Kyphosis is a forward rounding of the back. Some rounding is normal, but the term "kyphosis" usually refers to an exaggerated rounding of the back. While kyphosis can occur at any age, it's most common in older women.
Age-related kyphosis often occurs after osteoporosis weakens spinal bones to the point that they crack and compress. Other types of kyphosis are seen in infants or teens due to malformation of the spine or wedging of the spinal bones over time.
Mild kyphosis causes few problems, but severe cases can cause pain and be disfiguring. Treatment for kyphosis depends on your age, the cause of the curvature and its effects.
In addition to an abnormally curved spine, kyphosis can also cause back pain and stiffness in some people. Mild cases of kyphosis may produce no noticeable signs or symptoms.
When to see a doctor
Make an appointment with your doctor if you notice an increased curve in your upper back or in your child's spine.
The individual bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the upper back become more wedge-shaped. This deformity can be caused by a variety of problems, including:
- Osteoporosis. This bone-thinning disorder can result in crushed vertebrae (compression fractures). Osteoporosis is most common in older adults, particularly women, and in people who have taken high doses of corticosteroids for long periods of time.
- Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
- Scheuermann's disease. Also called Scheuermann's kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than are girls. The rounding of the back may worsen as the child finishes growing.
- Birth defects. If a baby's spinal column doesn't develop properly in the womb, the spinal bones may not form properly, causing kyphosis.
- Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Marfan syndrome or Prader-Willi disease.
- Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.
An increased curve in the upper spine also can be caused by slouching. Called postural kyphosis, this condition doesn't involve any deformities in the spine. It's most common in teenagers.
Kyphosis may cause the following complications:
- Body image problems. Adolescents especially may develop a poor body image from having a rounded back or from wearing a brace to correct the condition.
- Back pain. In some cases, the misalignment of the spine can lead to pain, which can become severe and disabling.
- Decreased appetite. In severe cases, the curve may cause the abdomen to be compressed and lead to decreased appetite.
If you or your child has signs or symptoms common to kyphosis, make an appointment with your family doctor. He or she may refer you to a doctor who specializes in the diagnosis and treatment of spine disorders.
What you can do
Before your appointment, you may want to write a list of answers to the following questions:
- When did you first notice the symptoms?
- Did any back injuries happen around the same time?
- Have any close biological relatives had similar signs and symptoms or been diagnosed with a spine disorder?
- What medications and supplements are taken regularly?
What to expect from your doctor
Your doctor may ask some of the following questions:
- Is there any pain? If so, where exactly does it hurt?
- Do symptoms include fever, chills or unexplained weight loss?
- Do symptoms include weakness, numbness, difficulty walking, or changes in bladder or bowel habits?
- Do symptoms include fatigue or shortness of breath?
During the physical exam, your doctor will check your height and may ask you to bend forward from the waist while he or she views the spine from the side. With kyphosis, the rounding of the upper back may become more obvious in this position. Your doctor might also perform a neurological exam to check your reflexes and muscle strength.
Depending upon your signs and symptoms, you may need:
- X-rays. Plain X-rays are used to determine the degree of curvature and can detect deformities of the vertebrae, which helps identify the type of kyphosis.
- Computerized tomography (CT scan). If more detail is required, your doctor might order a CT scan — which takes X-ray images from many different angles and then combines them to form cross-sectional images of internal structures.
- Magnetic resonance imaging (MRI). If your doctor suspects a tumor or infection, he or she may request an MRI of your spine. MRI uses radio waves and a very strong magnet to produce detailed images of both bone and soft tissues.
If you are experiencing any numbness or muscle weakness, your doctor may recommend several tests that can determine how well nerve impulses are traveling between your spinal cord and your extremities.
Kyphosis treatment depends on the cause of the condition and the signs and symptoms that are present.
Your doctor may suggest:
- Pain relievers. If over-the-counter medicines — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) — aren't enough, stronger pain medications are available by prescription.
- Osteoporosis drugs. In many older people, kyphosis is the first clue that they have osteoporosis. Bone-strengthening drugs may help prevent additional spinal fractures that would cause your kyphosis to worsen.
Some types of kyphosis can be helped by:
- Exercises. Stretching exercises can improve spinal flexibility and relieve back pain. Exercises that strengthen the abdominal muscles may help improve posture.
- Bracing. Children who have Scheuermann's disease may be able to stop the progression of kyphosis by wearing a body brace while their bones are still growing.
- Healthy lifestyle. Maintaining a healthy body weight and regular physical activity will help prevent back pain and relieve back symptoms from kyphosis.
- Maintaining good bone density. Proper diet with calcium and vitamin D and screening for low bone density, particularly if there is a family history of osteoporosis or history of previous fracture, may help older adults avoid weak bones, compression fractures and subsequent kyphosis.
Surgical and other procedures
If the kyphosis curve is very severe or if the curve is pinching the spinal cord or nerve roots, your doctor might suggest surgery to reduce the degree of curvature.
The most common procedure, called spinal fusion, connects two or more of the affected vertebrae permanently. Surgeons insert pieces of bone between the vertebrae and then fasten the vertebrae together with metal rods and screws until the spine heals together in a corrected position.
June 06, 2014
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.clinicalkey.com. Accessed July 11, 2013.
- Kyphosis (roundback) of the spine. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00423. Accessed April 10, 2012.
- Kado DM. Overview of hyperkyphosis in older persons. http://www.uptodate.com/home. Accessed July 11, 2013.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed July 11, 2013.
- Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1584/0.html. Accessed July 11, 2013.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed July 11, 2013.
- Larson AN (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 9, 2013.
- Wybier M, et al. Musculoskeletal imaging in progress: The EOS imaging system. Joint Bone Spine. 2013;80:238.
- Six years and more than 60 lifesized anatomic models to help plan complex surgeries. Mayo Clinic. http://newsletters.mayo.edu/newscenter/Article.aspx?contentID=DOCMAN-0000157800. Accessed Jan. 7, 2014.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Nov. 5, 2013.