Kyphosis: Definition, Causes, Symptoms, Diagnosis, Treatment, and Prognosis

Normal Spine vs Kyphosis

Kyphosis is a condition in which the spine has an excessive outward curve, causing a hunchback or rounded posture. Kyphosis can be caused by birth defects, abnormal growth of the vertebrae, or by poor posture. Symptoms can include back pain, neck pain, difficulty standing or walking, and a rounded appearance of the upper back. Treatment options may include physical therapy, medications, bracing, or surgery, depending on the severity of the condition.

What is Kyphosis?

Kyphosis is a condition in which the spine has an exaggerated curve in the upper back, causing the person to appear to be hunched over. It is also sometimes called a “rounded back” or “hunchback.”

Types and Causes of Kyphosis

Kyphosis is often categorized into different types,  and these have different underlying causes. 

Structural Kyphosis

Structural kyphosis is a deformity of the spine that is present from birth or develops during childhood. It is caused by abnormal development of the bones in the spine or by abnormal growth patterns. Some causes of structural kyphosis include:

  • Genetics
  • Birth Defects
  • Infections such as tuberculosis

Postural Kyphosis

Postural kyphosis is a curvature of the spine that is caused by poor posture or muscle weakness. It is more common in older adults and can be caused by factors such as:

  • Poor muscle tone
  • Poor posture
  • Osteoporosis (a condition that weakens the bones)
  • Sedentary lifestyle
  • Obesity

Scheuermann’s Kyphosis

Scheuermann’s kyphosis is a type of structural kyphosis that is caused by abnormal growth patterns in the vertebrae (the bones of the spine). The exact cause of Scheuermann’s kyphosis is not fully understood, but it is thought to be related to genetics and abnormal growth patterns.

Prevalence of Kyphosis

According to a review of the literature, the prevalence of kyphosis in the general population is estimated to be between 0.3% and 4.3%, with the most common age of onset being between 10 and 20 years. The prevalence of kyphosis may be higher in certain populations, such as those with osteoporosis or other underlying conditions that affect the spine.

Symptoms of Kyphosis

Kyphosis can cause a variety of symptoms, including:

  • A rounded appearance of the upper back: Kyphosis is characterized by an excessive outward curve of the spine, which can cause a rounded appearance of the upper back.
  • Back pain: Kyphosis can cause pain in the back, particularly in the upper back.
  • Neck pain: Kyphosis can also cause neck pain, as the neck muscles may be strained due to the abnormal curvature of the spine.
  • Difficulty standing or walking: Kyphosis can cause difficulty standing or walking due to the abnormal curvature of the spine, which can affect balance and stability.
  • Stiffness or difficulty moving: Kyphosis can cause stiffness or difficulty moving due to the abnormal curvature of the spine, which can affect the range of motion of the back and neck.
  • Difficulty breathing: In severe cases of kyphosis, the curvature of the spine can compress the lungs and make breathing difficult.

Diagnosing Kyphosis

History and Physical Examination

The diagnosis of kyphosis can often be made with history and physical examination alone. Examination of the spine may show excessive curve when viewed from the side, giving the appearance of a hunchback.

Imaging: X-Ray

In some cases, X-ray is used to confirm the diagnoses and determine the severity of the condition. X-rays use electromagnetic radiation to create images of the bones and help visualize abnormal curvature. 

There are several measurements that can be taken on X-ray, including the Kyphosis angle, which measures the degree of curvature of the spine as seen from a side view.

Treatment of Kyphosis

The treatment for kyphosis, a condition in which the spine has an excessive outward curve, causing a hunchback or rounded posture, will depend on the severity of the condition and the underlying cause. Some common treatment options for kyphosis include:

  • Medications: The doctor may prescribe medications to help reduce pain and inflammation in the back. These may include nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants.
  • Physical therapy: Physical therapy can help to improve muscle strength and flexibility, which can help to correct poor posture and reduce the curvature of the spine. Physical therapy may include exercises to strengthen the back and abdominal muscles, as well as stretches to improve flexibility.
  • Spinal Bracing: The doctor may recommend wearing a brace to help correct the curvature of the spine. Braces can help to reduce the load on the spine and may be worn during the day or at night.
  • Surgery: In severe cases of kyphosis, the doctor may recommend surgery to correct the curvature of the spine. Surgery may involve the use of screws, rods, or other devices to hold the spine in the correct position while it heals.

It is important to follow the treatment plan recommended by the doctor, as this can help to improve the outcome and prevent long-term problems. In some cases, kyphosis may be reversible with proper treatment and posture correction, while in other cases, it may be a lifelong condition that requires ongoing management.

Prognosis

Overall, the prognosis for kyphosis is generally good with appropriate treatment, and most people with kyphosis are able to lead normal, active lives. The key to success in the treatment of kyphosis is early diagnosis and appropriate treatment. The sooner the condition is diagnosed and treated, the better the outcome is likely to be. 

Sources

Tribus, C B. “Scheuermann’s kyphosis in adolescents and adults: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 6,1 (1998): 36-43. doi:10.5435/00124635-199801000-00004

Koelé, M C et al. “The Clinical Relevance of Hyperkyphosis: A Narrative Review.” Frontiers in endocrinology vol. 11 5. 24 Jan. 2020, doi:10.3389/fendo.2020.00005

Lam JC, Mukhdomi T. Kyphosis. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558945/

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for SpineInfo.com.