbar spine and might be one risk factor for potential low back pain. But we also found a studyCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title that concluded that the lumbar lordosis was significantly less in the LBP group compared with the group without LBP.
Despite the conclusion of this last study, it is – based on all the above studies – not reasonable to conclude that there is a relationship between LBP and the size of the lumbar lordosis. On the other hand it is likely that trunk muscles weakness can influence the shape of the lumbar lordosis and might be a cause of LBP.
Clinically Relevant Anatomy[edit | edit source]
The lumbar spine has an inward curvature or lordosis. A normal lumbar lordosis is characterized by a lumbosacral angle of 140°Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. However, when the curvature of the lumbar spine is very pronounced, we talk about hyperlordosis or swayback. In case of hyperlordosis the lumbosacral angle increases and the lumbar index (the chord of the lumbar lordosis) also increasesCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The causes of a hyperlordosis vary: congenital spine deformities, an anterior tilt of the hip, short back muscles and thigh and hamstrings that are too weak.
Epidemiology /Etiology[edit | edit source]
It is uncertain that the shape of the lumbar spine differs between gender and different ethnic origins (Masharawi Y et al.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title and Mosner EA et al.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title).
Characteristics/Clinical Presentation[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
add text here related to medical diagnostic procedures
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Examination[edit | edit source]
As we assume that the muscles around the lumbar spine (abdominal, extensors of the spine, hip flexors, hamstrings and quadriceps) have an influence on the lumbar spine, it may be useful to measure and/or inspect the lumbar lordosis. An inspection can provide valuable information on muscle weakness. Therefore, it is recommended not to skip the inspection. We look at the depth of lumbar lordosis and any sagittal deviations. But an inspection remains subjective, therefore we also can use a number of instruments to measure the lumbar lordosis, such as the flexible ruler. However, several studies indicate that the reliability of this instrument remains a matter of debate. Bryan JM et al.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title concluded that the flexible ruler a poor validity has in the assessment of actual lumbar lordosis. And Franklin W Lovell et al.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title concluded that the flexible ruler might be reliable as clinical measurement of lumbar lordosis, but only if it is taken by the same therapist over a short period of time.
Medical Management
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Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
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http://www.nlm.nih.gov/medlineplus/ency/article/003278.htm
http://bigbackpain.com/posture.html#swayback
Clinical Bottom Line[edit | edit source]
Add text here
Recent Related Research (from Pubmed)
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References[edit | edit source]
