Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prevention
Frequently Asked Questions
Kyphosisandlordosisare different curvatures seen in the spine. Excessive kyphosis in the thoracic spine—also called round-back or hunchback—is a spinal deformity where the spine curves forward, resulting in a usual rounding of the upper back.
With excessive lordosis—also called swayback—there is an excessive backward curving of the spine where the abdomen projects out. Both conditions can cause pain and comfort, and can even affect a person’s self-esteem.
Keep reading to learn more about the differences between excessive kyphosis and lordosis. Make sure you see your doctor for an appropriate diagnosis and so you or your child can receive proper treatment.
ljubaphoto / Getty Images
Kyphosis and lordosis occur in different subtypes.
Kyphosis TypesPostural kyphosisScheuermann’s kyphosisCongenital kyphosisLordosis TypesPostural lordosisCongenital/traumatic lordosisPost-surgical laminectomy hyperlordosisNeuromuscular lordosisLordosis secondary to hip flexion contracture
Kyphosis TypesPostural kyphosisScheuermann’s kyphosisCongenital kyphosis
Postural kyphosis
Scheuermann’s kyphosis
Congenital kyphosis
Lordosis TypesPostural lordosisCongenital/traumatic lordosisPost-surgical laminectomy hyperlordosisNeuromuscular lordosisLordosis secondary to hip flexion contracture
Postural lordosis
Congenital/traumatic lordosis
Post-surgical laminectomy hyperlordosis
Neuromuscular lordosis
Lordosis secondary to hip flexion contracture
Kyphosis Types
Excessive kyphosis affects up to 10% of school-age children.It can also affect adults, especially as they age. There are three types of kyphosis—postural, Scheuermann’s, and congenital.
Postural kyphosisis the most common type. It results from poor posture and slouching. It is more common in teenagers and affects girls more than boys.It rarely causes problems other than minor discomfort and a slightly rounded shape in the spine.
Scheuermann’s kyphosis is named after the Danish radiologist who first discovered the condition. With this type of kyphosis, the vertebrae are wedge-shaped rather than rectangular. The wedge-shaped bones will curve forward, make the spine appear rounded.
According to the Cleveland Clinic, Scheuermann’s kyphosis is more common in boys and can be painful, especially with activity or after standing or sitting for long periods.Additional symptoms include a hunchback appearance, a stiff spine, and difficulty breathing if the spine curvature is severe.
Congenital kyphosisis present at birth and much rarer than other types. It occurs when the vertebrae develop abnormally in the womb or fuse together.
Congenital kyphosis will get worse as the child grows. Children with this condition may have additional birth defects that affect the heart and kidneys.Treatment usually involves surgery in early childhood to stop the curvature from getting worse.
Lordosis Types
There are different types of excessive lordosis—postural, congenital, traumatic, post-surgical laminectomy hyperlordosis, neuromuscular lordosis, and lordosis secondary to hip flexion contracture.
Congenital lordosisis a birth defect that causes the connecting links of the spine to be misshapen.
Whatever the cause of congenital or traumatic lordosis, the vertebrae, over time, can slip forward and pinch the nerves of the spine, causing pain, numbness, weakness, or dysfunction of the legs.
Post-surgical laminectomy hyperlordosiscan occur in both adults and children, but is more common in children who have had surgery to remove spinal cord tumors.
Alaminectomyprocedure removes part of the vertebrae to reduce spinal cord or nerve root compression of the spine. If more than one part of the spine is involved, the spine can become unstable and overly curved (hyperlordotic position).
Lordosis secondary to hip flexion contractureis often the result of structural changes in the muscles, tendons, and ligaments of the hips, causing the pelvis to rotate forward. This will cause an individual to either lean forward or adopt a hyperlordotic spine to accommodate. The contracture can have various causes, includinginfection, injury, or muscle problems from different disorders.
Both excessive kyphosis and lordosis can be painful conditions. They affect different parts of the vertebrae.
Excessive Kyphosis SymptomsA visible hump of the upper back—appears higher than normal when bending forwardForward headRounded shouldersBack pain and stiffnessFatigueBreathing difficultiesMuscle tightnessExcessive Lordosis SymptomsSwayback (exaggerated posture—belly forward and swayed back hips)Gap at the lower back when lying on the backPain in the back and legsNumbness and tingling in the legsWeakness of the legs
Excessive Kyphosis SymptomsA visible hump of the upper back—appears higher than normal when bending forwardForward headRounded shouldersBack pain and stiffnessFatigueBreathing difficultiesMuscle tightness
A visible hump of the upper back—appears higher than normal when bending forward
Forward head
Rounded shoulders
Back pain and stiffness
Fatigue
Breathing difficulties
Muscle tightness
Excessive Lordosis SymptomsSwayback (exaggerated posture—belly forward and swayed back hips)Gap at the lower back when lying on the backPain in the back and legsNumbness and tingling in the legsWeakness of the legs
Swayback (exaggerated posture—belly forward and swayed back hips)
Gap at the lower back when lying on the back
Pain in the back and legs
Numbness and tingling in the legs
Weakness of the legs
Kyphosis Symptoms
Mild types of kyphosis cause few problems, but severe kyphosis causes pain and can be disfiguring.
Symptoms include:
Although rare, severe kyphosis can cause sensation loss in the legs, weakness, numbness, and tingling. Seek out immediate medical attention for these symptoms.
Lordosis Symptoms
Lordosis causes an inward curvature of thelumbar spine, the lower part of the spine just above the buttocks.
The amount of thoracic kyphosis and lumbar lordosis an individual has is based on the relationship between their spine, hips, and pelvis. The angle that determines this is called the pelvic incidence. Since everyone’s pelvic incidence is unique, there are no normal values for lumbar lordosis and thoracic kyphosis.
Excessive lordosis can cause severe pain in the back and legs for some people.
Additional symptoms might include:
Note that severe leg weakness may require urgent medical attention to avoid serious problems.
Further, severe complications of excessive lordosis might include loss of movement or restructured movement, fractures, or low back or leg pain.
Body Image
Both kyphosis and lordosis can cause poor body image. This is especially common in children and teens whose backs appear rounded or swayed back, or who need to wear a brace to correct symptoms.
Adults may also have concerns about body image. These concerns can lead to social isolation, anxiety, and depression in both adults and children.
There are different causes of excessive kyphosis and lordosis.
Excessive Kyphosis CausesFracturesOsteoporosisDisc degenerationGrowth spurtsBirth defectsChildhood syndromesCancer or cancer treatmentsRisk factors: age, being female, geneticsExcessive Lordosis CausesBad posture and slouchingBeing overweightTraumaSurgeryNeuromuscular conditionsHip conditions
Excessive Kyphosis CausesFracturesOsteoporosisDisc degenerationGrowth spurtsBirth defectsChildhood syndromesCancer or cancer treatmentsRisk factors: age, being female, genetics
Fractures
Osteoporosis
Disc degeneration
Growth spurts
Birth defects
Childhood syndromes
Cancer or cancer treatments
Risk factors: age, being female, genetics
Excessive Lordosis CausesBad posture and slouchingBeing overweightTraumaSurgeryNeuromuscular conditionsHip conditions
Bad posture and slouching
Being overweight
Trauma
Surgery
Neuromuscular conditions
Hip conditions
Kyphosis Causes
The individual bones of the vertebrae would normally appear like stacked cylinders in a column. Kyphosis causes the vertebrae to become wedge-like. This is related to many different causes:
Risk factors for kyphosis include age and genetics:
Lordosis Causes
Doctors don’t always know the cause of excessive lordosis. What they do know is that the condition often develops in childhood. Some children have a higher risk than others.
Lordosis is also associated with bad posture, being overweight, trauma, surgery, neuromuscular conditions, and hip problems:
Kyphosis and lordosis are diagnosed using similar methods. Diagnosis might include looking at family and personal medical history, a physical exam of the spine, imaging, and neurologic evaluation.
Family and Medical History
A doctor will ask questions about symptoms experienced, including what causes them and what makes them worse. They will also want to know about a family history of spine curvature disorders, including kyphosis and lordosis.
Physical Exam
A physical exam of the spine looks at spine curvature, balance, and range of motion.
For children, an Adam’s forward bend test is done. This test helps a physician see the slope of the spine and observe spinal deformities or curvatures.With this test, your child will be asked to bend forward with their feet together, knees straight, and arms hanging free.
The doctor may also ask the child (or adult) to lie down to see the curvature of the spine. A spine that becomes straightened with lying down is often related to conditions of poor posture.But if the spine is still curved with lying down, other causes are considered.
Imaging
X-rayscan produce detailed images of the spine to determine curvature, andcomputed tomography(CT) scans can produce detailed images of sections of the spine.
Magnetic resonance imaging(MRI) scans are done if a doctor suspects another condition, such as aspinal tumoror infection. MRI can produce very detailed images of the bone and tissue surrounding the spine.
Neurologic Evaluation
A neurologic exam is generally done if someone is experiencing tingling, spasms, and/or bladder/bowel control issues. Children and adults who experience these symptoms need to be seen for medical care right away.
Additional Testing
Adults who develop kyphosis or lordosis will need additional testing to determine underlying causes. This might include bloodwork to check for infections andbone density scansto assess the strength of bones and diagnose conditions that cause bone weakening, such as osteoporosis.
Treatment for excessive kyphosis or lordosis will depend on the cause and severity of the condition.
Excessive Kyphosis TreatmentPosture improvementsBracingPhysical therapySurgeryExcessive Lordosis TreatmentPain medicinesPhysical therapyWeight lossBracingSurgeryManaging underlying causes
Excessive Kyphosis TreatmentPosture improvementsBracingPhysical therapySurgery
Posture improvements
Bracing
Physical therapy
Excessive Lordosis TreatmentPain medicinesPhysical therapyWeight lossBracingSurgeryManaging underlying causes
Pain medicines
Weight loss
Managing underlying causes
Kyphosis Treatment
Children who have Scheuermann’s kyphosis are often treated withback bracingandphysical therapyto strengthen the muscles of the back and abdomen so they can better support the spine. This condition generally stops progressing once the child is older and has stopped growing.
Children born with congenital kyphosis often require surgery to correct spine curvature.Spinal fusion surgerycan correct the curvature and relieve pain.
Lordosis Treatment
Lordosis treatment is dependent on its cause and severity. Treatment options might include pain medications, physical therapy, weight loss, bracing, and surgery:
When lordosis results from another health condition, such as a hip disorder or a neuromuscular disorder, getting that condition under control can keep the condition from getting worse.
Managing Self-Image Concerns
Being diagnosed with a spine curvature condition can cause a lot of stress for children and teens. When your child is first diagnosed, they feel anxious, depressed, and withdrawn. Fortunately, these symptoms improve as they develop confidence in their treatment plan.
You can help your child develop a positive self-image. Some ways to do this might include:
Additional prevention measures include:
Management and treatment of any underlying causes might also help to prevent spinal curvature.
Summary
Kyphosis and lordosis are different spinal curvatures. In excessive kyphosis, the spine curves forward, rounding the upper back. In excessive lordosis, the spine curves backward, resulting in swayback. Both conditions can be painful.
There are a variety of causes for each condition. Diagnosis is through a physical exam, medical history, and imaging. Treatment will depend on the cause and severity.
A Word From Verywell
Most of the time, back pain is manageable and goes away without doctor-prescribed treatment. Back pain is less common in children and teenagers. Reach out to your doctor, or your child’s doctor, for back pain that lasts for days and doesn’t resolve with rest.
Can you have both lordosis and kyphosis?
It is possible to have both lordosis and kyphosis. Both are common in people withscoliosis, a sideways curvature of the spine that starts right before puberty.Having all three types of abnormal curvatures severely affects spine function and limits treatment options.
How do you correct kyphotic posture?
Are kyphosis and lordosis similar to scoliosis?
Scoliosis, kyphosis, and lordosis are the three main types of spine curvature disorders.Scoliosis causes a sideways curvature of the spine where the spine bends and twists to the side. Kyphosis and lordosis have different curvatures.
All three conditions can become severe and limit mobility, lead to breathing and coordination problems, and cause serious back pain.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Kyphosis.
Nationwide Children’s.Lordosis.
Boston Children’s Hospital.Lordosis.
MedlinePlus.Lordosis – lumbar.
Bezalel T, Carmeli E, Kalichman L.Scheuermann’s disease: radiographic pathomorphology and association with clinical features.Asian Spine J. 2019;13(1):86-95. doi:10.31616/asj.2018.0025
Roghani T, Zavieh MK, Manshadi FD, King N, Katzman W.Age-related hyperkyphosis: update of its potential causes and clinical impacts-narrative review.Aging Clin Exp Res. 2017;29(4):567-577. doi:10.1007/s40520-016-0617-3
Yau MS, Demissie S, Zhou Y, et al.Heritability of thoracic spine curvature and genetic correlations with other spine traits: the Framingham study.J Bone Miner Res. 2016;31(12):2077-2084. doi:10.1002/jbmr.2925
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Boston Children’s Hospital.Kyphosis in children.
Harvard Medical School.Bad backs and backpacks.
Loyola University Medical Center.Scoliosis and spinal curvature disorders.
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