Kyphosis: Causes, Symptoms and Diagnosis

What Causes Kyphosis?

Kyphosis, also known as roundback or hunchback, is a condition in which the spine in the upper back has an excessive curvature. The upper back, or thoracic region of the spine, is supposed to have a slight natural curve. The spine naturally curves in the neck, upper back, and lower back to help absorb shock and support the weight of the head. Kyphosis occurs when this natural arch is larger than normal.

If you have kyphosis, you may have a visible hump on your upper back. From the side, your upper back may be noticeably rounded or protruding. In addition, people with hunchback appear to be slouching and have noticeable rounding of the shoulders. Kyphosis can lead to excess pressure on the spine, causing pain. It may also cause breathing difficulties due to pressure put on the lungs.

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Kyphosis in elderly women is known as dowager’s hump.

Common causes of kyphosis

Kyphosis can affect people of any age. It rarely occurs in newborns because it’s usually caused by poor posture. Kyphosis caused by poor posture is called postural kyphosis.

Other potential causes of kyphosis include:

  • aging, especially if you have poor posture
  • muscle weakness in the upper back
  • Scheuermann’s disease, which occurs in children and has no known cause
  • arthritis or other bone degeneration diseases
  • osteoporosis, the loss of bone strength due to age
  • injury to the spine
  • slipped discs
  • scoliosis, or spinal curvature

The following conditions less commonly lead to kyphosis:

  • infection in the spine
  • birth defects, such as spina bifida
  • tumors
  • diseases of the endocrine system
  • diseases of the connective tissues
  • polio
  • Paget’s disease
  • muscular dystrophy
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When to seek treatment for kyphosis

You should seek treatment if your kyphosis is accompanied by:

  • pain
  • breathing difficulties
  • fatigue

Much of our bodily movement depends on the health of the spine, including our:

  • flexibility
  • mobility
  • activity

Getting treatment to help correct the curvature of your spine may help you reduce the risk of complications later in life, including arthritis and back pain.

Treating kyphosis

Treatment for kyphosis will depend on its severity and underlying cause. Here are some of the more common causes and treatments:

  • Scheuermann’s disease: A child may receive physical therapy, braces, or corrective surgery.
  • Infection: Your doctor will probably prescribe antibiotics for you.
  • Tumors: Typically, tumors are only removed if there’s concern for spinal cord compression. If this is present, the surgeon may try to remove the tumor, but frequently this destabilizes the bone. In such cases, a spinal fusion is often also necessary.
  • Osteoporosis: It’s essential to treat bone deterioration to prevent kyphosis from worsening.
  • Poor posture: You will not need aggressive treatments.
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The following treatments may help relieve the symptoms of kyphosis:

  • medication, to relieve pain, if necessary
  • physical therapy, to help build strength in the core and back muscles
  • yoga, to increase body awareness and build strength, flexibility, and range of motion
  • weight loss, to relieve excess burden on the spine
  • braces, especially in children and teens
  • surgery, in severe cases

Risks of untreated kyphosis

For most people, kyphosis does not cause serious health problems. This is dependent on the cause of the kyphosis. If kyphosis is caused by poor posture, you may suffer from pain and breathing difficulties. These will only get worse later in life.

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You can treat kyphosis early by:

  • strengthening the muscles of the back
  • seeing a physical therapist

Your goal will be to improve your posture long-term to decrease pain and other symptoms.

Spine Health. PROCEDURE 2 — LYING PRONE IN EXTENSION The patient, already lying prone, places the elbows under the shoulders and raises the top half of his body so that he comes to lean on elbows and forearms while pelvis and thighs remain on the couch. In this position the lumbar lordosis is automatically increased. Emphasis must be placed on allowing the low back to sag and the lordosis to increase. Fig. Lying prone in extension. Effects: Procedure 2 is a progression of procedure 1 and merely enhances its effects by increasing extension. Again, in derangement some time must be allowed to affect the contents of the disc and, if possible patients should remain in this position for five to ten minutes. In more acute patients sustained extension may not be well tolerated due to pain, and initially we must rely on the use of intermittent extension.
The Derangement Syndrome Of all mechanical low back problems that are encountered in general medical practise, mechanical derangement of the intervertebral disc is potentially the most disabling. It is my belief that in the lumbar spine, if in no other area, disturbance of the intervertebral disc mechanism is responsible for the production of symptoms in as many as ninety-five percent of our patients. Twenty-five years of clinical observation and treatment of lumbar conditions have convinced me that certain phenomena and the various movements which affect them, can occur only because of the hydrostatic properties invested in the intervertebral disc. For thirty years Cyriax has attributed lumbar pain to internal derangement of the intervertebral disc mechanism. He has outlined the cause of lumbago, and proposed that pain of a slow onset is likely to be produced by a nuclear protrusion while that of a sudden onset is caused by a displaced annular fragment. Although at present we are unable to prove either of ...
Spine Health. PROCEDURE 7 — EXTENSION MOBILISATION The patient lies prone as for procedure 1. The therapist stands to one side of the patient, crosses the arms and places the heels of the hands on the transverse processes of the appropriate lumbar segment. A gentle pressure is applied symmetrically and immediately released, but the hands must not lose contact. This is repeated rhythmically to the same segment about ten times. Each pressure is a little stronger than the previous one, depending on the patient’s tolerance and the behaviour of the pain. The procedure should be applied to the adjacent segments, one at a time, until all the areas affected have been mobilised. Fig. Positioning of hands prior to extension mobilisation. Extension mobilisation. Effects: In this procedure the external force applied by the therapist enhances the effects on derangement and dysfunction as described for the previous extension procedures. In general, symmetrical pressures are used on patients with central and bilateral symptoms. Therapist-...
The Derangements and Their Treatment DERANGEMENT ONE Central or symmetrical pain across L4/5. Rarely buttock or thigh pain No deformity In Derangement One the disturbance within the disc is at a comparatively embryonic stage. Due to minor posterior migration of the nucleus and its invasion of a small radial fissure in the inner annulus, there is a minimal disturbance of disc material. This causes mechanical deformation of structures posteriorly within and about the disc, resulting in central or symmetrical low back pain. The accumulation of disc material also leads to a minor blockage in the affected joint preventing full extension, but the blockage is not enough to force the deformity of kyphosis upon the joint. In patients with Derangement One the history, symptoms and signs are usually typical of the syndrome, and the test movements confirm the diagnosis of derangement. Because the disturbance within the joint is relatively small it responds well to the patients’ own movements, and the majority of pati...
Physical examination of the shoulder The shoulder girdle is composed of three joints and one “articulation”: the sternoclavicular joint the acromioclavicular joint the glenohumeral joint (the shoulder joint) the scapulothoracic articulation Fig. The shoulder girdle. Fig. The humerus has very minimal osseous support. Notice the shallow glenoid fossa in the shoulder as compared to the deep acetabular socket of the hip. All four work together in a synchronous rhythm to permit universal motion. Unlike the hip, which is a stable joint having deep acetabular socket support, the shoulder is a mobile joint with a shallow glenoid fossa. The humerus is suspended from the scapula by soft tissue, muscles, ligaments, and a joint capsule, and has only minimal osseous support. Examination of the shoulder begins with a careful visual inspection, followed by a detailed palpation of the bony structures and soft tissues comprising the shoulder girdle. Range of motion determination, muscle testing, neurologic assessment...