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M40.5 Lordosis – Causes, Symptoms & Treatment
M40.5 is the ICD-10 code for lordosis, an excessive inward curvature of the spine, most commonly affecting the lumbar (lower back) region.
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M40.5 is the ICD-10 code for lordosis, an excessive inward curvature of the spine, most commonly affecting the lumbar (lower back) region.
What is M40.5 – Lordosis?
M40.5 is the ICD-10 diagnosis code for lordosis, a type of spinal curvature. In lordosis, the spine curves excessively inward, most often in the lumbar (lower back) region, creating what is commonly known as hyperlordosis or swayback. A certain degree of lordotic curvature in the lumbar and cervical spine is normal and necessary for balance and movement. However, when this curvature becomes excessive, it can cause pain and functional problems.
Causes
Pathological lordosis can develop from a variety of causes, including:
- Muscle imbalances: Tight hip flexors combined with weak abdominal or gluteal muscles are among the most common contributors.
- Sedentary lifestyle: Prolonged sitting can weaken core muscles and encourage poor posture.
- Obesity: Excess abdominal weight shifts the center of gravity forward, increasing lumbar curvature.
- Pregnancy: The growing abdomen often causes a temporary increase in lumbar lordosis.
- Spinal conditions: Spondylolisthesis (vertebral slippage), disc herniation, or degenerative disc disease can contribute to or worsen lordosis.
- Congenital anomalies: Rare structural abnormalities of the spine present from birth.
- Metabolic bone diseases: Conditions such as rickets or osteoporosis may affect spinal alignment.
Symptoms
Many individuals with mild lordosis experience no symptoms. When the curvature is more pronounced, the following may occur:
- Lower back pain and muscle tension
- Restricted range of motion in the lumbar spine
- Numbness or tingling in the legs (if nerve compression is present)
- Visible protrusion of the abdomen and buttocks with a hollow lower back
- Accelerated wear of spinal joints (facet joint arthropathy)
Diagnosis
Lordosis is typically diagnosed through:
- Physical examination: The clinician assesses posture and spinal alignment in standing and supine positions.
- X-ray imaging: A lateral (side-view) X-ray of the spine allows precise measurement of the lordotic angle and evaluation of vertebral structures.
- MRI or CT scan: These are used when nerve involvement or underlying structural pathology is suspected.
The ICD-10 code M40.5 is assigned by the treating physician when a clinically relevant lordosis is confirmed.
Treatment
Treatment depends on the underlying cause and severity of the curvature:
- Physiotherapy: Targeted exercises to strengthen the core, abdominal, and gluteal muscles, combined with stretching of shortened hip flexors, form the cornerstone of treatment.
- Postural correction: Ergonomic adjustments in daily life (e.g., workstation setup, sitting habits) help reduce postural strain.
- Weight management: Reducing excess body weight significantly decreases mechanical load on the lumbar spine.
- Pain management: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac, as well as heat therapy, may be used for acute pain relief.
- Orthotic devices: Back braces may provide support in selected cases.
- Surgery: Surgical intervention is rarely required and is reserved for severe structural causes or neurological complications.
References
- World Health Organization (WHO): ICD-10 Version 2019, Chapter XIII – Diseases of the Musculoskeletal System and Connective Tissue, M40.5 Lordosis. URL: https://icd.who.int/browse10/2019/en
- Standaert, C.J. & Herring, S.A.: Expert opinion and controversies in musculoskeletal and sports medicine: Spine disorders. Archives of Physical Medicine and Rehabilitation, 2009.
- Kisner, C. & Colby, L.A.: Therapeutic Exercise: Foundations and Techniques. 7th edition. F.A. Davis Company, Philadelphia, 2017.
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