Kyphosis

Kyphosis, an excessive curve of the upper spine, can be caused by factors present before you were born or acquired during your life. This curve can put extra pressure on the spine, causing balance problems, pain, and bulging (herniated) discs. Treatments range from exercise to surgery based on what caused the kyphosis and how serious your symptoms are. Learn more about kyphosis.

Your spine’s natural curves help balance your body. When your spine curves too much, it puts extra pressure on the spinal bones (vertebrae) and joints (discs) in your spine. This can cause balance problems, pain, and bulging discs.

Kyphosis is an abnormal curve of the upper spine. A healthy spine has a slight curve forward (25- 45 degrees) between the neck and the mid-back. If the curve is greater than 50 degrees, you may have kyphosis.

Kyphosis treatments range from education to surgery. Your doctor will decide the right treatment for you based on the cause of your kyphosis and how severe it is. 

The most common symptom of kyphosis is pain in the middle or lower back.

Other symptoms of kyphosis include having:

• A rounded back
• Uneven shoulders or shoulder blades
• A forward tilt to the head
• Tenderness or stiffness in the spine
• Fatigued
• Trouble breathing

It's best to detect and treat kyphosis early, especially for children. You should see a doctor if you or your child have kyphosis symptoms or if you think that kyphosis may be a problem.

Kyphosis can be caused by a wide range of factors. Congenital diseases, including Scheuermann disease and spina bifida, can lead to kyphosis. It can also result from injury, osteoporosis, or infection. While kyphosis is more common in women than men, some causes are more common in men than women.

Known causes of kyphosis include:

• Degenerative spine diseases
• Connective tissue disorders
• Injury
• Muscular dystrophy
• Neurofibromatosis [noo r-oh-fahy-broh-muh-toh-sis]
• Osteoporosis [os-tee-oh-puh-roh-sis] 
• Osteogenesis [os-tee-oh-jen-uh-sis] imperfecta or "brittle bone disease"
• Paget disease
• Polio
• Scheuermann disease
• Spondylolisthesis [spon-dl-oh-lis-thee-sis], where one back bone (vertebra) slips forward onto another
• Some endocrine diseases
• Spina bifida
• Tuberculosis
• Tumors

You should give your healthcare provider as much information as you can to help them determine the cause of the kyphosis.

To learn more, your healthcare provider will discuss your symptoms with you, examine you, and perform tests. This section talks about some of the exams and tests your doctor may use.

Physical exam

Your doctor will check your body and its movement as part of a physical examand may check for:

• Weakness: Simple exercises can help test your strength.
• Range of motion: Your doctor may check your joints or watch you bend and twist.
• Tenderness: Your doctor may look for areas of soreness by touching parts of your body.
• Sensation and sensitivity: Your doctor may check to see that you can feel heat, cold, or a pin prick on parts of your body.
• Reflexes and motor skills: Your doctor may ask you to walk on your heels or toes or do tests to check your body’s reflexes.
• Spinal bone and muscle health. Your doctor may check the shape, tone, and position of the spinal bones and muscles.

Imaging studies

There are several tools that let your doctor take pictures of the inside of your body. Based on what they need to see, they may use one of the imaging studies listed below.

• X-ray. Beams of radiation create pictures of tissues, bones, and organs on film.
• MRI. Magnetic resonance imaging (MRI) uses strong magnets and radio waves to create images. MRI is very useful for looking at nerves in and around your spine.
• CT scan. Computed tomography (CT) uses a computer and x-rays to take pictures of cross-section views (“slices”) of your body. It’s very useful for highlighting abnormal tissue and clearly showing bone detail.

Bone density scan.

This scan uses x-ray or ultrasound to measure the amount of bone in a certain area. It can detect and assess osteoporosis (thinning bones). Since kyphosis can develop as a result of osteoporosis, a bone density scan may help diagnose this condition.Electrodiagnostic testing. “Electrodiagnostic testing” refers to tests that measure electrical activity in nerves and muscles. Two common tests are the electromyogram (e-lek-tro-MY-oh-gram), or EMG, and the nerve conduction study, or NCS. Results from these tests help your doctor assess nerve and muscle function and locate any damage.

Pulmonary function tests.

These tests might be needed if the kyphosis is causing breathing problems.

Kyphosis treatment depends on the cause of the disorder. If an infection or a tumor has caused kyphosis, you will need treatment right away, which may include surgery and medicine. Depending on the cause, the treatment plan may include 1 or more of the approaches detailed below.

Education and activity.

Your doctor can teach you what you can do on your own to relieve pain, regain strength, and decrease the risk of further damage. Medicines (pills you take by mouth). Your doctor may prescribe medicine to reduce inflammation, relax muscles, and ease pain. Take the medicine exactly as your healthcare provider says. Let your provider know about all other medicines you take including over-the-counter medicines, supplements, inhalers, liquid medicines, and patches.

Physical therapy.

Physical therapy includes a variety of treatments to promote healing, relieve pain, build strength and flexibility, and help prevent future injuries. Scheuermann disease, for example, is treated using physical therapy and traction.

Traction.

Traction is a way to decompress the vertebrae (bones) in the spine. Traction is done by a trained provider, or by braces or devices that gently lengthen the spine.

Spinal injection.

Your doctor may use a spinal injection to treat inflammation or ease pain. An injection can deliver medicine directly to the source of your symptoms. Common injections are:

• Epidural steroid (cortisone) injections. Injections near certain nerves or into the epidural space (the area around the nerves within the spinal canal) can help treat pain.
• Facet joint injections and nerve branch blocks. Injections in or near the facet joints can treat arthritic joint pain.
• Trigger point injections. Injections into tight, irritated muscle areas (trigger points) may help the muscle relax and ease pain.

Surgery.

Most spine problems, including kyphosis, can be treated without surgery. In some cases, however, your doctor may suggest surgery as a good option for relieving severe symptoms or constant pain. Some conditions, like congenital kyphosis in children, require surgery at an early age.

Options include kyphoplasty (KAI-fo-plas-tee), a surgery which straightens the spine.In this surgery, the surgeon injects a special balloon and cement into a collapsed vertebra. The balloon is inflated inside the vertebra to restore the original height of the bone, and the cement helps preserve this shape after the balloon is removed.

Nutrition and exercise that prevent osteoporosis can also reduce the risk of kyphosis in older adults. In cases where kyphosis is caused by a congenital condition or a disease, braces and other treatments may delay or prevent surgery, but they cannot prevent the disease.

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