Kyphosis is an outward (convex) curvature of areas of the spine. There is a natural kyphosis in her chest and end area. The convex curvature of the spine only becomes pathological when it occurs in an atypical location or when the Cobb angle is no longer within the normal range.
What is kyphosis?
Kyphosis is an excessive convex curvature of certain areas of the spine. In many cases, the curves do not cause any discomfort. See AbbreviationFinder for abbreviations related to Kyphosis.
A convex (curving outward) curvature of the spine is called kyphosis. The stability of the entire spine requires the natural kyphosis of the thoracic and end spine as well as the natural lordosis (curved inwards) of the lumbar spine. Kyphosis only becomes pathological when it occurs in an atypical location or significantly exceeds the natural curvature. If the kyphosis of the thoracic spine is abnormally worsened, it is referred to as hyperkyphosis or colloquially as a hump.
In Latin it is called gibbus. The so-called Cobb angle serves as a measure for assessing kyphosis. The normal range is between 30 and 50 degrees. The lumbar spine can also be untypically affected by kyphosis. Normally it is concave (inwards). In the case of pathological changes, a flat back or, in extreme cases, even kyphosis of the lumbar spine is possible.
Causes
The causes of pathological kyphosis are mostly postural defects. During evolution, the human spine had to adapt to walking upright over the last 5 million years. This process is apparently not yet fully completed. The spine is not yet so stable that extreme curvatures during development can be ruled out. This is why excessive kyphosis is occurring more frequently among today’s population.
In industrialized countries in particular, kyphosis is aggravated by frequent sedentary work. Postural kyphosis, which is often caused by poor posture in youth, is the most common form of kyphosis. In old age it is referred to as dowager’s hump and here it is the result of vertebral fractures or loss of musculoskeletal integrity. Another possible cause is Scheuermann’s disease. Scheuermann’s disease is a misdevelopment of adaptation during puberty. A growth spurt occurs during puberty.
If the back vertebrae are loaded incorrectly when the muscles are weak, the vertebral bodies will grow unevenly. The outer part of the vertebrae grows faster than the inner part, causing them to become wedge-shaped. This develops an extreme curvature of the spine in the chest area.
There are also congenital forms of kyphosis. The vertebral bodies can be malformed or fused together. Sometimes congenital kyphosis does not appear until the teenage years. Diet- related kyphosis is also possible with a vitamin D deficiency. Kyphoses also occur as a result of tuberculosis or vertebral fractures that have not healed after accidents.
Symptoms, Ailments & Signs
Kyphosis is an excessive convex curvature of certain areas of the spine. In many cases, the curves do not cause any discomfort. However, they must be monitored and treated conservatively. However, sometimes there is severe pain, breathing problems, problems with digestion, cardiovascular disorders, neurological problems or even neurological failures in the form of paralysis.
Overall, life expectancy is reduced in the extreme forms of kyphosis. Possible long-term consequences include chronic pain with sleep disorders, destruction of the vertebrae, impairment of the internal organs, sensory disturbances, damage to the spinal cord up to symptoms of paralysis, reduced mobility or psychological stress due to the disfigurement.
Diagnosis & course of disease
Imaging procedures such as spine images, CT or MRT are available to diagnose the causes of kyphosis. The Cobb angle can be determined on lateral x-rays. These procedures allow to identify signs of old fractures. However, the anamnesis of the medical history plays an important role in the diagnosis in order to be able to differentiate between postural defects and organic causes of the kyphosis.
Complications
Kyphosis can lead to a number of health problems. The imbalance of the spine is usually accompanied by chronic pain, which can result in sleep disorders and mental illness. The mental stress often increases due to the cosmetic disfigurement and sometimes triggers depression and anxiety disorders in those affected.
In the long term, misalignments and subsequent fractures can occur, which can also put a strain on the internal organs (especially the lungs and heart). The spinal cord can also be damaged and sometimes cause paralysis and dysfunction. In general, mobility is limited with kyphosis. This can lead to problems in everyday life and at work.
The sensory disturbances that often occur as an accompaniment exacerbate these complications. In addition, complications can also occur during the operation of a kyphosis. Inflammation of the soft tissues, impaired breathing, postoperative bleeding and nerve damage can occur. Prescribed painkillers can cause side effects.
Temporary digestive problems, high blood pressure or infections often occur. Some people react to the preparations, which are supposed to relieve the symptoms, with side effects such as headaches, nausea, vomiting, intestinal bleeding or clouded consciousness. When multiple drugs are taken at the same time, interactions can occur.
When should you go to the doctor?
Kyphosis does not always cause symptoms. Nevertheless, monitoring by the doctor is necessary. If symptoms such as pain, difficulty breathing or digestive problems are noticed, kyphosis may be the cause and need to be investigated. Neurological problems and cardiovascular disorders are also among the warning signs that should be checked out by a doctor. Chronic pain, sensory disturbances and signs of paralysis indicate that the curvature of the spine is already advanced and must therefore be clarified. If further complications such as high blood pressure or infections are noticed, it is best to speak to a doctor immediately.
The same applies to chronic headaches, nausea, clouding of consciousness and other complaints that cannot be clearly attributed to an illness. People who suffer from postural disorders or who have been diagnosed with a condition such as Scheuermann’s disease often also develop kyphosis. Vitamin D deficiency, tuberculosis and poorly healed vertebral fractures also promote curvature of the spine and require a medical examination. Affected people are best advised to consult their family doctor or an orthopaedist. The individual symptoms must be treated by the responsible medical specialists.
Treatment & Therapy
The treatment methods for kyphosis depend on its causes. In most cases, conservative treatment is sufficient. Physiotherapy exercises are carried out regularly. During these exercises, the back and chest muscles are trained at the same time. A constant straightening of the spine is only possible with strong muscles. The exercises also include regular stretching of the spine to prevent the worsening of postural defects.
The standard therapy for Scheuermann’s disease and lumbar kyphosis in Germany is the use of the Schroth method. Three-dimensional exercise techniques for straightening the spine, breathing exercises to increase the respiratory volume and movement strategies for everyday life are carried out. Wearing corsets in adolescents with severe kyphosis has also proven effective. However, since the corset has to be worn 3/4 of the day, the cooperation of the young people is required, which is not always easy.
In extreme cases of kyphosis, only surgical treatment often helps. However, this can only be carried out on adults because the growth process has not yet been completed in adolescents. In the surgical treatment method, two to three vertebrae are fused to restore the full resilience of the spine. This method is also known as spondylodesis. Furthermore, of course, any underlying diseases must be treated.
Outlook & Forecast
The prognosis varies depending on the age of the patient, the severity of the symptoms and the deformity of the spine. The underlying disease, concomitant diseases and obesity are further factors in the prognosis. It is not uncommon for patients with kyphosis to live without major impairments in everyday life.
Postural kyphosis can go unnoticed for a long time, as symptoms often only become apparent after the patient has been in the wrong posture for a long time. If left untreated, it can lead to back pain, restricted mobility or breathing difficulties. With timely and consistent treatment, the prognosis is usually good.
Kyphoses caused by Scheuermann’s disease limit themselves at the end of the growth phase, but cannot be cured. The prognosis is often favorable, and early diagnosis can prevent serious deformities. Kyphoses caused by ankylosing spondylitis are rarely severe today. Starting therapy in good time and administering suitable medication prevent disability.
If the patient suffers from kyphosis due to bone loss, regular check-ups are important. Vertebral fractures caused by osteoporosis require urgent treatment as there is a high risk of further vertebral fractures. The prognosis is unfavorable for a kyphosis of more than 60%. Severe degeneration of the spine affects the quality of life. This can be significantly improved by surgical therapy.
Prevention
Proper posture should be maintained to prevent kyphosis. Strengthening the back muscles through appropriate exercises can also prevent the formation of a crooked back. During sedentary activities, the back and neck muscles should be regularly relaxed by stretching and standing up. Ergonomic office furniture must be provided at the workplace.
Aftercare
Kyphosis, as a physiological phenomenon in itself, only requires therapy and subsequent aftercare if it is too severe and the symptoms associated with it are too great. The aftercare is designed in cooperation with the orthopedist or physiotherapist, but in many cases requires the cooperation of the patient for success. This applies above all to exercises learned in the context of physiotherapy, which are consistently continued at home.
These are usually exercises that serve two main purposes. On the one hand, the shortened musculature in the chest area is gently stretched in order to counteract the unhealthy, forward-bent posture over the long term. On the other hand, the muscles in the upper back are strengthened, which promotes a physiological straightening of the spine if the exercises are carried out regularly. In the fitness studio or rehabilitation sports, you can train on equipment that precisely performs the exercises required for targeted strengthening. This increases efficiency and noticeably reduces the risk of injury.
It is also important to ensure an upright posture during the aftercare of the kyphosis. This also includes the ergonomic design of the workplace. The bending of the upper body at the desk in particular must not be too strong and should also be interrupted again and again by active breaks. Yoga can help to sensitize for a straight back.
You can do that yourself
As an alternative to medical measures, kyphosis can be self-treated with various back exercises. Methods of physiotherapy or yoga specifically build up back and chest muscles and reduce the hunchback. An example exercise is stretching the chest muscles. This involves leaning one forearm against a wall and twisting the torso and head to the side until you feel a stretch in your chest. Backbends while standing and on your stomach are similarly effective. Special breathing techniques support these exercises by relaxing and relieving the muscles.
In order to eliminate kyphosis permanently, the measures mentioned must be carried out regularly. Especially in old age, targeted and consistent training is essential for successful treatment. In everyday life, you have to consciously pay attention to a straight posture. If you have a pronounced rounded back, it is sometimes necessary to wear a corset. The garment supports the entire holding apparatus and compensates for incorrect posture.
If pain or other discomfort occurs, the doctor must examine the kyphosis and, if necessary, prescribe an appropriate medication. Surgery may be required for major complications.
