Low Back & Pelvis

What It Is

Line drawing of the pelvis and lower spine from the side, with the top of the thigh bone, and arcs showing the pelvis tilting forward and back. — The forward pelvic tilt at the heart of lower cross syndrome, and the range it can move through.

Hyperlordosis is an exaggerated curve in the lumbar part of the spine (the lower back). The lower part of the back curves inward far more than it naturally should. It is sometimes called "swayback" (MedlinePlus, 2026). The spine needs a natural curve to work properly, and the inward curve of the lower back helps the spine cope with the load placed on it (Okpala, 2018). This is due largely to the shape of the individual spinal bones. If the curve becomes too great, the extra stress placed on other parts of the spine may cause pain (Okpala, 2018).

Some of the muscles around the spine and hip may become tight, while others become stretched and weak, causing an imbalance. Some therapists call this pattern "lower crossed syndrome": if you draw a line from the tight hip flexors to the tight lower back, and another from the weak hamstrings to the weak abdominals, the two lines form a cross. This is a way of describing muscle balance rather than a proven cause, and the research evidence for it is limited.

There Are a Number of Other Causes of an Increased Lordosis

Children: some children have a marked lordosis that usually corrects itself as they grow. This is called benign juvenile lordosis (MedlinePlus, 2026).
Spondylolisthesis: a condition where one of the spinal bones slips forward can cause an increased lordosis (MedlinePlus, 2026).
Pregnancy: the increased weight at the front can pull the spine into an extended (lordotic) position.
Excessive extending exercises and sports: some dance or gymnastics-related sports require a lot of arching (extension) through the spine, which can increase the lordosis.
Rarer causes: in children, much less common causes include some genetic conditions that affect bone growth or the muscles (MedlinePlus, 2026).

Hyperlordosis Anatomy

The spine has a natural inward curvature, known as a lordosis, in the lower back and the neck. The normal size of the lower back curve varies widely from person to person, and the measured angle also depends on the method used to measure it, so there is no single "correct" number (Okpala, 2018). When the curve is larger than usual, it may be called a hyperlordosis.

Hyperlordosis can place stress on the posterior (back) structures of the spine, such as the facet joints (the small joints at the back of each spinal bone). These joints may become inflamed and, in time, arthritic (facet joint arthritis, a type of spondylosis). This can cause pain in the lower back.

Hyperlordosis is also linked with a condition called spondylolisthesis (where one vertebra slips forward compared with the vertebra below). Spondylolisthesis can itself cause an increased lordosis (MedlinePlus, 2026). In young athletes and gymnasts, repeated arching of the back can cause a tiny crack (stress fracture) in a spinal bone, which can lead to spondylolisthesis (NHS, 2026). Spondylolisthesis can cause lower back pain, tight hamstrings, and pain, numbness or tingling down one leg (sciatica) (NHS, 2026).

So it is important to know that a normal spine has a lordosis in the lower back and in the neck. But when this lordosis is exaggerated, it might be known as an "increased lordosis" or a hyperlordosis.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Hyperlordosis

Most of the time, a lordosis is not treated if the back is flexible (when you bend forward, the curve reverses). A flexible lordosis is not likely to get worse or cause problems. If the curve is "fixed" and does not change when you bend forward, it needs checking by a doctor (MedlinePlus, 2026).

If your back is sore or stiff, I can help with hands-on work and an exercise programme to build strength in your core and hip muscles, plus a home programme to keep up between visits. See the My Approach tab for how I work.

1. Pilates/Yoga

Exercise programmes, including mind-body exercise such as yoga or Pilates-type exercise, are recommended for people with low back pain (NICE, 2016). They can help improve spinal stability and flexibility.

2. Weight Loss

Carrying extra weight can put more strain on the back. If you are overweight, getting to a healthy weight may help to ease that extra strain and is good for your general health and well-being.

Tips

The spine is key to the flexibility and movement of the body, so it is worth doing what you can to keep your spine healthy.
Good posture helps to keep your spine and back healthy.
If you are carrying extra weight, try to get back to a healthy weight.
If you have back pain, speak to a pharmacist or your family doctor or nurse practitioner about pain relief that is suitable for you.

Treatment

My Approach

Line drawings of the hip flexors (psoas and iliacus) at the front of the hip and the glute muscles and deep hip rotators behind. — The two sides of the pattern: hip flexors that tend to tighten and glutes that tend to switch off.

An increased curve in the low back doesn't always need treating, especially if it's flexible. When it comes with back pain, stiffness or tight hips, my aim is to ease what's sore, free up what's stiff and build strength around your pelvis and spine, so your back copes better day to day.

I start by asking about your history and assessing your posture standing and sitting, how your back and hips move, which muscles are tight and which are weak, and how you bend and lift. I go by what I find rather than assuming a set pattern. If the curve doesn't change when you bend forward, or anything else doesn't fit, I'll ask you to see your family doctor or nurse practitioner.

Hands-On Treatment

Lying with pillows to ease the arch, then warmth, myofascial work, massage and contract-relax stretches for tight muscles at the front of the hip and thigh and along the low back
Careful work on the deep hip flexor through the belly, if it's comfortable for you
Gentle mobilisation of stiff areas of the spine and pelvis, never with quick thrusts, and none at a level that moves too much, such as with spondylolisthesis
Brisk, stimulating work and cool applications to wake up weak glutes and hamstrings

Work on the glutes and inner thigh is only with your informed consent and a written consent form, and you can say no to any area at any time.

Exercise and Habits

Learning to find a comfortable middle position for your low back and gently switching on your deep tummy muscles
Pelvic tilts, bridges, glute work and hip flexor stretches, then planks, squats and lunges, and gym-based lifting if that's your sport
For dancers and gymnasts, managing how much back arching you do while we build strength
Breaking up long spells in one position, and support for your low back when sitting
A home programme between visits

I also see people through pregnancy, and with children I'll show you as the parent how to help with their exercises.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly for about 6 weeks, then we reassess and space visits out as you manage more on your own. Back pain often starts to ease within the first few weeks, and building strength and better habits usually takes around 6 to 12 weeks of regular exercise.

What I Focus On

Assessment

Hip Flexor & Low Back Release

Glute & Core Strength

Movement & Posture Habits

Home Programme

Please read

When to See a Doctor First

When to see your family doctor or nurse practitioner

Your child has an exaggerated posture or a curve in the back, or the curve does not change when they bend forward (MedlinePlus, 2026).
You have lower back pain that does not go away after 3 to 4 weeks (NHS, 2026).
You have pain, numbness or tingling down one leg for more than 3 or 4 weeks, or you are finding it difficult to walk or stand up straight (NHS, 2026).
You have other symptoms as well as back pain, such as a high temperature, sweating at night, or weight loss without trying (NHS, 2026).

Sources

References

MedlinePlus (2026) Lordosis - lumbar. National Library of Medicine. Available at: https://medlineplus.gov/ency/article/003278.htm (Accessed: 7 October 2026).
Okpala, F.O. (2018) 'Comparison of four radiographic angular measures of lumbar lordosis', Journal of Neurosciences in Rural Practice, 9(3), pp. 298–304. doi: 10.4103/jnrp.jnrp_508_17. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6050761/ (Accessed: 7 October 2026).
NHS (2026) Spondylolisthesis. Available at: https://www.nhs.uk/conditions/spondylolisthesis/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (NICE) (2016) Low back pain and sciatica in over 16s: assessment and management. NICE guideline NG59. Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooHyperlordosis

What It Is

There Are a Number of Other Causes of an Increased Lordosis

Hyperlordosis Anatomy

Self-Care & Treatment

How to Treat Hyperlordosis

1. Pilates/Yoga

2. Weight Loss

Tips

My Approach

Hands-On Treatment

Exercise and Habits

Typical Course

When to See a Doctor First

When to see your family doctor or nurse practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooHyperlordosis

What It Is

There Are a Number of Other Causes of an Increased Lordosis

Hyperlordosis Anatomy

Self-Care & Treatment

How to Treat Hyperlordosis

1. Pilates/Yoga

2. Weight Loss

Tips

My Approach

Hands-On Treatment

Exercise and Habits

Typical Course

When to See a Doctor First

When to see your family doctor or nurse practitioner

References

Related Conditions

Hyperkyphosis

Lower Back Pain

Patellofemoral Pain Syndrome

Hamstring Muscle Strain

Book a session