Kyphosis Explained

Medically Reviewed By Angela M. Bell, MD, FACP
Was this helpful?
2

Kyphosis describes an excessive curving of the upper back. Here is everything you need to know about the different types of kyphosis. Kyphosis causes an unusual rounding of the upper back, and it is commonly seen in adolescence. Most of the time, it requires no treatment, though bracing and physical therapy may help.

In cases of severe curvature or persistent back pain, surgery may be necessary. You can help prevent certain types of kyphosis by practicing good posture and taking care of your back.

This article further defines kyphosis. It also discusses the symptoms, causes, and treatments associated with the condition.

What is kyphosis?

A female's bare back
Eloisa Ramos/Stocksy United

Kyphosis is a spinal condition commonly observed in adolescence. It causes an unusual rounding of the upper back, resulting from excessive curvature of the thoracic spine.

Kyphosis is sometimes referred to as roundback. In cases of severe curvature, it may be called hunchback.

Most of the time, kyphosis causes few problems and does not require treatment. However, in some cases, a person with kyphosis may need to wear a brace or perform exercises to improve their posture. In severe cases, kyphosis is painful, causing breathing problems and requiring surgery to improve the symptoms.

Normally, the thoracic spine has a natural curve of 20–45 degrees. In kyphosis, however, the curve is greater than 50 degrees. When this occurs, it is difficult to stand up straight, and an atypical posture develops. Typically, the greater the curve of the spine, the more serious the condition is.

Types of kyphosis

There are three types of kyphosis: postural, congenital, and Scheuermann’s.

Postural

Postural kyphosis is the most common type of kyphosis, and it is more common in females than males. It is rarely painful and typically presents as poor posture and slouching. It is not associated with any structural irregularities of the spine.

This type of kyphosis typically corrects itself when the person stands up straight.

Congenital

Congenital kyphosis appears at birth and typically worsens as the child ages. It occurs when the spinal column does not develop normally when the baby is still growing inside the uterus. Several vertebrae may be fused, or the bones may not have formed properly.

This type of kyphosis usually requires surgical treatment to stop the progression of the curvature. Some children with congenital kyphosis may have other congenital anomalies that affect other parts of the body, such as the kidneys and heart.

Scheuermann’s

Scheuermann’s kyphosis is the result of a structural irregularity of the spine, in which the curve of the spine is sharp and angular. An X-ray will show that three or more consecutive vertebrae have a triangular shape rather than the typical rectangular shape. The irregular shape causes the vertebrae to wedge together toward the front of the spine, creating an exaggerated curvature in the thoracic spine.

This type of kyphosis is more common in males than females and typically stops progressing once the child is fully grown.

Vs. lordosis

In contrast to kyphosis, lordosis results in a curving of the lower back (lumbar spine). This can cause the abdomen to stick out and the pelvis to curve back and up.

Lordosis typically results from poor posture, genetics, an injury or illness affecting the spine, or surgery to the spine.

Most people with lordosis do not require surgery, except in extreme cases, such as when the nerves are involved. Exercises taught by a physical therapist are often helpful for people with lordosis.

Visit our hub to read more about bones, joints, and muscles.

What are the symptoms of kyphosis?

The symptoms of kyphosis depend on the cause and the severity of the curve of the spine.

The most common symptoms of kyphosis include:

  • a visible hump on the back
  • rounded shoulders
  • spine stiffness
  • mild back pain
  • fatigue
  • tight hamstrings

In rare cases, progressive kyphosis can lead to more severe symptoms, such as:

  • shortness of breath or breathing difficulties
  • a loss of sensation
  • changes in bowel or bladder habits
  • weakness, numbness, or tingling in the legs

What are the causes and risk factors for kyphosis?

The cause of kyphosis usually depends on the specific type a person has.

Kyphosis is sometimes the result of poor posture in childhood, often due to slouching or carrying a heavy schoolbag. There is also a possible genetic link, such as when the vertebrae do not develop correctly. Other times, the bones do not form correctly before a child is born.

Conditions that can increase your risk of developing kyphosis include:

How does a doctor diagnose kyphosis?

Often, mild kyphosis goes unnoticed until a child gets a scoliosis screening at school. This may then warrant a visit to a doctor.

In general, the doctor will diagnose kyphosis by performing a physical exam. They will typically perform the Adam’s forward bend test, in which they ask you to bend forward with both feet together, the knees straight, and the arms hanging down. This test allows the doctor to better see the slope of the spine and check for any spinal deformities.

The doctor may then ask you to lie down to see if the curve straightens. If it does, this is a sign that the curve is flexible.

Your doctor may also order a few tests to help diagnose the condition. These tests include:

  • An X-ray: An X-ray provides an image of the bones and can also help determine the degree of the spinal curve.
  • Pulmonary function tests: Doctors usually perform these tests if your spinal curve is severe. They can help determine if your breathing is restricted due to decreased chest space.
  • An MRI scan: This test is typically done if you develop neurological symptoms from worsening kyphosis, such as pain, tingling, weakness, or numbness.

Read about when to contact a doctor for back pain here.

What are the treatment options for kyphosis?

Treatment for kyphosis often depends on the severity of the curve and the type of kyphosis you have. Treatment is either nonsurgical or surgical.

Nonsurgical

Nonsurgical treatment is recommended for those who have postural kyphosis and those with Scheuermann’s kyphosis who have curves of less than 70–75 degrees. Your doctor may simply observe and monitor the curve through periodic visits or X-rays to make sure that it is not getting worse.

Physical therapy exercises can help correct poor posture and relieve the back pain associated with misalignment of the spine. If physical therapy does not relieve back pain, your doctor may recommend taking over-the-counter pain medications. In some cases, such as in people with Scheuermann’s kyphosis who are still growing,

a doctor may recommend bracing.

Surgical

Surgery is usually recommended for people with congenital kyphosis, those with Scheuermann’s kyphosis who have curves greater than 70–75 degrees, and individuals who have severe back pain.

The most common surgical procedure for kyphosis is spinal fusion. Fusing the vertebrae helps reduce the degree of spinal curve, alleviates back pain, and prevents worsening of the spinal curve. The goal of spinal fusion is to reduce the degree of the curve by 50%.

What are the potential complications of kyphosis?

Complications of kyphosis typically only occur in severe cases. Sometimes, for example, the nerves running through the spine can become compressed, and this can cause symptoms.

Some other examples of potential complications include:

  • persistent pain that is not controlled by medications
  • breathing difficulties
  • numbness, weakness, or tingling in the arms or legs
  • problems with balance
  • a loss of bladder or bowel control

Is kyphosis preventable?

Postural kyphosis is typically preventable by paying attention to your posture and taking care of your back. Specifically, you can help prevent postural kyphosis by:

  • not slouching
  • sitting upright in a chair with your lower back supported
  • regularly exercising to strengthen the muscles and ligaments in your back
  • avoiding carrying heavy schoolbags that could strain your back

Congenital

kyphosis and Scheuermann’s kyphosis are not usually preventable.

Summary

Kyphosis is a spinal condition that causes curvature in the upper back (thoracic spine). It is commonly seen in adolescence, but it can develop at any age.

There are three types: postural, congenital, and Scheuermann’s. You can help prevent postural kyphosis by practicing good posture and exercising your back.

Doctors usually treat kyphosis nonsurgically, except in severe cases. Most often, your doctor will

periodically monitor the curve in your back to make sure that it is not getting worse.

Was this helpful?
2
Medical Reviewer: Angela M. Bell, MD, FACP
Last Review Date: 2022 May 17
View All Spine Conditions Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.