Kyphosis

Kyphosis is a spine curvature, and it can be abnormal.

What is Kyphosis?

The kyphosis definition is an “exaggerated outward curvature of the thoracic region of the spine resulting in a rounded upper back”.¹ It is a “forward rounding”, and although some curvature is normal, this degree of rounding is not. While it can be most commonly found in older women, it can occur at any age. The age-related curvature is typically due to osteoporosis, which weakens bones and leads them to compress and crack. Kyphosis can also be found in teens or infants, due to spinal malformation or “wedging of the spinal bones over time”. If the kyphotic curve is mild, there may be no symptoms, but a large degree of rounding can be painful and disfiguring. Treatments depend on the cause, effects, and age. Symptoms are usually stiffness and back pain. It is important to seek treatment if the curve increases significantly. When the upper back vertebrae become “wedge-shaped”, this deformity leads to the abnormal rounding. This situation can be caused by osteoporosis bone thinning, as noted before. Older adults, especially women, are most affected, as are patients who have taken too many higher doses of corticosteroids. Another cause of kyphosis is disk degeneration. When the disks between the vertebrae dry out, they shrink, and this worsens the condition. Scheuermann’s kyphosis (Scheuermann’s disease) is another curved spine cause that occurs during the pre-puberty growth spurt. This impacts boys more than girls. Spine curvature may also be a result of birth defect, various other syndromes (Prader-Willi disease, Marfan syndrome), and cancer or cancer treatments (chemotherapy, radiation). Sometimes spinal curves are just caused by slouching, and this type is called “postural kyphosis”. It is commonly found in teenagers. The complications of this disorder include body image issues, back pain, and decreased appetite, due to the compressed abdomen.²

Types of Kyphosis

Postural kyphosis is the most common form of the disorder, and it is typically found in adolescent girls. Due to the poor posture and weakened ligaments and back muscles, the patient will experience muscle fatigue and pain. It does not lead to a more severe curvature, and there is little chance of pulmonary, neurologic, or cardiac problems. Scheuermann’s kyphosis is also found during adolescence, as previously noted. It is a “structural deformity of the vertebrae”. In fact, Scheuermann’s disease is more likely to be the cause of scoliosis than any other kyphosis type. Congenital kyphosis is the most uncommon type, and it is due to abnormal development before birth. Adults can develop a curved spine from compression fractures, osteoporosis, ankylosing spondylitis, degenerative arthritis, spinal tumors, and spinal infections.³ Some types of paralytic disorders (cerebral palsy, muscular dystrophy, polio) could lead to kyphosis. The condition can also develop after spine surgery, such as from an unstable spinal fusion that causes spinal collapse.⁴ Cervical kyphosis is a curve in the neck area of the spine. Typically, the neck has an inward curve, or lordosis, and the abnormal condition is a reversal to a forward curve.⁵ Thoracic kyphosis occurs when the rib cage area of the spine has a more exaggerated curve, which leads to a hump, sometimes called “dowager’s hump, hunchback, roundback, or humpback”. Kyphosis can also affect the lumbar region (lower back). Having a kyphosis in the upper back can lead to the hunched appearance, trouble standing up, fatigue, pain, and even a loss of height.⁶

Kyphosis Exercises

Exercises and chiropractic care can improve the rounded back. Strong back muscles can “counteract the forward pull on the spine” leading to a decrease in “the angle of kyphosis”. In a study, one year of exercise demonstrated that “the progress of kyphosis in women ages 50 to 59 was delayed” in comparison to the patients who did not perform the “extension exercises”. One chiropractor recommended five exercises. The first is called “Mirror Image”, which is performing the “opposite movement of the posture that you are trying to correct”. The patient should be standing against a wall and tucking the chin while bringing the head over the shoulders, pulling the shoulder blades down and back. Another is “Head Retraction”, in which the patient lies on the floor and pulls the chin down, like a double chin. “Superman” is an exercise on the stomach, in which the patient extends the hands in front, lifting the arms and legs while looking down. In “Life Extension”, the patient stretches the tight chest muscles while strengthening the back muscles. While standing and engaging the core, with the shoulders down and the chest up, the patient should raise the arms up like a “Y” and breathe. “Thoracic Spine Foam Rolling” is done while the patient lies on the floor with a foam roller across the mid-back. The patient gently rolls over the foam roller to massage the back muscles.⁷ Sometimes athletes, such as weight lifters, can experience kyphosis due to muscle imbalances. If it is untreated, the athletes may no longer be able to do shoulder presses or other overhead exercises. One exercise to try is “shoulder packing” in which the person stands up straight and pulls the shoulder blades down and back, while keeping the abs tight. The “bird dog” is performed by being on “all fours” and raising the “right arm and left leg simultaneously”, while balancing, and then switching sides. This is an exercise that is done in Pilates and yoga classes, as well. Another option is the “wall stretch” in which the person stands “one side against the wall, the arm up and palm flat against the wall, then turn(s) to face away from the upturned arm”. This is done for both sides of the body.⁸

Chiropractic Care

Surgical treatment is not necessarily required for curved backs. Chiropractors can not only help patients learn special exercises to treat their condition, but they can use spinal manipulation (gentle thrust) to provide relief and alignment. Another technique that might be used is flexion-distraction, which is a non-thrusting and gentle manipulation. Some patients may benefit from instrument-assisted manipulation, in which the chiropractor uses a “hand-held instrument to apply force without thrusting”. Additional manual therapy treatments could also be employed, such as trigger point therapy, “manual joint stretching and resistance techniques”, and instrument-assisted therapy for the soft tissues, such as the Graston technique. In the latter, there are “gentle, repeated strokes of the instrument” over the injured area. Some other ways to reduce inflammation include ultrasound and “interferential electrical stimulation”, which “uses a low frequency electrical current to stimulate muscles”.⁹