17671 Kyphosis

Overview

Kyphosis is a condition where the upper part of the spine curves forward more than usual. This is sometimes called a 'hunchback' curve. In a normal spine, there is a slight natural curve in the upper back. With kyphosis, that curve becomes exaggerated, which can affect posture and cause discomfort.

Yes. Some amount of forward spinal curvature is normal, and noticeable kyphosis is quite common, especially as people get older. Most cases are mild and do not cause serious health problems.

Kyphosis can affect people at any age. Teenagers may develop it from a growth condition called Scheuermann's disease. Older adults often get it from weak bones (osteoporosis) or from wear-and-tear in the spine. It also affects people who have had poor posture for many years.

Symptoms

Common symptoms

• A visible forward rounding of the upper back
• Aching or stiffness in the back, often after sitting or standing
• Tiredness or discomfort in the neck and shoulders
• In severe cases, a feeling of tightness or limited breathing

Symptoms in children

• A bump or hump on the back that becomes more obvious when bending forward
• Back pain that gets worse during sports or other activity
• Posture that looks poor even when they are trying to stand straight
• A stiff or rigid section of the spine

Symptoms in older adults

• A rounding back that becomes more noticeable with age
• A loss of height over time
• Back pain from muscles working harder to keep the body upright
• Difficulty standing up straight or looking ahead without tilting the head

Causes

Main causes

• Postural kyphosis: caused by long-term slouching or leaning forward during sitting or standing
• Scheuermann's disease: a growth disorder in teenagers that makes the vertebrae wedge-shaped
• Age-related changes: weakened vertebrae from osteoporosis or thinning of the bones
• Congenital kyphosis: a spine that doesn't form correctly before birth
• Less common causes: spinal injury, infection, or a tumour

Risk factors

• Being a teenager during a rapid growth spurt
• Being female, as osteoporosis is more common after menopause
• Repetitive activities that put stress on the spine, often from manual work or sports
• A family history of spinal disorders
• Long periods of poor posture, such as hunching over screens

When to see a doctor

See a doctor urgently if:

• You have sudden severe back pain and cannot move your legs normally
• You lose control of your bladder or bowels
• You notice a rapid change in the shape of your back, especially after an injury

Book a routine appointment if:

• You see a visible curve that is getting more noticeable
• Back pain affects daily activities or lasts for more than a few weeks
• You are concerned about your child's posture or a hump on their back

Diagnosis

A doctor will ask about your symptoms and medical history, then examine your back. They will look at your posture from the side, ask you to bend forward, and check for any tenderness or stiffness. Sometimes they will also check your nerve function.

Tests that may be done

• Physical examination to assess posture and movement
• X-ray, which is the main test used to measure the curve
• MRI if there is concern about the discs, nerves, or spinal cord
• Bone density test in older adults to check for osteoporosis

What to expect at your appointment

You will likely be referred to a specialist, such as an orthopaedic doctor, if the curve is significant or causing symptoms. Most tests are simple and painless. The doctor will discuss results with you and recommend the next steps.

Treatment

Treatment depends on the cause and severity of the curve. For many people, the focus is on improving posture, stretching tight muscles, and strengthening the back. Children with a growing spine might need a back brace. Surgery is only considered for severe curves when other treatments have not helped.

Self-care at home

• Sit and stand with your shoulders back and your head up
• Take frequent breaks if you sit at a desk for long hours
• Do gentle stretches and strengthening exercises recommended by a physiotherapist
• Choose a chair that supports the natural curve of your lower back
• For older adults, talk to your doctor about protecting bone strength

Medical treatments

Your healthcare provider may suggest physiotherapy to teach you safe and effective exercises. They can also advise on pain management, using medicines only after checking what is safe for you. In some cases, a back brace is helpful, especially for children who are still growing. For adults with osteoporosis, addressing bone health is an important part of treatment.

When is surgery considered?

Surgery is very rarely needed. It may be considered if a curve is very large (more than 70 degrees), causes severe pain, or affects the spinal cord or nerves. The operation involves straightening and fusing the spine. Only a specialist can decide if surgery is right for you.

Living with this condition

A mild kyphosis does not usually limit your everyday life. You can stay active and do most activities as normal. If pain flares up, gentle movement and rest in a comfortable position can help.

Lifestyle tips

• Stay active with activities like swimming, walking, or cycle-riding
• Keep a healthy weight to reduce strain on your back
• Set up your work or study area so your back is supported
• Try activities that improve flexibility and core strength

Diet and exercise

Regular exercise is good for your spine and your mood. A balanced diet with enough calcium and vitamin D helps keep bones strong, especially as you age. If you are unsure about which exercises are safe, a physiotherapist can advise you.

Mental health and emotional wellbeing

It is normal to feel self-conscious about a curved back, especially if other people can see it. Back pain can also make you feel frustrated or low. Remember that your worth is not about posture. Talking to someone you trust, or a counsellor, can make a big difference.

Prevention

You cannot always prevent kyphosis, especially if it runs in your family or is part of a growth condition. But you can reduce the risk of it getting worse by keeping good posture, staying active, and taking care of your bone health.

Vaccines

There is no vaccine for kyphosis.

Screening programmes

There is no routine screening for kyphosis in most health systems. However, a doctor can measure a curve during a regular check-up if there is concern.

Complications

If left untreated

• The curve may slowly get worse, especially in teenagers during growth
• Chronic back pain and stiffness can develop
• In severe curves, breathing may become more difficult because the chest is compressed
• Nerve compression can lead to weakness or numbness in the legs

Long-term outlook

The outlook for kyphosis is generally very positive. Most people manage well with simple treatments like exercises and good posture habits. Even when the curve is more significant, treatments are effective and surgery is usually successful for those few who need it. There is much you can do to stay active and comfortable.

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