Kyphosis

Your spine is a complex structure made up of individual bones called vertebrae, separated by discs that act as cushions. These vertebrae are stacked from the base of your skull down to your pelvis. They form natural curves that support your posture and allow movement. However, when the curvature of your upper spine becomes exaggerated, it can lead to a condition called kyphosis.

What is Kyphosis?

Kyphosis is an excessive outward curve of the upper spine. It makes you look hunched or slouched. This condition is often mild and needs no treatment. But, if it worsens, you may have pain, breathing issues, or other health problems.

Types of Kyphosis

There are several types, each with its own causes and characteristics.

Postural kyphosis

This is the most common type. It typically occurs during adolescence due to slouching or poor posture. The ligaments and muscles that hold your vertebrae in place can stretch. This pulls your vertebrae out of their normal position and causes a rounded shape in your spine. It usually doesn’t cause pain or long-term health issues. You can often fix postural kyphosis. Focusing on better posture and strengthening your muscles is key.

Scheuermann’s kyphosis

Scheuermann’s kyphosis occurs when the vertebrae are unusually shaped. Instead of being rectangular, they are wedge-shaped. This causes them to curve forward, giving the spine a rounded appearance. It often occurs in teenagers and may be painful, especially during physical activity or prolonged sitting.

Congenital kyphosis

This form is present at birth and occurs when the spine doesn’t develop properly in the womb. The curvature can worsen as the child grows, and surgery may be needed to correct it.

Cervical kyphosis

Cervical kyphosis affects the neck region, from the bottom of your head to the upper neck. In this type, the spine curves forward instead of its natural backward curve. It can lead to neck stiffness, pain, or even nerve compression.

Hyperkyphosis

This type involves a forward curve of the spine greater than 50 degrees. Hyperkyphosis is most often seen in older adults. It is commonly caused by age-related conditions, such as osteoporosis, which weakens the spine.

Causes of Kyphosis

The reason why someone has this condition varies depending on the type and can include:

• Poor posture—especially in postural kyphosis
• Aging and associated bone loss, known as osteoporosis
• Abnormal vertebral shape
• Spinal injuries
• Congenital conditions affecting spinal growth

Symptoms of Kyphosis

Symptoms can range from mild to severe. Common signs include:

• Rounded shoulders or a hunched upper back
• Tightness in the back and hamstrings
• Back pain or stiffness
• Fatigue or difficulty standing for long periods

In severe cases, you may experience difficulty breathing, numbness or tingling in your legs, or even incontinence. If you notice any of these symptoms, it’s important to have a doctor evaluate you right away.

Diagnosis

Diagnosing this condition begins with a physical exam, where your doctor will assess the curve of your spine and check for flexibility. They may ask you to perform a forward-bending test to get a better view of your spine’s curve. Additional tests may include:

• X-rays to measure the degree of spinal curvature
• MRI to determine if the curve is affecting your spinal cord or nerves
• Pulmonary function tests to check for breathing difficulties caused by the curvature

A normal spinal curve falls between 20 and 45 degrees. If the curve exceeds 50 degrees, your doctor will diagnose you.

Kyphosis Treatment

Treatment depends on the type and the severity of the condition:

• Exercise and physical therapy can help. They can strengthen your back and core muscles. This improves your posture and reduces pain, especially with postural kyphosis.
• Anti-inflammatory medications like ibuprofen (Advil, Motrin) and naproxen (Aleve) can help reduce inflammation and relieve discomfort.
• Bracing can help prevent the curve from worsening in children with Scheuermann’s kyphosis.
• Surgery may be necessary in severe cases. Spinal fusion is the most common procedure used to straighten and stabilize the spine. A kyphoplasty procedure may be another, less invasive option.

Prevention Tips

Not all kyphosis can be prevented. But good posture and strong back muscles can lower your risk of postural kyphosis. Other preventative measures include:

• Using proper lifting and carrying techniques
• Maintaining a healthy body weight
• Regular exercise to improve strength and flexibility

If you notice a spinal curve affecting your posture, it’s time to make an appointment with a specialist. They can evaluate your symptoms and recommend steps to improve and manage underlying issues.

Can kyphosis worsen with age?

Yes, particularly in cases of hyperkyphosis. Age-related conditions like osteoporosis can weaken the spine, increasing the forward curvature as you age.

Is surgery the only option for kyphosis?

Not always. While surgery may be recommended for severe cases, especially those causing pain or breathing issues, non-surgical treatments like physical therapy may help in less severe cases.

Can kyphosis affect my breathing?

Yes, in severe cases, the forward curvature of the spine can compress the lungs, making it difficult to breathe. This is more common in hyperkyphosis or Scheuermann’s kyphosis.

Can kyphosis lead to other spinal problems?

It does not directly cause other spinal conditions. However, it may be present alongside scoliosis. It may also increase your risk of spinal fractures due to weak bones.

Shane Mangrum, MD

Christopher Tomaras, MD

David Tran, MD

Raymond Walkup, MD