Kyphosis
Also known as: Hunchback, Round back, Dowager's hump
Kyphosis is an exaggerated forward rounding of the upper back. Everyone's upper spine curves slightly, but when the curve becomes excessive it can create a visible hump, a stooped posture and back pain. The most common type is postural kyphosis, which develops from slouching and is flexible and correctable. Scheuermann's kyphosis is a stiffer form that develops in adolescence when the vertebrae grow unevenly into a wedge shape. In older adults, kyphosis most often results from osteoporosis-related compression fractures of the vertebrae. Mild kyphosis often needs only exercise and posture work, while severe curves can affect breathing and need bracing or, rarely, surgery.
At a Glance
- Common symptoms
- A visibly rounded or hunched upper back, Shoulders that appear rounded forward and a head that juts ahead of the body, Back pain and stiffness, especially after standing or sitting for long periods
- Main treatments
- Posture training and exercises to strengthen the back extensors and core and stretch the chest and hamstrings, often with a physiotherapist, Pain relief with over-the-counter medications when needed, Treating osteoporosis with bone-strengthening medications, calcium and vitamin D to prevent further fractures
- Category
- Musculoskeletal · Common; mild age-related kyphosis affects a large proportion of older adults, and Scheuermann's kyphosis affects a small percentage of adolescents
- See a doctor if
- A rounded back that is becoming more noticeable or is accompanied by persistent pain
Symptoms
Causes
- Poor posture and slouching, especially during adolescence (postural kyphosis)
- Scheuermann's disease, in which vertebrae develop a wedge shape during growth
- Osteoporosis causing compression fractures that collapse the front of the vertebrae
- Degenerative disc disease and arthritis of the spine with age
- Birth defects of the spine (congenital kyphosis)
- Less commonly, spinal injury, infection, tumours or connective tissue disorders
Risk Factors
- Adolescence, when postural and Scheuermann's kyphosis most often appear
- Older age, particularly in women with osteoporosis
- Low bone density or a history of vertebral fractures
- Weak core and back muscles and a sedentary lifestyle
- Prolonged slouching over screens or desks
- Conditions such as Marfan syndrome or Ehlers-Danlos syndrome
Diagnosis
- Physical examination, including the forward-bend test to view the curve from the side and check whether it is flexible
- Standing X-rays of the spine to measure the angle of the curve
- Neurological examination of strength, sensation and reflexes
- Bone density scan in older adults to check for osteoporosis
- MRI if nerve symptoms or a structural problem are suspected
Treatment
- Posture training and exercises to strengthen the back extensors and core and stretch the chest and hamstrings, often with a physiotherapist
- Pain relief with over-the-counter medications when needed
- Treating osteoporosis with bone-strengthening medications, calcium and vitamin D to prevent further fractures
- Bracing for adolescents with Scheuermann's kyphosis who are still growing and have a progressing curve
- Surgery (spinal fusion) for severe curves, progressive deformity, intractable pain or nerve compression
- Supportive: yoga, Pilates or swimming to maintain spinal mobility and strength
- Supportive: ergonomic adjustments to desks, screens and chairs to reduce slouching
Prevention
- Practise good posture: ears over shoulders and shoulders over hips when sitting and standing
- Strengthen your back and core with regular exercise
- Set screens at eye level and take breaks from prolonged sitting
- Protect bone health with weight-bearing exercise, calcium, vitamin D and not smoking
- Carry backpacks on both shoulders and keep loads light
- Have bone density checked if you are at risk of osteoporosis
When to See a Doctor
- A rounded back that is becoming more noticeable or is accompanied by persistent pain
- A hump in a child or teenager that does not straighten when they stand up tall
- Numbness, tingling or weakness in the legs, or changes in bladder or bowel control (needs urgent assessment)
- Shortness of breath associated with a curved spine
- Sudden back pain in an older adult, which may signal a vertebral fracture
Frequently Asked Questions
Related Conditions
Have questions about Kyphosis?
Ask Mother Nature AI for personalized, evidence-based guidance.
Ask about KyphosisMedical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.