Kyphosis is the term used to describe a type of abnormal curve in the spine in which there is too much forward curve in the spine. Kyphosis can have varying symptoms and degrees of severity, from minor changes in the shape of your spine to severe deformity, nerve problems, and chronic pain. The larger the abnormal curve, the more serious the problem.
The spine is divided into three sections: the cervical spine or neck, the thoracic spine or mid back, and the lumbar spine or low back. Each of these sections has a specific, normal curve to it. The cervical spine looks like a backward “C”, which is called a lordotic curve. The thoracic spine has a regular “C” shape with the opening of the “C” in the front of your body, which is called a kyphotic curve. The lumbar spine, like the cervical spine, also has a backward “C” shape or lordotic curve.
Kyphosis is most common in the thoracic spine, though it can also affect the cervical and lumbar spine. Kyphosis in the thoracic spine exaggerates the natural curve of the thoracic spine. Kyphosis in the cervical or lumbar spine is a condition in which the normal inward curve of the spine reverses. This causes an abnormal forward curve in the spine.
Types of Kyphosis
There are several types of kyphosis –
- Postural Kyphosis – Postural kyphosis is the most common type of kyphosis. It is often attributed to slouching. It represents an exaggerated, but flexible, increase of the natural curve of the spine. Postural kyphosis usually becomes noticeable during adolescence. It is more common among girls than boys. It rarely causes pain.
- Scheuermann’s Kyphosis – Scheuermann’s kyphosis is named after the Danish radiologist who first described the condition. As with postural kyphosis, Scheuermann’s kyphosis often becomes apparent during the teen years; however, patients with Scheuermann’s kyphosis have a significantly more severe deformity, particularly thin individuals. Scheuermann’s kyphosis usually affects the upper (thoracic) spine. It can also occur in the lower (lumbar) back area. If pain is present, it is usually felt at the apex of the curve.
- Congenital Kyphosis – In some infants, the spinal column does not develop properly while the fetus is still in the womb. The bones may not form as they should. Several vertebrae may be fused together. Either of these abnormal situations may cause progressive kyphosis as the child grows.
Methods of treating kyphosis have evolved over time. Today there are numerous effective treatment options for correcting a severe kyphotic deformity.
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. 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.
Risk Factors
Kyphosis is more common in girls than in boys. Although kyphosis can occur in any race or gender, there are some risk factors that could increase the odds of getting this disease. Adolescent girls who do not use proper posture techniques are at a higher risk of developing postural kyphosis. Boys who are between 10 and 15 have the greatest risk of getting Scheuermann’s kyphosis than their female counterparts. An adult is at a high risk of getting kyphosis if they have osteoporosis or other conditions which could result in spinal fractures. People who have connective tissue disorders such as Marfan syndrome are also at an increased risk of getting kyphosis during their lifetime.
Symptoms
If people have kyphosis, the easiest-to-recognize symptom is a rounded back. The extreme curve in the upper spine will cause them to hunch forward.
In addition to having a rounded back, people may have these other symptoms –
- Mild to severe back pain
- Back pain with movement
- Fatigue
- Tenderness and stiffness in the spine
- Forward posture of the head
- Chest pain or difficulty breathing (severe cases)
- Difference in shoulder height
- Tight hamstrings (muscles in the back of the thighs)
Complications
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.
Treatment
Medications –
- 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.
Bracing – For curves that progress, or in initially severe cases, a brace may be used to help straighten the spine and try to prevent further progression during growing years. Brace treatment for kyphosis is only used for patients who are still growing and is not an effective treatment for adult patients. Brace treatment for Scheuermann’s kyphosis in growing adolescents is similar to bracing for patients with scoliosis, however, the location and type of the brace may vary depending on the location of the kyphosis.
Exercises – Stretching exercises can improve spinal flexibility and relieve back pain. Exercises that strengthen the abdominal muscles may help improve posture.
Healthy lifestyle – Maintaining a healthy body weight and regular physical activity will help prevent back pain and relieve back symptoms from kyphosis.
Physical Therapy – Adolescents and adults with kyphosis may work with a physical therapist. A well-rounded rehabilitation program assists in calming pain and inflammation, improving mobility and strength, and helping with daily activities with greater ease and ability.
Alternative Treatment
Calcium + Vitamin D + Magnesium – The modern American diet is wreaking havoc on bone health. Many foods that are consumed on a daily basis lack nutrient density and block proper absorption of key vitamins. Gone are the days where large quantities of milk in one sitting are recommended for healthy bones. Science now recommends spreading out calcium intake throughout the day, and pairing certain food for optimal calcium absorption. For calcium to reach optimal absorption it should be paired with foods rich in Vitamin D and Magnesium.
Boron is ubiquitous throughout the human body, with the highest concentrations found in the bones and dental enamel. It helps in spinal health.
Vitamin K is a fat-soluble vitamin known for its effect in blood clotting, which it accomplishes by regulating the coagulation cascade via its ability to bind calcium ions (Ca2+), among other mechanisms. Three known vitamin K–dependent proteins have been isolated in bone: MGP (matrix Gla protein), protein S, and osteocalcin. One of vitamin K’s roles in helping to maintain healthy bone mass is linked to its importance in the formation of osteocalcin by osteoblasts. The synthesis of osteocalcin requires both vitamin D and vitamin K.
Omega-3 fatty acids is proven way to improve cardiovascular health, Omega-3 fatty acids have also shown some benefit to those with rheumatoid arthritis, reducing morning stiffness and joint swelling
Traditional Chinese Medicine (TCM) and acupuncture: TCM has been proven over thousands of years to help treat many different physical ailments. Based on herbs (usually brewed into tea or soup), TCM can improve how your body uses calcium, which in turn helps bone health.
Reference –
http://www.webmd.com/back-pain/guide/types-of-spine-curvature-disorders
http://www.spinemd.com/symptoms-conditions/kyphosis
http://www.childrenshospital.org/conditions-and-treatments/conditions/kyphosis
http://www.sportsinjuryclinic.net/sport-injuries/upper-back-neck/kyphosis
http://www.spine-health.com/video/kyphosis-video-what-kyphosis
https://www.nlm.nih.gov/medlineplus/ency/article/001240.htm
http://www.healthline.com/symptom/kyphosis
http://www.nhs.uk/Conditions/kyphosis/Pages/introduction.aspx
http://www.mayoclinic.org/diseases-conditions/kyphosis/basics/complications/con-20026732