What Is Straightening of the Normal Cervical Lordosis? Can It Cause Problems?

by Chris Centeno, MD /
what is straightening of the normal cervical lordosis
The fact that the neck has a normal curve is an important and often overlooked issue. In many patients with neck pain, this curve goes away, leading to biomechanical problems that can cause degenerated discs. Now a new study shows that it can also cause decreased blood flow to the back of the brain!

What Is Straightening of the Normal Cervical Lordosis?

If you read a handful of neck X-ray reports, you’ll likely see that the radiologist has said on a few that there is “straightening of the normal cervical lordosis.” To understand what this is, you have to understand how the spine is constructed.what is straightening of the cervical lordosis

When the normal curve is lost, there are a number of terms used by the radiologist:

  • Straightening of the normal cervical lordosis
  • Loss of cervical lordosis
  • Straightening of the cervical lordosis

Your neck, upper back, and low back all have counterbalanced curves. One goes one way, and the adjoining curve goes the opposite way. When the curve points toward the front, it’s called a lordosis and toward the back, it’s called a kyphosis. These curves balance the force of the head and allow you to stand with minimal muscle energy. They also equally distribute the forces between the front of the individual vertebrae, where the disc is located, and the back of the verterbrae, where the facet joints live.

Why Is Straightening of the Normal Cervical Lordosis a Big Problem?

loss of cervical lordosisWhen you lose the normal neck curve, the weight of the head is no longer balanced by the opposing curve (kyphosis) in the upper back. This causes muscle power to be needed to keep the head upright. For example, in the picture to the right, the head is being held up by the muscles at the back of the neck, leading to overload where those muscles attach to the skull, causing headache pain. This also causes more weight to be transferred to the discs between the vertebrae, which can lead to more wear-and-tear disc degeneration.

How Does Straightening of the Normal Cervical Lordosis Happen?

One of the more common causes of straightening of the normal cervical lordosis is car crashes where the neck ligaments are damaged. Other causes are more insidious, like looking down all the time to interact with a cell phone, tightness in the chest wall and psoas from sitting too much, or just getting older.

New Research on Straightening of the Normal Cervical Lordosis

While we’ve known that straightening of the neck curve was bad news, a new study just upped the ante of bad stuff that happens when you have this problem. This research looked at 30 patients with and 30 matched controls without loss of cervical lordosis. Doppler ultrasound was used to measure the blood flow through the vertebral artery. This important blood vessel courses through holes in the neck bones, so it could be vulnerable if the relationships between the neck bones change. In the patients with loss of the normal neck curve, the diameter of the artery was small with less and slowed blood flow through the vessel. Yikes! Given that this is one of the major sources of blood flow to the brain, this could be a huge future problem for teenagers who have been glued to their phone since childhood!

How Can You Treat Straightening of the Normal Cervical Lordosis?

From a conservative-therapy standpoint, there are some nice programs specifically designed to get the curve back. One is used by chiropractors and uses special traction machines to fix the curve. Physical therapists can also work on stretching out and releasing the tight muscles in the chest and pelvis. If the neck ligaments are damaged, then highly precise injections into these ligaments using platelets or stem cells may help. Surgery is usually not recommended as a viable solution.
The upshot? We’ve known that the neck curve is a big deal in helping avoid structural overload and degeneration of muscles, tendons, and discs, but this new study is a bit scary. The fact that the blood supply to the brain is also impacted by this change is a big concern!
Can a stem cell procedure help me? To find out if you might be a candidate for a Regenexx stem cell procedure, complete our Regenexx Procedure Candidate Form online.

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23 thoughts on “What Is Straightening of the Normal Cervical Lordosis? Can It Cause Problems?

  1. Karen Buyerr

    Is this something you can see in an MRI?

    1. Regenexx Team Post author

      Karen,
      You can see the straightening of normal Cervical Lordosis on MRI, and the most straightforward solution is to correct that.
      How Can You Treat Straightening of the Normal Cervical Lordosis? From a conservative-therapy standpoint, there are some nice programs specifically designed to get the curve back. One is used by chiropractors and uses special traction machines to fix the curve. Physical therapists can also work on stretching out and releasing the tight muscles in the chest and pelvis. If the neck ligaments are damaged, then highly precise injections into these ligaments using platelets or stem cells may help. Surgery is usually not recommended as a viable solution.

      But to visualize blood flow to the Brain, more specialized tests are used:
      A special type of MRI called magnetic resonance angiography, or MRA, lets doctors precisely visualize narrowing or blockage of blood vessels in the brain.
      Transcranial Doppler (TCD):
      This test uses sound waves to measure blood flow through the major blood vessels in the brain. Narrow areas inside of a blood vessel demonstrate faster blood flow than normal areas. This information can be used by doctors to follow the progress of occluded blood vessels.
      Another important use for the TCD is the assessment of blood flow through blood vessels in the area of a hemorrhagic stroke, as these blood vessels have a propensity to undergo “vasospasm” a dangerous contraction of the wall of a blood vessel which can block blood flow.
      Cerebral Angiography:
      Stroke doctors use this test to visualize blood vessels in the neck and brain. During this test a special dye which can be seen using X-rays is injected into the carotid arteries, which bring blood to the brain. In a person who has a partial or a total obstruction in one of these blood vessels, or in any other blood vessel inside the brain, little or no dye can be seen flowing through it.

  2. chris

    The abstract didn’t say, but did the full study state what system they used to measure the curves, and what parameters defined “loss of curve”?

    When you say surgery is not recommended as a viable solution, thank you for using the word viable. Amputating large amounts of spinal anatomy, and then drilling a metal cage system into a persons neck is a barbaric solution.

    As far as I am concerned, autonomous driving can’t come soon enough. The amount of lives and serious injuries that will not happen is going to be amazing.

  3. Dr. Scott Davis

    As this information pertains to someone without the barbaric cage, can you please give a brief description of what the possibilities to help someone who has the cadaver bone graft, titanium plate, and 6 screws from C3-6?
    I remember the neurosurgeon running an ink pen and his ID card along the bottom of my foot; then explained that I have Babinski’s. Very soon I will make an appointment with one of the physician’s in the Regenexx network, but I found this and other articles on the spine problems with stem cells or enriched blood injections a superior procedure to surgeries. Yet, I have some hesitation about success rate and the actual process, beyond setting the appointment.
    Thanks again for your help in learning about the possibility.

    1. Regenexx Team

      Scott,
      In cases of spinal fusion, typically the approach is to use injections to beef up ligaments above and below the fused area to provide better stability and to reduce facet joint break down and nerve irritation. Obviously, every case is different with regard to what’s causing pain or nerve compression.

  4. Lisa Johnson

    I was just diagnosed with loss of cervical lordosis and narrowing of c5-6 and c6-7 disc spaces. I have been having pain from my neck to my upper arm and down my right arm, stiffness, headaches, difficulty swallowing (only for 2 weeks), occasional dizziness and occasional numbness for the past 9 months. I never had any neck issues or complaints previously to Jan of this year. I was basically lifting and stacking hundreds of times a day (for 8 hrs 5 days a week) for 6 months previous to my symptoms. I am currently in physio but as of present the chiro/physio will not do anything but put me in light traction and use ice/heat/tens/laser. Chiro says I’m too swollen to do any real work. When should I expect to start actually trying to resolve this loss of curve? I’m in quite a bit of pain but shouldn’t we start doing something more aggressive sooner?

    1. Regenexx Team Post author

      Lisa,
      Beginning with the least invasive treatment, as you have, is the best plan. Physical therapy has been shown to be very helpful in spinal stenosis, but when it doesn’t help the right type of exam to track down what’s causing what and treatment with your own platelets and or stem cells, is often a good next step. Please see: http://www.regenexx.com/blog/spinal-stenosis-options-pt-as-effective-as-surgery/ and http://www.regenexx.com/blog/spinal-stenosis-surgery-alternatives/ http://www.regenexx.com/blog/neck-epidural-failed/ and http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/ We’d need to take a look at your MRI’s and medical history to weigh in on your particular situation. If you’d like to see if we can help, please submit the Candidate form.

      1. Melissa Youngblood

        I had the stem cell procedure after a year in and a half of physical therapy, epidurals and facet shots and nothing worked not even the stem cells. Now back in Physical therapy. what other options do I have at this time?

        1. Chris Centeno Post author

          I would have to know more about exactly what you had done. What type of stem cells? How were they injected? In exactly what structures were they injected?

  5. Maureen O'Neil

    I had C3 – C6 of my cervical spine fused in August 2011. As a result of this procedure my neck was fused in a downward position. I cannot raise my head up straight. I cannot look into a mirror. I have been in a downward spiral medically, with both pain increasing and mobility decreasing ever since. An Orthopedic Surgeon has told me that since this happened, I have developed scoliosis in both the thoracic and lumbar areas. I am in constant pain, hardly able to walk or do much of anything at all. He has suggested that he can ‘fix this problem. It would entail an ENTIRE SPINAL FUSION. from C2 through the sacrum, Steel rods and all. He told me my back would then be straight and my head would be straight up.
    Needless to say, this sounds quite drastic. I can’t fine anyone that has had this procedure to give me any input. Do you have any words of advice? Thank ou.

    1. Regenexx Team Post author

      Maureen,
      Hearing your story confirms yet again, why Fusion is such a problem! We’ve definitely treated Scoliosis very successfully, and we’d be glad to take a look. Of course, each case is different and we’d need to get you on the phone and go over your MRI’s and medical history in the Candidacy Evaluation process to see if you’d be a good Candidate. If you’d like us to weigh in, please submit the Candidate form: http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/ and http://www.regenexx.com/blog/should-i-get-a-back-fusion/

  6. Kyushi

    Will my height be affected after treating it?

    1. Regenexx Team Post author

      Kyushi,
      After a cervical fusion, or after treatment with advanced regenerative medicine and interventional orthopedics?

  7. Cassi Hammond

    Besides pain, what other symptoms can this cause? I have had 4 months of intermittent Apraxia of speech and gait. I have not had a stroke and although I have slightly low lying cerebellum tonsils no neurologist will say I have Chiari. I just got an MRI report yesterday and am going thorough it. There is a LOT on it but the very first thing is “there is a diffuse straightening the cervical spine without reversal of normal cervical lordosis.” Do you think this can cause Apraxia? My episodes are getting longer and more intense (this past weekend I lost my speech completely).

    1. Regenexx Team Post author

      Cassi,
      There is no way for us to comment without seeing the MRI (not the report). If you’d like us to weigh in, Please submit the Candidate form to the right of the Blog.

  8. Linda

    My X-ray impression:
    Mild disk disease changes C5-6 and C6-7 which have clearly increased since 2011.
    Mild kyphosis and complete loss of lordosis.
    C-4 has a small anterior osteophytes at these levels as well as involving the inferior
    endplate.
    What should I do?
    Thank you

    1. Chris Centeno Post author

      Providing any advice on something like this would take an MRI and a good exam and history, not just looking at an x-ray report.

  9. LUIS GORDIAN

    Hi:
    The following is the impression of my neck X ray:
    “Findings are consistent with mild straightening of cervical spine lordosis end degenerative changes particularly at the C5-C7 levels.
    I’m suffering of pain in the neck muscle and dizziness.
    What can I do to fix that?

    1. Regenexx Team Post author

      Luis,
      We’d need to examine you and see the MRI images to advise in your particular case, but Degenerated disc patients tend to lose disc height which can lead to a wide range of complications. Our treatment focuses on treating Compressed nerves (stenosis), Facet joint overload leading to arthritis, and Lax ligaments that result in overall spinal instability. There is a wealth of information here including procedure videos, a spine seminar, and free e book: https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  10. Anthony

    What type of imaging can tell that neck ligaments are damaged?

    1. Regenexx Team Post author

      Anthony,
      The most common test is a DMX (Digital Motion X-ray). This test involves the patient tilting his or her head side to side while a real-time X-ray is taken of the upper cervical joint movement. Other tests that are helpful include an upper-cervical-specific MRI (which uses a head coil)and a movement-based CT scan.

  11. BD

    4-18-18 MRI:

    “There is straightening of cervical lordosis which may in part be positional. ” and a lot of other issue but what does ‘may in part be positional’ mean?

    1. Regenexx Team Post author

      BD,
      Positional things like looking down all the time, or from psoas from sitting too much.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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