Kyphosis

What is Kyphosis?

Kyphosis is a condition in which your upper spine develops an exaggerated curve that makes your back rounder than usual. It gives you a slouched or hunched-over look. It’s sometimes called “roundback,” or in serious cases, “hunchback.”

Your spine includes 33 bones called vertebrae. Its slight curve helps you stay upright and balanced.

Normally the spine curves between 20 and 45 degrees. With kyphosis, the curve is bigger -- more than 50 degrees.

Most of the time, kyphosis doesn't cause any problems and you don't need to treat it. Sometimes it's not even noticeable. Rarely, the curve can be severe enough to cause pain or affect your breathing.

If the curve gets worse, hurts, or makes you uncomfortable with your appearance, your doctor can fix it. The type of treatment you need depends on your age, the kind of kyphosis you have, and how it affects you.

Types of Kyphosis

Kyphosis comes in a few different kinds. The most common ones are:

Postural kyphosis. This type usually develops during the teenage years when kids slouch. The curve disappears when they stand up straight. Postural kyphosis usually doesn't get worse or cause problems.

Age-related kyphosis. As you get older, the bones of your spine can weaken from osteoporosis, degenerative disk disease, or small fractures. This creates a hunched appearance.

Post-traumatic kyphosis. Fractures to your spine can damage the vertebrae and cause the spine to curve.

Scheuermann's kyphosis. Normal vertebrae are rectangular. But in this type of kyphosis, they are wedge-shaped. The unusual shape pushes the bones together, which makes the spine curve forward. Scheuermann's kyphosis usually starts during the teenage years and gets worse over time.

Congenital kyphosis. This type happens when a baby's spine doesn't form normally in the womb. The curve gets worse as the child grows.

Kyphosis Symptoms

Your symptoms depend on which type of kyphosis you have. Postural kyphosis may not cause any symptoms, other than a slight rounding in your back when you slouch.

More serious forms cause a visible rounding or hump in the back, along with symptoms like:

Back pain

Stiffness in the spine

Rounded shoulders

Different-height shoulders

Weakness, numbness, or tingling in the legs

Tight hamstrings (muscles in the backs of the thighs)

Trouble breathing or swallowing

Having a hard time walking

Kyphosis Causes

You're more likely to get kyphosis as you age. Wear and tear can weaken the bones of the spine to the point that they crack or shorten. Kyphosis from poor posture or a birth defect mainly affects children and teens.

Conditions that can cause kyphosis include:

Osteoporosis

Fractures of the spine

Shrinking of the disks that cushion the vertebrae

A problem with the way the spinal bones develop in the womb

Scheuermann's disease -- a disorder of the spine that affects children

Cancer in the spine

Disorders that affect connective tissue, including Ehlers-Danlos syndrome and Marfan syndrome.

Kyphosis Diagnosis

Scoliosis screenings at school often uncover kyphosis in children. To confirm the diagnosis, your doctor will ask you or your child to bend forward and then will look for a curve in the back.

An X-ray can help your doctor see the spinal bones more clearly and check the degree of the curve. This test will show any changes to the vertebrae, including breaks. An MRI can show whether any growths are putting pressure on the nerves of the spine.

If you've had symptoms like weakness, numbness, or tingling, your doctor may do a neurological exam to check your reflexes and muscle strength. For symptoms like breathing problems, a pulmonary function test can check how well your lungs work.

Kyphosis Treatment

You or your child may not need treatment for a mild curve that doesn't cause symptoms. Your doctor should check the curve over time with exams and X-rays to make sure it doesn't get worse.

If the curve is large or it causes pain, physical therapy may help. The therapist will teach you exercises to improve your posture and strengthen the muscles in your belly that support your spine.

Kids with Scheuermann's kyphosis may get a brace to wear for a few hours each day. It can straighten the curve in a child who’s still growing. A brace won’t correct kyphosis for an adult, but it may help with the pain.

You can try an over-the-counter, non-steroidal anti-inflammatory pain reliever (NSAID) like ibuprofen or aspirin.

Surgery can also reduce the curve and prevent it from getting worse in both children and adults. It may be an option if you or your child has:

Severe back pain that doesn't improve with other treatments

Congenital kyphosis

Scheuermann's kyphosis that causes a curve of more than 75 degrees

Serious complications

Spinal fusion is the surgery that doctors use most often. During this procedure, the surgeon lines up the bones of the spine and fuses them together to stop them from moving. They fill in the spaces between the vertebrae with small pieces of bone. Metal screws, plates, or rods hold the spine in place while it heals.

Kyphosis Complications

Without treatment, kyphosis is likely to get worse over time. That can lead to serious complications including:

Lung, digestive, and heart problems: A serious spine curve can compress organs in the chest and abdomen. That can make it hard to breathe and cause acid reflux or trouble swallowing. It can even affect heart function.

Nerve damage: If your vertebrae aren’t lined up the way they should be, they can pinch the nerves that run down your spine. That can cause numbness, weakness, or tingling in your legs and feet, loss of balance, or even loss of control of your bladder and bowels.

Physical limitations: Serious kyphosis can make it hard to walk, lie down, or get out of a chair. You may not be able to sit normally or tilt your head to look up.

Emotional issues: Young people especially may have trouble with body image.

Kyphosis Outlook

Mild kyphosis shouldn't have any impact on your life. Severe kyphosis can cause deformity, pain, and breathing problems, but surgery can correct it. Once you or your child gets treatment, it's important to follow up with your doctor regularly to check for changes in the spine.

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