What is kyphosis?
Kyphosis, also called hunchback or round back, refers to the forward bend of the spine or backbone. This condition is evident while looking at the affected person from their side profile. It can occur at any age, although it is more common in adolescents. This forward slant of the spine makes people look like they are slouching.
The spine normally has 4 types of curvatures which are helpful in maintaining posture, balance and shock absorption & distribution. An excessive slant affects the posture and leads to other health issues. In most cases, kyphosis is mild and causes only aesthetic concerns but if excessive, it can lead to pain and breathing problems. An angle of kyphosis greater than 40 degrees is called hyperkyphosis.
What are the types of kyphosis?
- Postural kyphosis- This is the commonest form of kyphosis. It starts during the adolescent years and is more common among girls. Due to postural imbalance, the growing muscles that surround the spine develop differently. A slouched posture causes weakness of the extensor muscles and posterior ligaments of the spine, although the vertebrae tend to develop normally. In older individuals, the weakening of the surrounding muscles can contribute to poor posture
- Scheuermann’s kyphosis – There is a structural deformity in the spine that occurs before puberty, resulting in excessive bending. The vertebrae in people with Scheuermann disease are wedge-shaped, in contrast to the normal rectangular shape. This condition appears more in teenagers and boys are affected more than girls
- Congenital kyphosis – In people with congenital kyphosis, the spine fails to develop properly during pregnancy and hence they are born with a deformed spine. It gets worse as the child grows older and requires surgery to prevent the condition from worsening. This condition may be present along with other birth defects, such as deformities of the heart or the kidneys
What are the causes of kyphosis?
- Poor posture
- Structural deformities of the spine
- Developmental defects affecting the spine
- Old age
- Injury or fractures of the spine
- As a consequence of certain spine surgeries
- Congenital conditions such as Ehlers-Danlos syndrome (group of disorders that occur due to abnormal collagen synthesis)
What are the complications of kyphosis?
- Pain and stiffness in the back and shoulder regions
- Numbness and tingling sensation in legs
- Difficulties in breathing
- Difficulty maintaining balance
- Difficulty in digestion due to compression of the alimentary canal (in severe cases)
- Having trouble with bowel and bladder movements
- Poor self-image and low confidence (this is seen in teenagers)
What are the diagnostic tests for kyphosis?
Kyphosis is usually diagnosed on the basis of a physical examination. Your doctor asks you about your symptoms and performs these tests to confirm the condition –
- Adam’s forward bend test: In this, your doctor asks you to bend forward with your feet together, knees straight and arms hanging free by your side. This helps to see the curve of the spine.
In addition, you may also have to undergo a neurological examination where your doctor will test the functioning of your nerves.
- X-rays – Standing lateral spine X-ray
- MRI scan – To check for compression of the spinal cord and complications
- Pulmonary function test – To assess for any breathing difficulties
What is the treatment for kyphosis?
There are 2 treatment options for kyphosis – non-surgical and surgical. The plan of action depends on –
- Your age
- Any other medical conditions you have
- The type of kyphosis
- The severity of the condition
Non-surgical treatment options
- Physiotherapy – This helps strengthen the muscles, alleviates pain and improves posture
- Medicines – To relieve pain and inflammation. These include over-the-counter medicines such as paracetamol, NSAID or stronger painkillers in case of severe pain. Your doctor may also prescribe anti-osteoporotic medications in order to prevent fractures
- Back brace – This is recommended for children with Scheuermann’s kyphosis in order to arrest the progression of the condition
Surgery is recommended for people with severe kyphosis (curve greater than 750), congenital kyphosis, severe back pain and other signs of spinal cord compression.
What lifestyle adjustments would make it easier to cope with kyphosis?
- Exercise is an important element in coping with kyphosis. In addition to strengthening the core muscles in the back and abdomen, it increases your flexibility and eases your movement
- Maintain good posture
- Practice yoga
How do I prevent kyphosis?
- Maintain good posture while standing and sitting. Avoid slouching
- Carry heavy luggage, school books etc. in sturdy backpacks or roller bags
- Strengthen the core muscles of the back and abdomen through regular exercise