Can you fix lordosis

Hollow back: what to do about hyperlordosis?

A hollow back is a generally non-congenital curvature of the spine that is caused by a misalignment or deformation of the lumbar spine in the body. Depending on the severity, those affected suffer from restrictions in their movement or from back pain. A hollow back can be treated well - depending on the stage. The therapy aims to stretch the muscles shortened by the deformity so that a correct posture is possible again.

Back pain: surprising triggers

Back pain: surprising triggers

What is a hollow back?

A hollow back (also: hyperlordosis) describes an excessively strong protrusion of the spine in the area of ​​the lower back. This also arches the abdomen and pelvis forward. The rib cage appears flattened as it shifts behind the body axis.

Normally the hollow back is not a congenital disease, but acquired through malposition. In addition to the pathological (acquired) hyperlordosis, there is also the congenital hyperlordosis, for example among the pygmies and other African ethnic groups, which is not pathological and therefore does not require any treatment.

What is lordosis?

A lordosis describes the so-called ventral curvature of the spine, i.e. the curvature towards the front of the body. The healthy spine is not straight, but - viewed from the side - has four curves so that it appears S-shaped. It is curved forwards in the neck and lumbar area (lordosis) and backwards in the sternum and sacrum area (kyphosis). If these bends look normal to the front, one speaks of a harmonious lordosis.

The curvature of the spine became evolutionarily necessary with the upright two-legged gait. This "construction" ensures that the spine reacts flexibly to vibrations and can cushion them. The lordosis ensures the stability of the individual vertebral bodies and at the same time reduces the strain on the muscles. In hyperlordosis, however, there is a pathological protrusion of the affected spinal column sections.

Flat back: what is a flattened lordosis?

With a flat back, the physiological curvature of the spine is flattened or eliminated. There is a decrease in the natural cervical spine lordosis, thoracic spine kyphosis and, above all, lumbar spine lordosis.

A flattened lordosis refers to the reduced curvature in the cervical spine (cervical spine) and lumbar spine (lumbar spine) so that the spine appears straight.

Causes and development: why do you have a hollow back?

The formation of a hollow back can have various causes. One of the most common reasons is the combination of a lack of movement and permanent poor posture of the spine. This mostly affects people who have a seated or standing job. The poor posture is exacerbated by sitting on pieces of furniture that do not meet the ergonomic requirements.

There are also other factors that favor the formation of a hollow back:
  • Being overweight promotes the development of hyperlordosis by shifting the brackets.
  • Pomarino's disease (walking forefoot or tiptoe) can also lead to the formation of a hollow back, as the spine also adapts to the changed body balance here.
  • External influences such as an accident can also contribute to the development of a hollow back.
  • Insufficiently developed abdominal and back muscles also promote the process of hyperlordosis formation. The poor posture shortens the tendons and ligaments as well as muscles of the back, so that a correct back posture is difficult to achieve.

Hollow back in children

The reasons mentioned can also lead to a hollow back in children. The most common reason is a lack of movement, which can cause a misalignment of the spine.

Children and young people who, for example, carry heavy rucksacks, school bags or sports bags on their backs on a permanent basis can develop a hollow back. A hyperlordosis can develop from the harmonious lordosis.

Due to the growth, the hyperlordosis can regress even without treatment, so that from the age of ten the hips and pelvis should be stable. However, a doctor should always be consulted if there are any abnormalities.

What symptoms does a hollow back cause?

Due to the misalignment of the spine, the still image changes so that the hollow back can be seen relatively quickly with the naked eye. The forward pelvis results in a protruding abdomen and thus an upper body shifted backwards.

Initially, the hyperlordosis remains symptom-free, although tension can develop. But with increasing, mostly age-related, weakening of the supporting chest and back muscles, back pain develops. Whether this occurs and the intensity of the back pain depends on the extent of the hyperlordosis: The back muscles that are overstrained by the poor posture can lead to pronounced pain.

In addition, the lower back can become immobile by shortening the muscles and tendons involved, which can limit mobility. This makes bending and lifting objects particularly difficult for people with hyperlordosis.

In addition to changing the static image, the incorrect posture also changes the gait pattern, as the forward pelvis affects walking. In some sufferers, the hollow back also leads to numbness in the legs and feet, as the changed position of the spine can squeeze nerves.

Diagnosis - How does the doctor recognize the hollow back?

The diagnosis can be made relatively quickly by an experienced medical professional. A simple assessment is often sufficient here, as a change in the curvature of the spine can be seen with the naked eye. If symptoms such as tension, back pain, irritation from crushed nerves or an immobile back are complained about, the assumption that it is hyperlordosis increases.

Nevertheless, other examination methods such as x-rays or - for children between six and 16 years of age - the posture test according to Matthias are often used. During the test, the doctor will ask you to stand up straight, close your eyes and stretch your arms straight in front of you for 30 seconds. If there is a hollow back, the affected children sway or tilt forward.

Relieve back pain with gentle therapies

Relieve back pain with gentle therapies

Therapy: what to do about a hollow back?

You can get rid of a hollow back - depending on its severity and strength - in many cases or at least correct it as far as possible. There are various treatment options here. Exercise, which serves to strengthen the abdominal and chest muscles, can lead to a positive change in the back muscles and a correction of the stance of the spine.

Physiotherapy treatments such as massages and fango can also be recommended. The massages and mud treatments help to relax the tense muscles and thus to stretch them out. However, massages and mud alone are not enough to stretch the shortened muscles in the long term, so that physiotherapy or physical activity is necessary.

Exercises against a hollow back: what is suitable?

Exercises against the hollow back, such as relaxation, back and prone exercises, as well as hip flexor exercises and bench presses, can also be helpful. The recommended hip flexor exercises are knee raises, lunge and kneeling positions:

  • When lifting the knee, you lie flat on your back and pull your left leg firmly in the direction of your chest with both hands, so that you can feel a slight pulling of the muscles in the right leg. This position should be held for 15 to 20 seconds. Then the exercise is performed with the right leg. There should be three passes per leg.
  • The lunge is aimed at 90-degree leg flexion while standing (forward). The other leg remains straight.
  • The kneeling position means "standing" on your knees. While holding this position, try to lean back (just enough to be able to actively breathe). Again, the goal is to hold the position for 15 to 20 seconds. Five rounds are recommended.

It is advisable to discuss all exercises with the attending physician beforehand. If any exercise causes pain, avoid doing it and seek advice from a doctor.

Other exercises at home should also be discussed during physiotherapy. Yoga, Nordic walking, back and crawl swimming are also particularly suitable.

Fascia exercises for back pain

Fascia exercises for back pain

What else helps against a hollow back?

In the case of sick people who have a sedentary job, it often helps to replace the seating options so that they meet the ergonomic conditions. In some cases, corsets or support bandages can also be used to correct posture. Corsets are also successfully used in scoliosis (a lateral deviation of the spine with twisting of the vertebral bodies) and the hunched back, also known as hyperkyphosis (formation of a "hump" due to pathological intensification of the kyphosis).

If the pain persists, pain medication can also be used for therapy. In the case of particularly severe forms of the hollow back, an operation can be performed.

To be on the safe side, the therapy should always be discussed with the attending physician first. The treatment can be tailored to the severity of the disease and respond to it.

Which mattress is suitable for a hollow back?

Changing the mattress can also support the therapy. The mattress should let the body sink in in the area of ​​the heavier pelvis and provide reliable support in the chest area.

The hardness of the mattress can also affect the position of the spine:

  • A hard mattress, for example, prevents the body from sinking in optimally and creates a kink in the spine.
  • If the mattress is too soft, the spine cannot sag optimally and this in turn leads to a kink in the spine.

It is important that the back is optimally supported in the lumbar region and that the pelvis does not sag. In this position, the spine can relax and is less prone to malalignment.

How does a hollow back disease work?

After the disease is diagnosed, a hollow back is treated individually. In most cases, the symptoms are easily treatable. However, a hollow back cannot be cured, only treated so that the symptoms decrease. To prevent aggravation, a hollow back should not be left untreated.

Regular physical activity and targeted training through appropriate exercises are particularly important. Otherwise the spine can fall back into its unhealthy shape and the hollow back can appear stronger.

Accordingly, one cannot simply train the hollow back after a certain period of time, but must continuously pay attention to physical activity and correct vertebral posture.

How do you prevent a hollow back?

A hollow back can be avoided relatively easily by ensuring that there is sufficient exercise and sporting activity in early childhood and adolescence. For example, a sport that uses the chest and back muscles equally (such as swimming or push-ups) should be performed regularly. In addition, ergonomic seating and back-friendly mattresses should be used.

If hyperlordosis is first suspected, an orthopedic surgeon should be consulted promptly so that measures can be taken in good time. Care must be taken that the posture does not deteriorate unnoticed and the hollow back is thus more pronounced.

Last update: May 13th, 2020
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