Kyphosis is an exaggerated forward curve of the spine, often caused by poor posture, genetics, or injury. It can affect appearance and cause discomfort.

Kyphosis of the spine, also known as hyperkyphosis or roundback, is a condition in which the upper back has an excessive forward curvature, or curvature of more than 50 degrees.

In the past the condition had been referred as hunchback or dowager hump, which are not medical terms and are no longer acceptable.

The upper back, or thoracic region of the spine, naturally has a slight curve. The spine naturally curves in the neck, upper back, and lower back to help absorb shock and support the head’s weight. Kyphosis occurs when the vertebrae (bones in one’s spine) become misshapen, and this natural curve is larger than usual.

People with mild kyphosis may not notice any signs or symptoms. However, those with moderate to severe kyphosis may experience back pain, stiffness, and visible rounding of the upper back. In some cases, kyphosis can lead to excess pressure on the spine and lungs, leading to difficulties with breathing.

The signs and symptoms of kyphosis vary. They also depend upon the cause and severity of the spinal curve. Common symptoms include, but are not limited to:

  • rounded shoulders
  • difference in shoulder height
  • a visible hump on the back
  • pain or stiffness in the back and shoulders
  • fatigue
  • tight hamstrings (muscles in the back of the thigh)

In rare cases, kyphosis may also lead to complications such as:

The three most common types of kyphosis include:

Postural kyphosis

Postural kyphosis is the most common type of kyphosis. It usually develops during adolescence as a result of clinically poor posture at a time when the body is rapidly growing.

Postural kyphosis is rarely painful and can usually be corrected when the patient stands upright. The exaggerated spinal curve does not tend to worsen or lead to problems later in life.

Postural kyphosis tends to affect female teenagers more frequently than it does for than males.

Are sex and gender the same thing?

People often use the terms sex and gender interchangeably, but they have different meanings:

  • “Sex” refers to the physical characteristics that differentiate male, female, and intersex bodies.
  • “Gender” refers to a person’s identity and how they feel inside. Examples include man, woman, nonbinary, agender, bigender, genderfluid, pangender, and trans. A person’s gender identity may be different from the sex they were assigned at birth.
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Scheuermann’s disease

Scheuermann’s kyphosis is a condition named after the Danish radiologist who first identified it. Like postural kyphosis, Scheuermann’s kyphosis appears most often in teenagers.

However, unlike postural kyphosis, it appears most commonly among males. Scheuermann’s kyphosis is caused by a structural abnormality in the spine, usually three or more irregularly shaped vertebrae, and cannot be corrected by standing upright.

The exaggerated curve tends to be rigid and can cause pain during physical activity or if the patient has been standing or sitting for long periods of time.

Congenital kyphosis

Congenital kyphosis occurs when an infant’s spine develops abnormally in the womb. For example, vertebrae may be misshapen or fused together.

Patients with congenital kyphosis typically require corrective surgery early in life and may have additional birth defects affecting the heart and kidneys.

Kyphosis can be present at birth or develop later in life. Other than poor posture, congenital factors, or Scheuermann’s disease, other common causes for kyphosis include:

Less common causes of kyphosis include:

Treatment for kyphosis will depend on its severity and underlying cause. If you have a mild to moderate case of kyphosis and are experiencing painful symptoms or limited mobility, your physician may recommend treatments such as:

  • pain medication
  • physical therapy to build strength in the core and back muscles
  • wearing a back brace
  • postural exercises

In severe cases of kyphosis, such as congenital kyphosis, the health of your internal organs may also be impacted. This could result in complications such as difficulties with breathing and incontinence. In these cases, your physician may recommend corrective surgery such as spinal fusion.

When to see a doctor?

In severe cases, you could also experience symptoms that can be serious or life threatening and need immediate medical attention. These include:

What happens if kyphosis is left untreated?

If left untreated, kyphosis may cause complications such as chronic back pain, limited mobility, back deformity, weakness or numbness in one’s limbs, or respiratory issues.

Can kyphosis be reversed?

Postural kyphosis can be corrected by improving one’s posture and strengthening the back muscles through regular exercise or physical therapy. Scheuermann’s kyphosis can be corrected with similar methods once a child grows. Those with more severe or congenital kyphosis will likely need surgery to correct their curvature.

What is the difference between kyphosis and lordosis?

Lordosis, like kyphosis, is a condition affecting the inward curvature of the lower spine. Unlike kyphosis, when there is an exaggerated forward curve of the spine, lordosis, also known as “swayback,” affects the inward curvature of the spine. Doing certain lordosis exercises can help relieve symptoms.

If kyphosis is diagnosed and treated early, patients can manage their symptoms without surgical intervention.

Patients with kyphosis are encouraged to meet regularly with their physician to monitor the progression of their spinal curve. This will ensure that a patient’s treatment is current, best positioning them to lead a healthy and active lifestyle.