Lordosis Treatment Charlotte NC | Can Lumbar Lordosis Be Corrected? | Clear Life Scoliosis

By Dr. Justin Dick, DC · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published October 26, 2026

Lumbar lordosis can be changed in some patients, but the evidence that changing it relieves pain is weaker than the evidence that it can be measured. The best trial I found, by Diab and Moustafa, randomized 80 adults with chronic low back pain and a reduced low back curve. Adding lumbar extension traction to stretching changed the curve and segmental motion on radiographs more than stretching alone, but the reported pain difference between groups was not statistically significant. That gap between what moved on film and what the patient felt is the center of this topic.

I am Dr. Justin Dick at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. I use structural rehabilitation in practice, and I think patients deserve to see the limits of that evidence along with the case for it.

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Too Much Curve and Too Little Curve

Hyperlordosis is an increased inward curve of the low back. Hypolordosis, often written as "loss of lordosis" or "straightening" on a report, is a reduced curve. Been and Kalichman reviewed more than 120 papers and concluded that the optimal lordotic range is unknown and depends on body weight, activity, strength, and flexibility. They found a consistent association between greater lordosis and spondylolysis and isthmic spondylolisthesis, no association with other degenerative findings, and inconclusive evidence for a link with low back pain.

The Pain Association

Chun and colleagues pooled 13 observational studies with 796 patients with low back pain and 927 controls. The pain group had smaller lordosis on average, and the difference was largest in patients with disc herniation or degeneration. Observational data cannot tell us direction. A painful disc and protective muscle guarding can flatten the low back, and a flat low back can change disc loading. Both readings fit the data. In adults with spinal deformity, Glassman and colleagues found that kyphosis in the lumbar region was poorly tolerated, which is the strongest evidence that a reversed low back curve matters.

What Has Been Shown to Change the Curve

Diab and Moustafa randomized 80 patients aged 40 to 50 with chronic mechanical low back pain and hypolordosis. Both groups had stretching and infrared heat; one group also had lumbar extension traction. At follow-up, the traction group had greater change in the radiographic curve and in segmental translation and rotation at most lumbar levels. The authors concluded the traction approach was superior for pain, but their results section reports pain differences with p values of .1 and .3, which do not meet the usual threshold for significance. I read this trial as evidence that alignment can be changed and as weak evidence that the change reduced pain more than stretching did.

What Exercise Does and Does Not Do

Hayden and colleagues, in a 2021 Cochrane review of 249 trials, found moderate-certainty evidence that exercise reduces chronic low back pain by about 15 points on a 100-point scale compared with no treatment or usual care. Those trials measured pain and function, not lordosis. Owen and colleagues' network meta-analysis of 89 trials found that stretching alone did not differ from true control for pain or function. A home stretching routine aimed at "fixing" lordosis has little direct support.

When Lordosis Is Not the Problem

A lordosis angle on a report is not a diagnosis on its own. Pelvic anatomy sets much of the curve, so the same number can be normal in one person and not in another. Before treating a curve, I want to know whether it fits the pelvis, whether the patient is balanced over the hips, and whether the symptoms match. Leg pain, numbness, or weakness point toward a nerve problem, which my post on pinched nerve vs herniated disc covers.

How Dr. Justin Dick Approaches Lordosis at Clear Life

At our Charlotte office, a lordosis complaint starts with a standing lateral radiograph when clinically indicated, measurement against pelvic parameters, and a neurological exam. When the curve is outside the expected range and symptoms fit, care can include structural rehabilitation, traction, and exercise, with repeat measurement to see whether anything changed. Our page on sagittal alignment explains the measurements.

Comparison

Research and Evidence

Evidence tiering: Hayden is a Cochrane systematic review, Owen a network meta-analysis, Diab and Moustafa a single randomized trial, Chun a meta-analysis of observational studies, and Been and Kalichman a narrative review. The single trial of curve-changing treatment is small and its pain conclusion goes further than its own statistics. Mechanistic reasoning about disc loading with reduced lordosis is reasoning, not tested outcome.

My own published work includes conservative structural rehabilitation of the low back. The refractory lumbar pain case, Refractory Lumbar Pain Following Motor Vehicle Collision in a Geriatric Patient With Prior Lumbar Surgery (Cureus, 2026, PMID 41694169), describes one older patient with prior lumbar surgery. It is a single case and cannot be generalized.

References

1. Been E, Kalichman L. Lumbar lordosis. Spine J. 2014;14(1):87-97. doi:10.1016/j.spinee.2013.07.464
2. Chun SW, Lim CY, Kim K, Hwang J, Chung SG. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine J. 2017;17(8):1180-1191. doi:10.1016/j.spinee.2017.04.034
3. Glassman SD, Bridwell K, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30(18):2024-9. doi:10.1097/01.brs.0000179086.30449.96
4. Diab AA, Moustafa IM. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial. J Manipulative Physiol Ther. 2012;35(4):246-53. doi:10.1016/j.jmpt.2012.04.021
5. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. doi:10.1002/14651858.CD009790.pub2
6. Owen PJ, Miller CT, Mundell NL, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020;54(21):1279-1287. doi:10.1136/bjsports-2019-100886
7. Roussouly P, Gollogly S, Berthonnaud E, Dimnet J. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine. 2005;30(3):346-53. doi:10.1097/01.brs.0000152379.54463.65
8. Dick JM. Refractory lumbar pain following motor vehicle collision in a geriatric patient with prior lumbar surgery: clinical resolution after multimodal conservative spinal structural rehabilitation. Cureus. 2026;18(2):e103540. doi:10.7759/cureus.103540

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Service Area

Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin Dick.

Related Pages

• Scoliosis Biomechanics and Sagittal Alignment
• Kyphosis Treatment in Charlotte
• Pinched Nerve vs Herniated Disc
• My MRI Shows a Herniated Disc
• Best Exercises for Scoliosis
• Scoliosis Treatment for Adults
• Spine Structure, Pain, and Degeneration
• What Does a Chiropractor Actually Do
• Radiographic Imaging Credentials
• Dr. Justin Dick Research

Schedule an Evaluation in Charlotte

If a report says your lordosis is lost or increased, the number needs context from your pelvis, your balance, and your symptoms. Dr. Justin Dick provides that review at our Charlotte office.

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