Kyphosis - Definition and Treatment Options

Kyphosis is a condition involving a hunched back. Depending on its severity, there are medical and alternative treatments, such as chiropractic, available for the pain of this disorder.

What is Kyphosis?

Kyphosis is also known as “roundback or Kelso’s hunchback”, where the spine is overly curved in the upper back (thoracic vertebrae). This can be due to developmental problems, such as from Scheuermann’s disease, osteoporosis, trauma, compression fractures, or degenerative diseases, such as arthritis. In this disorder, the spine loses its “lordotic profile”, leading the back to bow and causing a slouch.¹ Kyphosis is measured with the Cobb angle, which is “the angle formed between a line drawn parallel to the…vertebrae above the fracture and a line drawn parallel to the…vertebra one level below the fracture”.² Most cases are mild, but debilitating and serious cases can lead to many additional problems, such as difficulties in digestion and breathing, pain, neurological and cardiovascular problems, and even a shorter life. The most severe cases tend to require strong interventions, such as spinal fusion surgery. There are a few classifications of this disorder. Postural kyphosis, which can also be known as “slouching” in young people, may be corrected with resolving muscular imbalances. In the elderly, this condition is called “hyperkyphosis”, and it can be caused by aging or fractures. Scheuermann’s kyphosis is a worse condition, and it can be very painful. It is a “form of juvenile osteochondrosis”, and it is found in teenagers. In this condition, patients cannot correct their own posture, and the curve in the spine is rigid. It is often more painful after standing or sitting for too long, or from physical activity. The vertebrae and disks no longer appear normal; they are wedge-shaped or herniated. Patients may feel fatigue and social isolation. Congenital kyphosis refers to infants whose spine did not develop properly. Nutritional kyphosis can happen with a lack of vitamin D, causing rickets and softened bones. Some people who have not had their fractures of the vertebrae corrected might develop post-traumatic kyphosis.³

Treatment Options

Medically, conservative kyphosis treatments range from body braces to physical therapy. The most complicated conditions can require spinal fusion surgery. This is especially true in the cases of vertebral collapse. Kyphoplasty is a less invasive surgery that “may arrest the deformity and relieve the pain”, and it is performed to restore the damaged vertebra. Spinal fusion surgery carries risks: tissue inflammation, nerve injuries, bleeding, and breathing difficulties. Some patients require multiplesurgeries, and the long-term outcome is unknown.⁴ Chiropractic care may help some patients with certain types of kyphosis. A recent case study examined chiropractic treatment for Scheuermann’s kyphosis. The patient had been taking pain medication to manage the pain of the condition. The chiropractic plan used cervical and thoracic spine manipulation, as well as physical therapy and exercises. The patient demonstrated “improvements in retraction of shoulders and anterior head carriage”. Patients can benefit from the pain relief and postural correction of chiropractic care. Chiropractic can help patients who might not be compliant with wearing their braces, and for those conditions that don’t warrant the risks of back surgery.⁵Patients with this hunchback condition should avoid certain physical activities that affect the thoracic spine, and chiropractic treatment should be customized for the type of kyphosis.⁶