Also known as loss of the lumbar curve, lumbar lordosis reduction usually occurs as an acquired deformity where the natural curve disappears. The most common cause is poor posture.

Posture is the position in which we hold our body against gravity while standing and moving in daily life. A healthy spine is essential for good posture.

When viewed from the side, the spine has four curves: the curves in the neck and lower back (lumbar) bend inward, while those in the upper back (thoracic) and tailbone areas bend outward. Thanks to these curves, our spine supports the body, allowing weight-bearing and movement functions.

What Is Lumbar Flattening?
Lumbar flattening refers to a decrease or loss of the natural curve in the lower back. Medically called lumbar lordosis, this condition shifts the body’s center of gravity, resulting in altered load distribution on the spine and lower back.

How Does Lumbar Flattening Occur?
Prolonged maintenance of the same position causes increased muscle tension and leads to muscle spasms in the lower back muscles. This gradually reduces the curve in that part of the spine (curve flattening). Over time, the muscle spasms also affect the intervertebral discs. These factors trigger each other and cause lumbar flattening. Long-term flattening may lead to structural damage in the discs, increasing the risk of herniated discs.

What Causes Lumbar Flattening?
While there are many causes, the main one is a sedentary lifestyle. People with desk jobs or those who must stay in one position for long periods are at higher risk (lack of movement weakens and weakens back muscles). Other causes include:

• Sitting in incorrect postures for long durations,
• Being overweight (excess weight increases the load on the skeletal system),
• Carrying heavy loads frequently due to occupation,
• Trauma or impact to the lower back area,
• Diseases affecting the entire spine like ankylosing spondylitis (AS),
• Spinal surgeries such as laminectomy,
• Being tall and very thin (the lower back cannot support the neck’s load),
• Congenital spinal deformities like scoliosis,
• Conditions like osteoporosis and bone weakening.

What Are the Symptoms of Lumbar Flattening?
The disruption of the spinal structure in the lower back causes muscles, tendons, and ligaments to lose strength. Occasional tension in muscles and tendons occurs as the body tries to adapt to lumbar flattening. Common symptoms include:

• Localized pain that increases with sitting, standing up, or bending forward, which may become constant over time,
• Difficulty standing upright,
• Increased tendency to bend forward,
• Muscle pain and fatigue,
• Pain radiating to the legs over time.

How Is Lumbar Flattening Diagnosed?
Patients typically visit the doctor due to pain. A detailed medical history (anamnesis) is taken by a physical therapy and rehabilitation specialist. A thorough physical examination leads to diagnosis or suspicion. Definitive diagnosis is made using imaging tests like X-rays and MRI.

Can Lumbar Flattening Be Treated?
Yes, it can be treated, but conservative treatment is recommended. Physical therapy and rehabilitation are the first choices. Initially, lumbar exercises should be applied to relax the shortened and stiffened muscles. Stretching, strengthening, and flexibility exercises should be planned. Muscle relaxants and anti-inflammatory medications may be used for pain relief.

Timely physical therapy and rehabilitation programs yield positive results. The focus should first be on eliminating factors causing lumbar lordosis loss (such as poor sitting posture). Once these are corrected, rehabilitation and exercise treatments will be more effective. If ignored and untreated, the risk of developing herniated discs increases.

Use of back braces is generally not recommended for lumbar flattening because they may cause muscle weakness.