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Kyphosis - Types, Causes, Symptoms, Diagnosis, and Treatment

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Are you embarrassed about your hunchback? Read this article to seek ways to improve your posture and to reverse kyphosis.

Medically reviewed by

Dr. Suman Saurabh

Published At March 14, 2022
Reviewed AtJune 6, 2023

What Does Kyphosis Mean?

Kyphosis, otherwise called hunchback or roundback, is when the upper portion of the spine has severe curvature. The part of the spine present in the upper back (thoracic region of the spine) is slightly curved naturally. But, extensive curvature results in a prominent hump in the upper back, and it can appear rounded or protruding from the side. Individuals affected with kyphosis slouch and have a visible rounding of the shoulders. This abnormal spine curvature puts excess pressure on the spine, leading to back pain, stiffness, and altered gait. Sometimes, the person might find it hard to breathe due to pressure on the lungs. This condition can occur at any age but is more common in teenagers and older women. Dowager's hump is used to describe kyphosis in older women. Weakness in the spinal bones is to be blamed for age-related kyphosis, and kyphosis in infants or adolescents is due to the spine's malformation.

The spine naturally has a series of inward curves in the neck and lower back when seen from the side, which helps in the absorption of shock due to the body weight and supports the head's weight and is called lordosis or lordotic curvature. The upper back spine has a slight outward curvature called kyphosis, and hyperkyphosis is when this curvature is abnormal. But in everyday usage, a prominent or abnormal bend in the upper back is called kyphosis.

Mostly, kyphosis does not cause severe complications and does not require treatment. Sometimes, a back brace might be needed to strengthen the spine. In severe kyphosis cases, surgery might be required to reduce excessive curvature and relieve pressure on the lungs.

What Are the Types of Kyphosis?

There are three main types of kyphosis:

  1. Postural - The most common form and is caused by poor posture. You have to maintain the natural curvature of the spine at all times, and slouching too much can result in this abnormal curvature. It is mostly seen in adolescent girls.

  2. Congenital - It is the rarest form of kyphosis and is caused during fetal development. Here, vertebrae are fused, which can worsen with age.

  3. Scheuermann's Kyphosis - Otherwise called Scheuermann's disease. When the vertebrae's front portion does not grow as fast as the back, the bones take a wedge shape, resulting in this type of deformity. It can also involve the lower spine. It is commonly seen in adolescent girls.

What Are the Signs and Symptoms Associated With Kyphosis?

Mild cases of kyphosis make the patients self-conscious about how they look but do not cause health problems. In severe cases, it can result in:

  • Rounded or hunched back.

  • Back pain.

  • Upper back stiffness.

  • Tight hamstring.

  • Breathing problems.

These signs become evident after a growth spurt occurs around puberty. These symptoms do not worsen or progress with time and generally remain constant.

Rarely, the compression of the spinal cord and nerves can result in:

Sometimes, it can compress the heart and lungs, leading to chest pain and shortness of breath, leading to heart or respiratory failure.

What Causes Kyphosis?

The possible causes of kyphosis include:

  1. Aging - Aging, when combined with poor posture, is the main cause of kyphosis.

  2. Vertebral Fractures or Spinal Injury - Compression fracture of the vertebrae can result in abnormal spine curvature.

  3. Ehlers - Danlos syndrome and Marfan syndrome.

  4. Weak muscles in the upper back.

  5. Arthritis or bone degeneration diseases like ankylosing spondylitis.

  6. Herniated disc.

  7. Muscular Dystrophy - This genetic condition causes the weakening of the muscles, including the ones around the spine.

  8. Disc Degeneration - With age, discs that provide cushioning between spinal vertebrae shrink and result in kyphosis.

  9. Osteoporosis - A condition where the bones become thin, including the bones in the spine, making the vertebrae weak and prone to vertebral compression fractures. It commonly affects older women and people under prolonged corticosteroid treatment.

  10. Congenital Abnormalities - Sometimes, infants are born with spinal bone deformities.

  11. Cancer - Cancer of the spine can result in weakened vertebrae and increase the risk of compression fractures and kyphosis.

  12. Scoliosis - Abnormal spinal curvature sideways.

  13. Spine infection.

  14. Polio - Otherwise called poliomyelitis, it is caused by the poliovirus.

  15. Paget Disease - It is a chronic condition where there is excessive bone resorption, resulting in bone deformities.

When to Consult a Doctor for Kyphosis?

If your spine is abnormally curved, and you are experiencing pain, tiredness, or breathing problems, consult your doctor immediately. You might also experience flexibility problems and struggle to maintain proper posture.

How Is Kyphosis Diagnosed?

A physical examination, including height, is usually sufficient to diagnose kyphosis. You might be asked to bend forward so that the doctor can view the spinal curvature from the side. The doctor will assess your balance and range of motion by asking you to perform various stretches and exercises. You might also be asked to lie flat on a surface while the doctor examines the spine. If the spine remains curved, it is congenital or some other type of kyphosis, and if the spine straightens out, poor posture is likely the cause.

A neurological examination might be needed to check for muscle strength and reflexes. X-rays, CT (computed tomography) scans, and MRI (magnetic resonance imaging) might be needed to detect spine deformities.

What Are the Treatment Options of Kyphosis?

Most cases of kyphosis do not need treatment, as they are mild and do not result in any symptoms. For moderate to severe cases, treatment aims to prevent the worsening of the curvature and relieve symptoms. The treatment options include:

1) Non-Surgical Treatment

Physiotherapy is done to strengthen the muscles in the back and abdomen. This relieves pressure on the spine, improving posture. Postural and Scheuermann's kyphosis are usually treated with non-surgical treatment. A spinal brace can also be used to support the spine and correct posture, and help proper growth. But, braces are useful only when the spine is still growing. NSAIDs (nonsteroidal anti-inflammatory drugs) can help with discomfort.

2) Surgical Treatment

People with severe and congenital kyphosis might benefit from surgery. Spinal fusion is the most often used surgical option for kyphosis. Here, vertebrae are fused to form a single bone segment. And for severe kyphosis, rods, screws, and plates are inserted into the spine to correct the curvature.

What Are the Possible Complications of Kyphosis?

Back pain is the main complication associated with kyphosis. The other complications are:

  • Breathing difficulties due to pressure on the lungs.

  • Weak back muscles can affect a person's ability to do tasks like walking and standing up straight. It can also cause pain when looking up or lying down.

  • Compression of the digestive tract can result in acid reflux, digestive problems, and problems swallowing.

  • Teens and adolescents with kyphosis develop a poor body image due to a hunched back and rounded shoulders. This can lead to anxiety, social isolation, and depression.

  • Numbness or weakness in the arms and legs.

  • Loss of bladder and bowel control.

Conclusion:

Untreated or progressive kyphosis is known to be associated with complications that can significantly reduce your quality of life. In most cases, kyphosis is caused due to poor posture, so treating kyphosis early by strengthening the muscles of the back can help improve your posture and can prevent your condition from progressing.

For more information on the various treatment options for kyphosis, consult an orthopedician or physiotherapist online.

Frequently Asked Questions

1.

Is Kyphosis Curable?

Kyphosis refers to an abnormally curved spine caused due to poor posture. Some individuals may suffer from kyphosis from birth. Patients with congenital kyphosis may require surgical intervention to improve their posture. For other individuals, following a few exercises and consciously maintaining a proper posture may help treat kyphosis. 

2.

What Is the Recommended Sleep Position for Kyphosis?

Patients with kyphosis are advised to sleep on the back with a pillow under the upper back and head to prevent discomfort and promote better spine alignment. Alternatively, some individuals prefer sleeping on their side with a pillow rolled up between their knees to help with spine alignment. 

3.

Is Spine Straightening Possible?

Spine straightening refers to maintaining a proper alignment so that an individual does not suffer back pain. It relieves the symptoms and prevents further progression of spine curvature. Some degree of spine straightening is achievable with appropriate treatment. Non-surgical approaches like physiotherapy and yoga improve and strengthen the spine.

4.

Are All Individuals at Risk of Kyphosis?

Kyphosis affects people of all ages and genders. Some risk factors for kyphosis are mentioned below:
- Age - With age, most individuals are susceptible to kyphosis due to loss of bone density.
- Genetics - Hereditary kyphosis may run in families.
- Poor Posture - Frequent slouching and poor posture may result in undue stress on the spine.
- Trauma - Any trauma or injury to the spine from a car accident or fall affects the vertebrae and may potentially lead to curvature.

5.

Is It Possible to Fix Kyphosis Quickly?

It is not possible to fix kyphosis immediately as it may take a minimum of three months if an individual takes a non-surgical route. Maintaining good posture can help to fasten the treatment and relieve any pain symptoms. Surgical intervention may be recommended in patients with severe curvature to correct severe posture.

6.

What Yoga Poses Help Kyphosis?

Yoga cannot completely cure kyphosis but may help manage symptoms and promote better alignment. Some useful yoga poses are listed below:
- Cobra Pose - The pose involves bending the back muscles that promote spinal alignment.
- Triangle Pose - It helps stretch the spine and opens the chest muscles, which aids with spinal alignment.
- Child’s Pose - The forward bend helps to stretch the spine and reduces tension in the back.

7.

Which Age Is Mostly Affected by Kyphosis?

Many studies have suggested that older individuals, especially those above 50 years, are frequently affected by kyphosis. This is because bone density is lost as people age, which may result in osteoporosis. As the bones tend to be weak, they may result in spine curvature resulting in kyphosis.

8.

Does Physical Therapy Fix Kyphosis?

Yes, physical therapy plays a crucial role in strengthening the back muscles and is an effective treatment for people with kyphosis. Stretching relieves tension and improves the tone of back muscles. Understanding proper body mechanics improves posture and prevents further damage. 

9.

Is Height Affected by Kyphosis?

Yes, due to curvature of the spine, there are higher chances an individual may feel differences in height due to kyphosis. This can be corrected by treating the underlying cause and promoting good posture. Severe curvature of the spine may cause compression of the spinal vertebra. 

10.

Is It Possible to Prevent Kyphosis From Worsening?

Early diagnosis of kyphosis can prevent the condition from turning severe and causing unnecessary complications. Staying active and healthy has proven to improve the spinal alignment of an individual. Understanding body mechanics while lifting heavy objects is important to prevent spine injury.

11.

Does Walking Help Kyphosis?

Walking helps improve kyphosis as it is a form of exercise. It strengthens the muscles of the back and core and supports proper spine alignment. It is crucial to note that walking alone cannot completely cure kyphosis. Additional medical interventions like physiotherapy may help accelerate the healing process. 

12.

Can Kyphosis Occur Due to Sudden Changes?

No, kyphosis usually occurs gradually over time and is less likely to occur due to sudden changes. Trauma or spinal injury could be the only possible cause of sudden spine alignment changes. Regardless of the cause, if an individual experiences severe back pain, it is better to consult a doctor immediately. 
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Dr. Suman Saurabh
Dr. Suman Saurabh

Orthopedician and Traumatology

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