What Is Kyphosis?
Kyphosis is a condition that results in an increase in the forward curvature of the upper portion of the spine (thoracic) along the sagittal plane. While it is normal for every person to have some degree of curvature of the spine, a Kyphosis causes the top of the back to appear more rounded than normal or abnormally curved or hunched.
Because the body must compensate for the spinal abnormality, in some cases of kyphosis, individuals may experience back pain, stiffness, tenderness, or tiredness. These symptoms may worsen over time and eventually result in challenges with breathing and eating normally.
Types of Kyphosis
There are five primary types of kyphosis, each resulting from different causes:
- Congenital Kyphosis: Typically affecting babies as their spines are developing, this form of kyphosis can be corrected with surgery. Congenital kyphosis may not be detected until the teenage years, making surgery higher risk of complications. Some links have been shown between kyphosis and cerebral palsy.
- Postural Kyphosis: Consistent bad posture can lead to muscle weakness and malformation, creating poor alignment. In older individuals, this can also be caused by osteoporosis or from spinal fractures that cause the bone blocks to collapse.
- Nutritional Kyphosis: Also known as metabolic kyphosis, this typically develops from the body’s inability to process nutritional minerals like calcium, phosphorus and magnesium that help to build up bone structure and make them strong. The result in mineral deficiencies is weak bones that are fragile and easily fractured.
- Scheuermann’s Kyphosis: This condition defines when the vertebrae becomes trapezoid shaped (instead of rectangular) and results in misshapen vertebrae stacking improperly creating curvature.
- Post-traumatic Kyphosis: Resulting from injury and breakage following an accident, the vertebrae are fractured causing bones to collapse and the spine to develop curvature.
Causes of Kyphosis
Made up of 24 rectangular-shaped bones called vertebrae, the spine is made of bones stacked one on top of the other separated by discs which act as shock absorbers. Ligaments are bands of tissue that hold the vertebrae together along with muscles, which protect the spine and provide strength for the back to perform day-to-day tasks. While it is normal for there to be natural curvature of the spine (this allows for space inside the chest for our organs), kyphosis is a condition wherein the middle section of the vertebrae (thoracic) develop an abnormal curvature.
Slouching, leaning, slumping, bad posture and carrying excessively heavy bags can all lead to the muscles and ligaments that support the vertebrae to stretch out of position. There are also conditions where the vertebrae don’t develop properly, either in the womb or over time as the spine is growing. Some of these cases may be genetic.
Additional conditions that may cause kyphosis are osteoporosis, spina bifida, muscular dystrophy, tuberculosis, Paget’s bone disease, cervical spondylosis and neurofibromatosis type1.
Risk Factors for Kyphosis
Age-related kyphosis and osteoporosis can lead to an increased risk of fractures in weakened bones. Physical therapy that focuses on proper posture and spine alignment as well as body-mechanic education can lower risk of bone-breakage and kyphosis.
Other conditions that can increase risk for developing kyphosis include spinal tumors, chronic disorders (such as Paget’s disease), genetics and genetic disorders (such as muscular dystrophy and spina bifida), spinal injury and infectious diseases (like polio or tuberculosis).
Screening for & Preventing Kyphosis
As children grow and the spine is developing, doctors typically perform basic examinations that monitor spinal development. There are certain exercises and movements that test balance and range of motion, as well as the shape of the spine that can help your doctor diagnose any worrisome curvature of the spine. These tests will also help the doctor determine whether the curvature is a result of bad posture or is a problem with the spinal structure.
If symptoms of kyphosis are present, doctors may perform an X-ray exam or other scans (like a CT or MRI) to help them monitor or diagnose the severity of the condition. Adults may also need a blood test to screen for tuberculosis or other infections, or a bone density scan to test bone strength.
Signs & Symptoms of Kyphosis
Early stages of kyphosis are often painless, when curvature is at a minimum. Severity of symptoms vary among individuals, with the more extreme cases resulting in difficulty breathing, and depletion of heart, nerve and intestinal functions. Less severe cases result in problems standing, sitting and walking. Some kyphosis patients may develop nerve pain due to compression along the spine. More extreme cases may require surgery.
Early detection can help with symptom management, and working with a spine specialist to monitor growth and curvature will help patients determine a long-term treatment plan.
Diagnosing Kyphosis
When signs of kyphosis are detected based on physical examination, doctors will confirm the diagnosis with an X-ray. Early detection will allow medical professionals and specialists to monitor the spine’s curve as the patient grows.
Treating Kyphosis
Only the most extreme cases of kyphosis will require surgical intervention. Most cases are managed with a combination of over-the-counter pain medication for general discomfort and physical therapy. By incorporating gentle exercises and stretching that promote back health, flexibility and muscle strengthening, kyphosis patients can typically help spinal formation.
Some young patients with extreme curvature may wear braces to correct the spinal malformation as they grow. Braces are designed to be convenient, allowing for a wide range of activity.
Living with Kyphosis
Young people with kyphosis will benefit from physical therapy and exercises that help stretch ligaments and muscles, and to develop strength around the affected vertebrae. Movements that focus on proper posture and spine alignment can lower risk of bone-breakage and severity of kyphosis.Body-mechanic education will help patients and their families feel supported, with an action plan to correct spinal malformations.
Adult and elderly patients with osteoporosis will also benefit from muscle-strengthening exercises and physical therapy, as well as gentle exercises like swimming, walking and yoga. Supplements and medication that promote bone-strengthening are also recommended.