Kyphosis

Kyphosis is a condition in which the upper part of the spine (the thoracic region) curves excessively backward. The spine normally has a small natural curve; when this curve exceeds normal limits, the upper back appears rounded or hunched, and the shoulders slump forward.

Kyphosis can result from changes in bone structure, poor posture and alignment, or diseases affecting the spine. Symptoms range from appearance alone to back pain, fatigue, and—in severe cases—breathing problems.

Types

The most common type is postural kyphosis, usually seen in young people and often reversible when the person straightens the back. Scheuermann kyphosis involves a permanent change in the shape of small vertebrae, causing a curve that cannot be straightened easily. There is also congenital kyphosis, when the spine fails to develop properly in the womb, and age-related kyphosis resulting from bone weakness.

Causes and risks

Common causes include osteoporosis, which weakens bone and causes small vertebral fractures, particularly in older women. Spine infections such as tuberculosis, tumors, injury, and neurological and nerve diseases can also contribute. Prolonged poor posture and weak back muscles can worsen the condition.

Diagnosis

A doctor begins with physical examination, observing the curve of the back when standing and bending. Spinal X-rays taken from the side measure the degree of curvature. If needed, advanced imaging such as MRI confirms whether spinal cord or nerve compression has occurred.

Treatment

Mild postural kyphosis is usually managed with exercises to strengthen back muscles and education in proper posture. More severe cases in still-growing young people may warrant a back brace. Surgery is considered when the curve is very pronounced, chronic pain is present, or nerves are compressed; treating the underlying cause—for example, strengthening bone—is also important.