Kyphosis

What is Kyphosis

Kyphosis is a spinal disorder. It involves an excessive outward curve of the spine that causes abnormal rounding of the upper back. It occurs when the spinal bones (vertebrae) in the upper back (thoracic spine) become wedge-shaped and cause deformity.

Kyphosis is sometimes called dowager’s hump, hunchback, or roundback. It is most common among elderly people, but it can occur at any age.

What are the causes?

There are four main types of kyphosis, which have different causes. They include:

  • Postural kyphosis. This type is caused by poor posture or slouching. It does not involve severe abnormalities in the bone structure of the spine. This is the most common type of kyphosis, and it usually becomes noticeable during adolescence.
  • Congenital kyphosis. This is caused when the spine fails to develop normally while in the womb. A person is born with this type of kyphosis.
  • Scheuermann kyphosis. In this type of kyphosis, several of the vertebrae are more triangular in shape for unknown reasons. The curved spine usually becomes noticeable during adolescence.
  • Osteoporotic kyphosis. This type is caused by thinning and loss of density in the bones (osteoporosis), which results in small breaks (compression fractures) in the thoracic vertebrae. The compression fractures cause these vertebrae to become wedge-shaped over time.

Other possible causes include:

  • Certain syndromes, such as Marfan syndrome or Prader–Willi disease.
  • Cancer and treatment for cancer. Cancer and its treatment can weaken the vertebrae and cause compression fractures.
  • Disk degeneration. This refers to the drying out and shrinking of the soft, circular structures between the vertebrae as part of the natural aging process.

What are the signs or symptoms?

The symptoms of kyphosis vary based on the cause and how severe the curve is (the severity). Symptoms may include:

  • Rounded shoulders.
  • A visible hump on the back.
  • Fatigue.
  • Back pain (usually mild).
  • Spine stiffness.
  • Muscle tightness in the back of the thighs (hamstrings).
  • Loss of height.

Severe symptoms of this condition include:

  • Loss of feeling in affected areas of the back.
  • Shortness of breath.
  • Weakness, numbness, or tingling in the legs.

How is this diagnosed?

This condition may be diagnosed based on:

  • A physical exam. Your health care provider may press on your spine to check for areas of tenderness. Severe cases of curvature will be noticeable by the rounding of the upper back. Milder cases may be harder to diagnose.
  • Your medical history. Your health care provider may ask about your general health and your symptoms.
  • X-rays.
  • MRI.
  • Tests of the nerves and nervous system (neurological tests).

How is this treated?

Treatment for this condition depends on your age and overall health, and the type and severity of your kyphosis. Non-surgical treatment may include:

  • Observation. Your health care provider may monitor your condition over time to make sure that it does not cause problems or get worse.
  • Physical therapy. This involves movements and exercises to strengthen the back.
  • NSAIDs to help relieve back pain, such as aspirin, ibuprofen, and naproxen.
  • Wearing a back brace to correct the curve.

Surgery (spinal fusion or kyphoplasty) may be recommended if:

  • You have congenital kyphosis.
  • You have Scheuermann kyphosis with a curve greater than 75 degrees.
  • You have severe back pain that does not improve with non-surgical treatment.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Exercise regularly. Ask your health care provider what activities and exercises are best for you. Keeping your back strong and flexible may help to relieve symptoms and prevent your condition from getting worse.
  • If physical therapy was prescribed, do exercises as instructed.
  • Maintain good posture.
  • If you were prescribed a back brace:
    • Wear the brace as told by your health care provider.
    • Remove the brace for bathing.
    • Avoid heavy lifting. Do not lift anything that is heavier than the limit that you are told until your health care provider says that it is safe.
  • Keep all follow-up visits as told by your health care provider. This is important, especially if your health care provider is monitoring your condition.

Contact a health care provider if:

  • You notice a round hump forming on your back.
  • You have pain that does not get better with medicine.

Summary

  • Kyphosis is a spinal disorder. It involves an excessive outward curve of the spine that causes abnormal rounding of the upper back.
  • Symptoms of kyphosis vary based on the cause and severe the curve is.
  • There are non-surgical and surgical treatments for kyphosis.
  • Exercise regularly. Ask your health care provider what activities and exercises are best for you. Keeping your back strong and flexible may help to relieve symptoms and prevent your condition from getting worse.
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