Kyphosis: a forward curvature in the back

An abnormal forward curvature of the back is called kyphosis. If this is present to a severe extent, it is also referred to as a hunchback. There can be various causes, such as incorrect posture, tumors, infections or a delay in the development of the spine. The extent to which it can be treated depends on the severity of the complaints. You can choose exercises, a brace or a surgical procedure.

Abnormal curvature

Normally, a healthy spine will show a slight forward curvature at the thoracic vertebrae. In the cervical and lumbar vertebrae it bends backwards. If there is an abnormal curvature, where the convex side points backwards in the chest and tailbone area, it is called a kyphosis. People also speak of a hunchback or crooked back. An abnormal curvature backwards that causes a hollow back is called lordosis.

Cause

There can be several causes for this condition. For example, the spine may not have been properly developed before birth. It can also be caused by an accident, diseases such as polio (infantile paralysis) or by incorrect posture, for example by walking very crooked. In addition, it can be the result of an infection such as tuberculosis, a tumor or rheumatic diseases. An example is the disease ankylosing spondylitis, in which the joints and connective tissue ligaments in the spine become inflamed and stiff. For example, old age can cause bone decalcification, which can cause vertebrae to collapse. That is why older people walk more hunched over.

Diagnosis

A convex back is sometimes very visible on the outside. In addition, there may be back pain and a stiff back. Kyphosis can be diagnosed based on the patient’s complaints and a physical examination. The severity of the curvature is determined using an X-ray. If there is a suspicion of a tumor, an infection or another serious cause, another MRI scan will be made.

Therapy

The treatment of kyphosis and lordosis depends on the cause. Common methods of treating kyphosis are exercises, correction of the deformity with the help of an orthosis (an orthopedic device, a brace) or surgical intervention. These measures can be used separately or in combination. Exercises can also be used to combat complaints resulting from lordosis due to incorrect posture

Wrong attitude

A slouching posture can cause kyphosis to develop in a short time. If a child suffers from weak muscles and the child sits around, the normal balance is disturbed. Normally, balance is maintained by strengthening the forward muscles in the lumbar and neck areas. By improving posture through exercises, this deviation can disappear. If nothing is done about the sagging posture, over time the spine will become stuck and a permanent deformity of the spine will develop. The deformity is partly caused by the constant overload of the thoracic vertebrae, which become lower at the front than at the back. If the curvature increases, it can negatively affect breathing and the heart.

Stiffening in the back

If the spine can still move, exercises and sleeping on your stomach can be done to reduce the curvature. If stiffness has occurred so that the spine is no longer mobile, prolonged rest is necessary, requiring a lot of lying in the prone position. Changes in the discs between the vertebrae can cause severe kyphosis at a young age. You mainly see this in boys who are already well developed physically, but who do a lot of heavy physical work. Their spine has then been overloaded.

Outlook

As far as pain is concerned, the outlook in case of kyphosis is favorable. If the spine is no longer mobile, it can no longer be corrected. The patient must take into account that the spine will become worn out more quickly and therefore heavy physical work is not recommended.

In the elderly

In the elderly, vertebrae usually become more brittle and collapse at the front, where they are most heavily loaded. The joints between the vertebrae will become stiffened due to age-related wear and tear. In them, the increased back curvature can no longer be compensated by strengthening the lumbar curvature and neck curvature. This causes them to walk further forward. Small tears, bleeding and minor injuries will also play a role in the deterioration of the intervertebral discs. This can occur due to osteoporosis, especially in women over the age of 50. There may be something you can do to increase bone density by taking high doses of vitamin D and hormones. If there is kyphosis due to old age, rest, warmth and possibly a corset can relieve the complaints.

In children

When children sit in an incorrect position for a long time, mild kyphotic symptoms may develop. This mainly occurs in the first years of primary school because a child then sits in a somewhat forced position. Close attention must be paid to the posture of these children and physiotherapy may be necessary. Give the child plenty of exercise such as gymnastics and all kinds of other forms of exercise.

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