Overview

A back rounded to the front.
Hunchback (kyphosis) usually refers to an abnormally curved spine. It is most common in older women and is often linked to osteoporosis.
Some people with kyphosis experience back pain and stiffness. Others have no other symptoms than an exaggerated forward rounding of the back.
Severe kyphosis can be painful and disfiguring. Treatment can include pain medication, physical therapy, and sometimes surgery.

Symptoms

If you have kyphosis, you may have a noticeable lump on your upper back. On the side, the upper back can be noticeably rounded or protruding.

In addition, people with kyphosis appear slumped with noticeable rounded shoulders. Kyphosis can put excessive pressure on the spine and cause pain. It can also cause difficulty breathing due to the pressure on the lungs.

Causes

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.

Abnormal vertebrae can be caused by:

Fractures. Broken or bruised vertebrae (compression fractures) can cause the spine to bend. Mild compression fractures often do not produce any visible signs or symptoms.
Osteoporosis. This bone thinning disorder can cause the spine to curl, especially if weakened vertebrae cause compression fractures. Osteoporosis is more common in older women and people who have been taking corticosteroids for a long time.
Degeneration of the intervertebral disc. The flexible, circular discs act as a cushion between the spine. As you age, these intervertebral discs dry out and shrink, often making kyphosis worse.
Scheuermann’s disease. This disease, also called Scheuermann’s kyphosis, usually begins during the growth spurt that occurs before puberty. Boys are more often affected than girls.
Congenital malformations. Bones in the spine that don’t develop properly before birth can cause kyphosis.
Syndromes. Kyphosis in children can also be associated with certain syndromes such as Ehlers-Danlos syndrome and Marfan syndrome.
Cancer and cancer treatments. Spinal cancer can weaken the vertebrae and make them more prone to compression fractures, just like chemotherapy and radiation can do for cancer.

Treatments

Treatment for kyphosis depends on its severity and the underlying cause. Here are some of the most common causes and their treatments:

Scheuermann’s disease. A child can receive physical therapy, braces, or corrective surgery.
Tumor. Typically, tumors are only removed if there is a problem with the compression of the spinal cord. If this is present, your surgeon may attempt to remove the tumor, but this often destabilizes the bone. Spinal fusion is also often required in such cases.
Osteoporosis. Treating bone loss is important to keep kyphosis from getting worse. Medication can be very helpful.
Bad position. Postural exercises can help. You don’t need any aggressive treatments.
The following treatments can help relieve symptoms of kyphosis:

Medication can relieve pain if needed.
Physiotherapy can help strengthen core and back muscles.
Yoga can increase body awareness and build strength, flexibility and freedom of movement.
Losing weight can also relieve the spine.
Wearing braces can be particularly helpful for children and adolescents.
In severe cases, surgery may be required.

Diagonsis

Often times, school scoliosis screening is the time a provider first notices a child’s kyphosis. In other cases, teenagers or their parents notice a rounded back. You should see your doctor for a full diagnosis.

A healthcare professional will perform a physical exam to examine the spine. The provider can ask you (or your child) to perform the Adam’s Forward Bend Test. You are asked to lean forward with your feet together, knees straight, and arms free. This test helps the provider identify the curvature of the spine or other spinal problems such as scoliosis (a curvature of the spine).

You can get a spine x-ray to measure the curvature of the spine. The natural curve is between 20 and 45 degrees. A provider diagnoses kyphosis when the curve is greater than 50 degrees.

Risk factor

Kyphosis is an exaggerated rounding of the back forward. It can occur at any age, but is more common in older women.

Age-related kyphosis is often caused by weak bones in the spine that cause compression or rupture. Other types of kyphosis can occur in infants or adolescents due to a malformation of the spine or a jamming of the bones of the spine over time.