Kyphosis vs Lordosis vs Scoliosis: Curves and Assessment

Normal spinal curves versus a change needing assessment

AAOS spine anatomy guidance explains that the neck and lower back normally curve inward, called lordosis, while the upper back curves outward, called kyphosis. These normal curves help with balance.

A curve may be excessive or reduced, and clinicians sometimes use the same words when discussing an abnormal curve. Lordosis is not automatically a disease or evidence of weak abdominal muscles. Ask whether a report describes normal anatomy or a clinically important change.

Kyphosis: cause and flexibility matter

NHS kyphosis guidance distinguishes postural, Scheuermann's and congenital forms. Kyphosis can also occur after spinal injury or with conditions such as osteoporosis. A rounded upper back should not always be explained as a habit that can be corrected by sitting straighter.

Assessment considers the curve's flexibility, symptoms and underlying cause. Physiotherapy may help pain and stiffness, but it should not promise to straighten a structural curve. Specialist monitoring, a prescribed brace or surgery may be considered in selected cases.

Scoliosis: screening is different from measuring the curve

Uneven shoulders, waist shape or a rib prominence may prompt an examination. A home photograph or wall-gap test cannot confirm the diagnosis or select treatment.

The Scoliosis Research Society's assessment guidance describes a forward bend examination and a scoliometer to assess trunk rotation. The spinal curve's Cobb angle is measured on an X-ray; it is not the same measurement as the scoliometer reading.

Bring previous imaging and reports if available. Ask whether the curve is changing, how remaining growth affects decisions and when it needs to be checked again. Our scoliosis guide explores the condition in more detail.

Treatment differs during growth and adulthood

NHS guidance for children with scoliosis describes monitoring, specialist bracing and surgery according to age, curve severity and progression. A brace used during growth aims to limit worsening; it should not be replaced with a shop-bought posture support.

NHS adult-scoliosis guidance focuses on symptoms and function. Suitable exercise may help pain, although it is unlikely to change the spinal curve. Most adults do not need surgery.

For a concern about lordosis, agree what the assessment has actually found and which symptoms or activities need help. A lower-back appearance alone is not a reason to prescribe the same core exercise routine to everyone.

Discuss symptom management through our posture and movement service after appropriate assessment. The posture guide explains everyday variation, while our home exercise guide helps you prepare for an individualized programme.

Back symptoms needing urgent medical attention

A new or worsening curve, persistent pain or a concern about a child's back deserves medical assessment. Do not postpone a review while trying to change its appearance with exercises.

NHS back pain guidance advises urgent assessment for sudden severe or rapidly worsening pain, or back pain with fever or feeling generally unwell. Seek emergency care for back pain with symptoms in both legs, loss of feeling around the genitals or anus, new bladder or bowel changes, chest pain, or pain following a serious accident.