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What is Swayback?

swayback and other spinal posturesNormal spinal curves create an s-shape when viewed from the side but many people suffer from swayback, a condition where the lower spine’s lordotic curve is exaggerated. Although many people do not pay much attention to this kind of abnormal spinal curve while they are young it can lead to significant problems later in life as the weight of the body is not optimally balanced and spinal stenosis may develop.

Those who are obese, who suffer from osteoporosis and spondylolisthesis, or achondroplasia, discitis or kyphosis of the upper spine are all at an increased risk of swayback, although the condition may occur at any age and to different degrees.

Correct Spinal Posture and Why it Matters

The normal spinal curve positions the head over the pelvis, thus distributing weight fairly evenly throughout the spinal column and allowing the spinal discs to work as shock absorbers. An abnormally curved spine places extra stress on specific discs and can predispose a person to disc herniation, spinal stenosis and back pain. Swayback may become apparent when a person finds that shirts and dresses tend to puff out at the back, or when a significant hollow is present when standing or lying down. The buttocks appear to be stuck out when excessive lordosis is present and those wearing high heels can see this accentuated even further.


Symptoms of Swayback

Symptoms of swayback include lower back pain, mobility issues and referred pain in the other areas of the spine as the body tries to correct the problem. In many cases the lordosis is correctable through postural re-education, but if the curve does not lessen when bending forwards or when trying to stand straight it can be that the hyperlordosis is fixed and that lower back surgery is needed to realign the spine.

Diagnosis Swayback (Hyperlordosis of the Lumbar Spine)

Doctors will usually take into account the severity of the curve, the rapidity of progression of that curve, and the pain and debility experienced by a patient before determining which treatment, if any, is appropriate for swayback. Some bending and twisting exercises will be performed in the doctor’s office in order to assess range of motion, persistence of the lordosis and other spinal abnormalities. Nerve assessments may also be carried out if pain and/or paraesthesia is an issue. Diagnostic imaging is not usually necessary for a diagnosis but it may be helpful in cases where surgery appears to be of likely benefit.

Treating Swayback

Prior to undergoing surgery, most patients will treat swayback with analgesics and anti-inflammatories, a course of physical therapy, spinal bracing and general health improvements. Surgery to correct swayback and reduce lower back pain may take the form of spinal fusion, disc replacement, discectomy and osteotomies. Treating swayback early will usually mean that less invasive treatments or less extensive surgeries are necessary and that a progressive degeneration of the spinal curve can be halted or slowed to some degree.

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