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alex7373
9th February 2008, 11:23 PM
does anyone know the causes of lordosis?

i'm 33 now..when i was 25 i experienced body composition changes with weight gain in my stomach and chest, weight loss in my arms and legs. At this same time my lower back curved inward.

since then i've seen a endocrinologist and i've been diagnosed with adult growth hormone defiecency (still waiting for the mri of pit gland).

the aghd explains the hormonal changes and weight gain in chest and stomach. I can only assume that my lordosis was caused by the extra weight in chest and weak abdominal muscles. would that be a good assumption?

what kind of doctor should i go to for lordosis? a rheumatologist?

Little Ali
10th February 2008, 03:48 PM
Hi there :welcome2:

I think that would be a good assumption to make. I would've thought scoliosis specialist would also deal with lordosis...not sure.

I'm sure someone will come along and give you some good advice soon.

In the meantime, I hope you like it here.

jfkimberly
10th February 2008, 08:32 PM
Lordosis refers to the natural inward curve of the lower spine... when this becomes exaggerated it is no longer "normal" and can become disfiguring (I hate that word) and can pose health risks. Often with pronounced lordosis, you will have compensatory kyphosis of the upper spine to keep you balanced. But the net result of this is that your torso appears shorter, your organs are all squished about in there, and you may experience pain. This is an orthopedic issue, and a specific one at that. You would want to see an orthopedist who specializes in kypho-scoliosis/lordosis. And in your case, you need one who is experienced working with adults (who, due to less flexibility, are generally treated differently than adolescents and children). Hopefully some of our adult UK patients here can help you find the name of an appropriate referral so you can get evaluated and see if treatment is necessary.

Oh, as for your thickened middle and skinny limbs... if your curves are pronounced enough, some of your apparent weight-gain might only be the visual consequence of the shortened and curving torso. Having been diagnosed with the AGHD deficiency, it is likely legitimate weight-gain, but the curves could be adding to the change in your appearance.

Good luck with your MRI. I do hope everything checks out with your pituitary gland. Can you get prescribed a synthetic hormone?

Amazed Jean
10th February 2008, 09:12 PM
Hello and Welcome to SSO. Causes are certainly questionable. You're best bet is to get a scoliosis guy to have a look at your spine and xrays. Some people never know the cause of their own case. Treatment varies too.

GillyG
10th February 2008, 10:59 PM
Hi Alex :welcome:

I would definitely agree you need to see an orthopaedic spinal specialist and get some X-rays done to see exactly what's going on. As Kim says, if we know where abouts you are we'll probably know one of the 'good guys' we can suggest for you.

alex7373
10th February 2008, 11:07 PM
thanks for the replies everyone. lots of great info

jfkimberly - yeah my back curve definitely makes my stomach look bigger than it really is. I feel all twisted about. I don't experience any pain but it is very uncomfortable.

i don't notice any kyphosis but my endocrinologist did mention that I had a slight hump at the shoulders.

does the shortened torso lead to a decrease in height? visually i feel shorter but that could be because of my posture. Even when standing up i have kind've a slumped posture.

do you know what organs can be squished about? I've had numbness and weakness in the groin since my lordosis developed. Also..pretty bad ED.

for my AGHD i've been prescribed growth hormone. It's a daily injection i've been on for about a month now.

alex7373
10th February 2008, 11:09 PM
Originally posted by GillyG@Feb 10 2008, 09:59 PM
Hi Alex :welcome:

I would definitely agree you need to see an orthopaedic spinal specialist and get some X-rays done to see exactly what's going on. As Kim says, if we know where abouts you are we'll probably know one of the 'good guys' we can suggest for you.
thanks for the welcome :)

i'm in Los Angeles

jfkimberly
10th February 2008, 11:14 PM
Yep. As your curves progress, you'll find yourself losing height, rather than gaining. Imagine taking a straight piece of wire of a certain length... now bend it into an S. End to end straight measurement is shorter than it was before. That wire is your spine. Even if your full-length legs are beneath it, you've still lost the length of your spine. Only now you're less proportional because you've got full-length legs and a shortened torso. It's all very frustrating.

Pretty much every organ in your torso will be competing for space. With kyphosis, you'll especially have difficulty with your lungs, because they take up pretty much the whole of your chest cavity, which is slowly folding in on itself... you could also have your heart squished a bit.

I also have pressure on my stomach and can't eat very large meals. Instead, I am supposed to eat smaller meals more frequently. I'm too lazy to bother fixing them, though, so I just end up eating less. That might be why I only weigh 40kg. *sigh*

You need to mention the numbness/weakness and ED to your spinal specialist ASAP. This could be unrelated, or it could be a sign of neurological involvement, which would necessitate more urgent treatment. Please get that referral soon!


ETA: Oh! You're in the US! Hrm. That changes the referral process. Good insurance?

alex7373
10th February 2008, 11:34 PM
Originally posted by jfkimberly@Feb 10 2008, 10:14 PM
Yep. As your curves progress, you'll find yourself losing height, rather than gaining. Imagine taking a straight piece of wire of a certain length... now bend it into an S. End to end straight measurement is shorter than it was before. That wire is your spine. Even if your full-length legs are beneath it, you've still lost the length of your spine. Only now you're less proportional because you've got full-length legs and a shortened torso. It's all very frustrating.

Pretty much every organ in your torso will be competing for space. With kyphosis, you'll especially have difficulty with your lungs, because they take up pretty much the whole of your chest cavity, which is slowly folding in on itself... you could also have your heart squished a bit.

I also have pressure on my stomach and can't eat very large meals. Instead, I am supposed to eat smaller meals more frequently. I'm too lazy to bother fixing them, though, so I just end up eating less. That might be why I only weigh 40kg. *sigh*

You need to mention the numbness/weakness and ED to your spinal specialist ASAP. This could be unrelated, or it could be a sign of neurological involvement, which would necessitate more urgent treatment. Please get that referral soon!


ETA: Oh! You're in the US! Hrm. That changes the referral process. Good insurance?
Hi

Yeah I have insurance but it's not the best.

I can't eat very large meals either. I used to be a big eater. Now if I eat too much which usually isn't alot i will start gagging.My stomach seems to get full much faster and also after a meal my stomach is distended more than it should be. I'm 5' 9 185 but i'm told i look like i'm 30 lbs heavier.

I have actually seen a neurologist. He did a nerve conduction test and when it came back normal he said there was nothing wrong with me and that I should see a psychiatrist. I was pretty shocked. Even more shocked when I got his bill and my ins wouldn't cover the test and I was billed 1,200.

I've seen a total of 8 different doctors none of which knew much about lordosis. I didn't know the term lordosis at the time , i just described what was happening. The neuro even said there was nothing wrong with my back. The first doc to take me seriously has been my endocrinologist and i'm actually getting some answers to my health problems.

i havn't seen a ortho though..my GP reffered me to a rheumatologist and he gave me some exercises to do.

jfkimberly
10th February 2008, 11:41 PM
I wonder... did you tell your GP about the numbness? Maybe he sent you to the rheumatologist for that.

If you can get a referral to a spinal specialist, it would be good to at least get xrays to see what you're dealing with. If your curves aren't too severe, then definitely see what the rheumatologist has to say about your symptoms. That might turn out to be a pretty good referral. But push for the ortho one, as well.

alex7373
10th February 2008, 11:45 PM
I'm not with that GP anymore. My insurance allows me to see a specialist without a refferal.

This was 7 years ago and the curve has gotten worse. They did take x-rays at the time and my GP said it was normal but i don't think he knew was he was looking for.

i found this office that is near me so i may make an appointment with them

http://www.thespinaldoctor.com/index.php?anchor=_affiliates

jfkimberly
10th February 2008, 11:51 PM
I just looked, and they seem to be a general spinal clinic... I don't have the reference site for you, but there are lists compiled by scoliosis patients... hold off on scheduling any appointments 'til you've found someone who specializes in scoliosis kyphosis/lordosis. We'll find you some names shortly.

alex7373
10th February 2008, 11:59 PM
great thanks :)

jfkimberly
11th February 2008, 12:13 AM
While we're waiting, you can start by doing a search here (http://www.srs.org/locator/locator.asp) (this may be the right resource... I just want more experienced people to back me up, because I don't hang out on other forums). When you get your search results, pay attention to what they say they specialize in. You don't want one for adolescents, since you're an adult, for example.

titch
11th February 2008, 06:40 PM
If you can reach San Francisco, then it would be worth seeing one of team at the UCSF medical school - Dr Serena Hu, Dr Sigurd Berven and Dr Deviren. They all deal with adults, and with extremely complex cases, so would definitely be a good place to start.

Possibly closer to you, there is Dr Behrooz Akbarnia, but I don't know much about him other than that he does deal with adults. Kimberly has found you the right resource for finding doctors in your region in any case, the SRS physician locator :-)

alex7373
13th February 2008, 04:59 AM
thanks for the link

san fran is a bit too far for me.

i found two doctors from that link that are near me

Neel Anand, MD
Institute for Spinal Disorders
(310) 423-9779
Cedar Sinai Medical Center
444 S San Vicente Boulevard, Suite 800
Los Angeles CA 90048
Adolescent, Adult Scoliosis, Aging Spine, Degenerative Conditions

&

Robert M. Bernstein, MD
Cedars-Sinai Medical Center
(310) 423-5224
444 S San Vincete Blvd
#603
Los Angeles CA 90048
Adolescent, Adult Scoliosis, Juvenile/Infantile

Kentish
15th February 2008, 03:26 AM
Sorry alex, I dont really know anything about lordosis but just wanted to welcome you you SSO :-)

jfkimberly
15th February 2008, 04:15 AM
Alex, you might review the NSF Forums (http://www.scoliosis.org/forum.php) and see if there are any patients who speak of their experiences with either of those doctors. Or you could just make an appointment with one or the other and see how it goes.

alex7373
27th March 2008, 06:20 AM
Well I went to get my back checked out. I went to one of the doctors listed from the link provided. I don’t want to name the Doc. He was a nice Doctor but I was disappointed by the lack of answers I got regarding why my back has been curving inward and forming a lordosis look.

When the Doctor first examined my back he noticed the inward curve. I forget what he said but it was something like “oh yes I see it..we’ll take x-rays” We took x –rays and then the doc went over the x-rays with me. My spine looked curved on the x-ray to me but when the Doc took some measuring tool to measure he said it was fine. I asked what I could do about my lordosis, what could have caused it etc and the Doc basically said there was nothing wrong with my back and because I didn’t have pain there was nothing they couild do.

It gets to the heart of how Doctors think. The Doc’s initial evaluation of my back prompted him to say that there was indeed an inward curve. But the x-rays by his evaluation showed normal curve.

I brought up the term lordosis but was told lordosis is just the name for the natural curve of a back.

The good news is I have x-rays and I took an MRI of lumbar spine so I have something to take with me if I choose to see a lordosis specialist.

jfkimberly
27th March 2008, 04:49 PM
Did he by any chance say anything about kyphosis (the outward curve of the upper spine)? Yes, it is natural to have some kyphosis and lordosis, but when it becomes exaggerated, then it can begin to cause problems. The good news, as you said, is you have a "baseline" set of x-rays now that you can refer to in a few years to demonstrate progression. Hold on to those.

I'm curious... did the specialist say nothing could be done, or did he say that your lordosis wasn't severe enough to bother to do anything since you don't have pain? I'm trying to get an idea of what your condition is, because surgeons do a cost-benefit analysis of it to determine whether it's worth the risks of surgery if you're not experiencing any problems (other than cosmetic) from it.

titch
27th March 2008, 10:28 PM
The normal range of lordosis is sometimes given to be 30-70° - 70° is really quite large, so if you're also someone with well developed gluteal muscles, it could look pretty big and yet still be (just!) within the normal range - so it may be that this is why he said he saw the curve, then assessed it after xray to be within normal range.

The doctor is correct that lordosis basically just refers to that curve of the spine - but then again, kyphosis basically just refers to the upper, outward curve. Yet, kyphosis is also used as a term when that curve is too big - similarly, people will be described sometimes as having lordosis when they have an excessive inward curve. Not all doctors will do this however, and it depends to a certain extent on how awkward they are. I've known people to be told quite specifically that they do not have flatback because they still have a certain amount of lordosis left, even when they have all the classic symptoms including being pitched forward by several inches.

About all I can really suggest is that you try to see someone else, and unfortunately to get a doctor who is highly skilled and experienced and knows how to really deal with adult deformity, that can mean travel. On the other hand, while it is upsetting to have something like this, as long as it is not causing you pain, it certainly wouldn't make any difference to wait a year or so now that you have baseline xrays and go to see someone else then.

I'm sorry your appointment wasn't more satisfying or useful.