When it comes to identifying the true underlying cause of your back pain, having too deep of a curve in your lower back is certainly one of the possible contributing factors. Changes in the curvature of your spine can occur as a result of the daily habits we subject our spines to, so if you regularly sit at your desk with slouched posture, or when you relax in the evening, you might be causing some changes to your spine that will only start to cause pain after they’ve been present for awhile. Changes in your spinal curve occur when the ligaments around the joints in your back start to loosen and remodel as we subject our spine to a certain posture on a daily basis. In the lower back, this can result in a deeper curve – known as a hyperlordosis, or a loss of curve – known as a hypolordosis. If you’ve previously received a diagnosis of simply a lordosis and panicked, this isn’t a diagnosis but an observation that a curve is present.

What Are Key Indicators Of A Hyperlordosis?

The trouble with changes in lordosis is that they can often be deceiving on the outside of the body. With a hyperlordosis, this is slightly less common than a hypolordosis, as generally behaviours are more common that resort in the curve lessening rather than deepening. With a deeper curve you may be much more likely to have issues with the facet joints, as there’s going to be increased pressure going through the back of the spine where those are located. Your hip flexors may also get quite tight, which you’ll feel on the inside of your hips and will also get quite tight if you spend a lot of time sitting throughout the day. Your hamstrings are also likely to get pulled and elongated due to your spine position, which can also result in them being tight as well.

X-rays vs. MRIs

When we see patients who have a spondylolisthesis present in their spine, these cases are

more likely to have a hyperlordosis. They’re also quite likely to have a disc bulge at L5-S1, which can give them the classic symptoms of sciatica down the leg or into the buttocks. Generally speaking, the traditional route of diagnosis someone with back pain will go through will be to have physio first, then perhaps have an MRI if that doesn’t resolve the problem and they’re displaying signs of a disc bulge. However, the issue with this is that an MRI done traditionally lying down may eliminate the ability to see that a spondylolisthesis is present and only see the disc bulge – a rather important thing to miss in order to give a thorough diagnosis. For this reason, we would often advocate using standing, weight-bearing X-rays in order to perform a thorough diagnosis. As you’ll probably spend a lot of your day weight-bearing on your spine, it’s important to analyse it in the same way as we can see how you’re standing on a daily basis, as well as an alignment that’s not disguised from lying down.

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The common question patients ask about using X-rays instead is, ‘Why X-rays if you can’t see a disc bulge on an X-ray?’. While it’s true you’ll be unable to see soft tissue on an X-ray, an MRI is often recommended when you’re very sure a disc bulge is present because other symptoms indicate this diagnosis. Instead, on an X-ray there will be a reduced amount of normal space in between the vertebrae, and the only place this disc material will have gone from in between in the vertebrae is out to the side – indicating that you have a bulging disc present. In this case, not only will you be able to catch the spondylolisthesis and see where there are any disc bulges, you will also be able to see the alignment that’s caused these problems to occur in the first place.

Getting A Thorough Examination

As we mentioned previously, the way your spine looks on the outside – may not be the case of how it is aligned on the inside. This makes having X-ray imaging done all the more important. If you have more fat tissue present around the glutes, or you have developed muscles in the glutes, both of these can be a reason why it looks on the outside as if you have a deeper curve. Underneath, the structure may indicate there isn’t a problem or that even the opposite is true. Likewise, an abnormal variation of a hyperlordosis that can occur usually as a result of an accident is where there is a sudden pivot at the base of the lumbar spine. This can resemble sway back posture but there is a hyperextension caused by trauma at the L5-S1 portion of the spine. If you were to visit a practitioner who didn’t perform any X-rays for the problem, they might recommend you to do posterior pelvic tucks to reduce the lumbar curve, which will be useful if indeed you have a deeper lordosis. However, if you have a reduced curve there already that’s disguised under any fat or muscle, you’re going to make the problem a whole lot worse.

So what are the lessons we can learn here? Make sure if you’re visiting a back pain specialist that they are advocates of using X-ray imaging where necessary to identify the problem. Here at The Mayfair Clinic, we examine the angles of your spine to accurately map out each section, so we can see exactly where the problems lie that need correcting. This will be helpful in getting a more in-depth understanding of your problem.

We hope you’ve found today’s article helpful! Remember, if you are struggling with back pain right now it can be more difficult to get the help that you need. If you’re not sure what you can be doing from home to help, please do visit our free membership area at www.backinshapeapp.com to sign up and go through our free lessons and stretches! If you have any questions about today’s topic, you can tune in to our live videos every weekday on Facebook or YouTube as we have a Q&A segment at the end you can ask questions on, or you can simply get in touch with us through our social channels or by emailing us at info@themayfairclinic.com.

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