Kyphosis is an exaggerated, forward rounding of the upper back.
In older people, kyphosis is often due to weakness in the spinal bones that causes them to compress or crack. Other types of kyphosis can appear in infants or teens due to malformation of the spine or wedging of the spinal bones over time.
Mild kyphosis causes few problems. Severe kyphosis can cause pain and be disfiguring. Treatment for kyphosis depends on your age, and the cause and effects of the curvature.
Mild kyphosis may produce no noticeable signs or symptoms. In fact, the upper back naturally has a little kyphosis. People who have excessive curvature may experience back pain and stiffness.
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 bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the back become more wedge shaped.
The shape of vertebrae can be changed by:
- Fractures. Broken vertebrae can result in curvature of the spine. Compression fractures, which can occur in weakened bone, are the most common. Mild compression fractures often don't produce noticeable signs or symptoms.
- Osteoporosis. Weak bones can cause spinal curvature, especially if weakened vertebrae develop compression fractures. Osteoporosis is most common in older women and people who have taken corticosteroids for long periods of time.
- Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks flatten 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.
- Other problems. Spinal bones that don't develop properly before birth can cause kyphosis. Kyphosis in children can also be associated with certain medical conditions, such as Ehlers-Danlos syndrome.
In addition to causing back pain, kyphosis may cause:
- Limited physical functions. Kyphosis is associated with weakened back muscles and difficulty doing tasks such as walking and getting out of chairs. The spinal curvature can also make it difficult to gaze upward or drive and can cause pain when you lie down.
- Digestive problems. Severe kyphosis can compress the digestive tract, causing problems such as acid reflux and difficulty with swallowing.
- Body image problems. People with kyphosis, especially adolescents, may have poor body image from having a rounded back.
Your health care provider will generally conduct a thorough physical examination, including checking your height. You may be asked to bend forward from the waist while the provider views your spine from the side. You may also undergo a neurological exam to check your reflexes and muscle strength.
Tests that may be ordered include:
- X-rays or CT scans. X-rays can determine the degree of curvature and detect deformities of the vertebrae. A CT scan might be recommended if your doctor wants more-detailed images.
- MRI. Using radio waves and a strong magnetic field, MRIs can detect infection or a tumor in your spine.
- Nerve tests. If you are experiencing numbness or muscle weakness, you may need tests to determine how well nerve impulses are traveling between your spinal cord and your extremities.
- Bone density tests. Low-density bone can worsen kyphosis and often can be improved with medications.
Kyphosis treatment depends on the cause and severity of your condition.
Kyphosis treatment may include:
- Pain relievers. If over-the-counter medicines — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) — aren't enough, stronger pain medications are available by prescription.
- Osteoporosis medications. Bone-strengthening medications may help prevent additional spinal fractures that would worsen your kyphosis.
Certain types of kyphosis may be helped by:
- Exercises. Stretching and strengthening exercises may help improve spinal flexibility and relieve back pain.
- Bracing. Children who have Scheuermann's disease may be able to stop the progression of kyphosis by wearing a spine brace while their bones are still growing.
Surgical and other procedures
Rarely, severe kyphosis can pinch the spinal cord or nerve roots. To correct this, surgery may be needed. The most common procedure is spinal fusion, where the surgeon uses metal rods and screws to fasten the spinal bones together in the correct position.
Compression fractures are usually treated without surgery.
Preparing for an appointment
You may be referred to a doctor who specializes in the diagnosis and treatment of spine disorders.
What you can do
- Be aware of any pre-appointment restrictions, such as restricting your diet.
- Write down your symptoms, including any that may seem unrelated to the reason you scheduled the appointment.
- Make a list of medications, vitamins and supplements you're taking.
- Write down your key medical information, including other conditions.
- Write down key personal information, including any recent changes or stressors in your life.
- Write down questions to ask your doctor.
- Ask a relative or friend to accompany you to help you remember what the doctor says.
Questions to ask your doctor
- What tests do I need? Is there any special preparation for them?
- Will I need treatment? What are my options, and what are the benefits and risks of each?
- I have other health problems. How can I best manage these conditions together?
In addition to the questions you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over other points in greater detail. You may be asked:
- When did you begin experiencing symptoms? How severe are they?
- Have your symptoms been continuous or occasional?
- What, if anything, seems to improve or worsen your symptoms?