Kyphosis

Overview

Kyphosis is a forward rounding of the upper back. It makes the back look more curved than usual. A small curve is common and often harmless. A larger curve can cause pain or other problems.

Mild kyphosis is common, especially as people get older. More serious curves are less common.

It can affect children, teenagers, and adults. In older adults, it is often linked to bone thinning (osteoporosis) and small spine fractures.

Symptoms

Common symptoms

• A rounded upper back that may be more visible when you bend forward
• Back pain or stiffness, especially in the upper back
• Tiredness in the back muscles
• A change in posture or how clothes fit
• In larger curves, trouble breathing or feeling full quickly after eating

Symptoms in children

• A rounded upper back noticed during growth spurts
• Shoulders that look uneven or a head that leans forward
• Back pain, especially in teens with a structural curve
• Often no pain at all

Symptoms in older adults

• A curve that gets worse over time
• Back pain from small spine fractures caused by weak bones
• Loss of height
• Stiffness and trouble looking up or standing straight
• Balance problems or falls

Causes

Main causes

• Postural kyphosis: a rounded back from habit and weak back muscles; it can improve with exercise
• Scheuermann's disease: a growth problem in teenagers that causes wedge-shaped bones in the spine
• Osteoporosis: weak bones can break and collapse, making the spine curve forward
• Degenerative changes: wear and tear of the discs and joints in the spine
• Congenital problems: a spine that did not form normally before birth
• Other causes: injury, infection, or rarely a tumor in the spine

Risk factors

• Older age
• Osteoporosis or a family history of weak bones
• A family history of spinal curve problems
• Weak back and core muscles
• Previous spine injury or surgery
• Smoking and low physical activity, which can weaken bones

When to see a doctor

See a doctor urgently if:

• You have new weakness, numbness, or loss of bladder or bowel control — call your local emergency number
• You have severe trouble breathing
• You have severe back pain after an injury
• You have back pain with fever or feel very unwell

Book a routine appointment if:

• You notice a curve that is getting worse
• Back pain lasts more than a few weeks
• You have pain at night or unexplained weight loss
• Your child has a rounded back or uneven shoulders
• You feel unsteady or have trouble looking up

Diagnosis

A doctor will ask about your health, pain, and family history. They will look at your back and may ask you to bend forward. This helps show the shape of the curve. If needed, they may order imaging tests.

Tests that may be done

• X-rays of the spine
• Bone density scan if weak bones are suspected
• MRI or CT scan if there are nerve symptoms or a serious cause is suspected
• Blood tests to look for infection or other problems

What to expect at your appointment

You may be asked to stand and bend forward. The doctor may measure your height and check your balance and nerves. Most tests are quick and painless. Ask your doctor to explain what the results mean.

Treatment

Treatment depends on the cause and size of the curve. Most people do not need surgery. The goals are to relieve pain, keep you active, and stop the curve from getting worse.

Self-care at home

• Stay active with gentle exercise
• Strengthen your back and core muscles
• Practice posture checks during the day
• Use a firm mattress and supportive chair
• Take breaks from sitting and move often
• Ask your doctor or pharmacist before using pain relief

Medical treatments

A doctor may suggest physical therapy, a structured exercise program, or a brace for a growing child. They may treat the underlying cause, such as weak bones. Pain relief can be discussed with your doctor, but no specific medicine is recommended here. Regular check-ups can show whether the curve is changing.

When is surgery considered?

Surgery is rare. It may be considered if the curve is severe, keeps getting worse, or presses on nerves and causes weakness, numbness, or bladder or bowel problems. A spine specialist can explain the risks and benefits.

Living with this condition

Most people with mild kyphosis can do their normal activities. You may need to adjust how you sit, lift, and exercise. Keep your muscles strong and your bones healthy.

Lifestyle tips

• Keep moving and avoid long periods of sitting
• Do strength and balance exercises
• Make your home safer to prevent falls
• Keep a healthy weight
• Do not smoke

Diet and exercise

Eat a balanced diet with enough calcium and vitamin D for bone health. Ask your doctor if you need a supplement. Weight-bearing exercise and gentle stretching can help. A physical therapist can teach safe exercises.

Mental health and emotional wellbeing

A curved back can affect how you feel about your body. It can cause worry or low mood. These feelings are common. If you feel overwhelmed or have thoughts of harming yourself, contact your local emergency number or a crisis service right away.

Prevention

Not all kyphosis can be prevented. You can lower your risk by keeping your bones strong, staying active, and treating osteoporosis early. Good posture and back strength may help with postural kyphosis.

Vaccines

There is no vaccine for kyphosis.

Screening programmes

Bone density screening may be recommended for some older adults. Ask your doctor whether you need it. Children with a curve may need regular check-ups during growth.

Complications

If left untreated

• Ongoing back pain and stiffness
• The curve getting worse
• Breathing problems in severe curves
• Nerve symptoms such as weakness or numbness
• Balance problems and falls
• Poor body image or low mood

Long-term outlook

Most people with mild kyphosis do well. Exercise, posture changes, and treating weak bones can help. A larger curve may need monitoring. Surgery is uncommon, and many people stay active and comfortable.

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