Lumbar lordosis: what is it and how to measure it


Lumbar lordosis is the natural internal curve of the lower back. It is a key element of posture, good or bad. When the angle of this bend is too great, which is often called a backward tilt, it can cause a variety of problems, including misalignment and pain. The same goes for too small an angle. However, determining a "normal" angle is more difficult than you might expect.

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The technical name for this inner curve is lordotic curve. Lumbar is the name of the area of the lumbar spine .

There is no normal range for lumbar lordosis. Angles vary greatly from person to person, as each person's lordosis is based on the relationship between the spine and the pelvis, a measurement called pelvic drop. Lumbar lordosis must correspond to a pelvic drop +/- 10 degrees.

Measuring your lordotic curve

X-rays are the first step for healthcare professionals to measure the lordotic curve. However, even this can be problematic. A 2014 study published in the Spine Journal found that the location during the test and the number of vertebrae included in the measurement can skew the results.

The confusion is compounded by the features you put on the X-ray table. Determining the angle of the lower back can be difficult, if not impossible, due to many factors, according to the study authors. These complicating factors include:

  • Age
  • Ground
  • Ethnicity
  • Athletics
  • Activity level
  • Strength
  • Flexibility
  • Body mass index (the ratio of height to weight used to determine if you are underweight, average weight, overweight, or obese)

X-ray interpretation

Healthcare professionals use various systems to interpret radiographs of the lumbar region and determine the degree of lumbar lordosis. They include:

  1. Determination of the Cobb angle of the lumbar arch in a profile radiograph
  2. Use of the centroid tangential radiological assessment of lumbar lordosis (TRALL) method
  3. Using Harrison's Posterior Tangent Line Drawing Techniques

A 2001 study found that Cobb angle determination is usually more accurate for the spine.

Why measure lumbar lordosis?

If it is so difficult to find normal values for a very normal phenomenon like lumbar arch, you may be wondering why this is done.

Despite the challenges, the information remains useful, especially when considering pelvic involvement. For example, during spinal fusion surgery, spine surgeons will measure lumbar lordosis and pelvic incidence to make sure the spine is aligned so that the patient can stand.

Researchers in the 2014 study mentioned above found an association between lumbar lordosis angle and spinal conditions such as spondylolysis and isthmic spondylolisthesis , so the measurement can be used to determine risk. It can also affect the treatment decisions you and your healthcare provider make if you have one or both of these back conditions.

A 2017 systematic review and meta-analysis found a strong association between low back pain and loss of lumbar lordosis angle, sometimes referred to as 'flat back', especially when decreased low back angle has been associated with degeneration of the lower back. herniated disc or discs.

what does this mean to you?

For those of us who want to take the initiative to deal with posture issues, this lack of determination about the "normalcy" of the extremely important curve of the lower back can be frustrating. To this end, there are a few things to keep in mind.

Lumbar lordosis itself is not a problem. However, when it becomes excessive, the back muscles can become tight and cause pain. It can also increase the risk of facet joint pain or spinal arthritis.

Conversely, if your lumbar lordosis is decreasing, possibly due to your habit of sitting hunched over every day at work, it may increase your risk of disc injury.

Although it is possible to be born with excessive or minimal curvature of the lower back, this is extremely rare. In most cases, posture and fitness are based on a lumbar flexion angle that does not match the angle of the pelvis.

Get the word of drug information

Based on all we know, probably the best way to adjust your lower back curve is with a basic exercise program. Regardless of your current number, strong core muscles can keep your back flexed in its optimal range or, if it's out of that range, bring it back.

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