What is kyphosis, symptoms, treatments, types and cure

What is kyphosis?

Known in medicine for “hyperkyphosis”, kyphosis is the increase in the angle of one of the physiological curvatures of the spine . It occurs in the chest area and makes the upper back appear more rounded than normal: it is the famous “hump”.

The spine has four physiological curvatures: cervical lordosis , thoracic kyphosis, lumbar lordosis and kyphosis of the sacrum. Each of them has its function, but when the angle of the curvature is too open or closed, they can cause problems for the patient.

In the case of thoracic kyphosis, the ideal angle of curvature is between 20º and 45º. Less or more than that can cause deformities, pain, stiffness, sensitivity, damage to the nervous system, among others.

The individual with kyphosis often presents the shoulders, neck and head tilted forward. The condition can arise as compensation for other conditions in the spine, such as lordosis and scoliosis .

Considered a spinal disease, kyphosis can be cured and is related to other diseases such as the curved postural back, Scheuermann’s disease (which begins in adolescence) and rheumatological diseases of the spine.

Spine

The spine is an anatomical structure composed of 24 bones stacked on top of each other. These bones are called vertebrae, and serve as a shelter for the spinal cord, a channel through which the body’s nerves pass and connect all parts of the body with the brain.

You can already see that the function of the spine is very important, right? But it doesn’t stop there: it is also the wonder that stabilizes our body and allows us to stand, sit, walk, among others. If our column was a little different, we might not be able to walk on 2 feet!

That is precisely why a slightly larger curve already brings so many complications. Being the pin that keeps our balance, it is essential that the spine is perfectly in place.

To help keep the bones stacked, there are two other structures: the intervertebral discs and the ligaments. The discs are, as the name says, between one vertebra and another, while the ligaments connect the vertebrae to the other bones, muscles and other structures in the region.

In the case of kyphosis, the vertebrae, ligaments and even discs are in the wrong position, impairing posture. If the curvature is not very sharp, there is only an aesthetic discomfort. However, depending on the severity of the case, there may be more serious complications.

Types of kyphosis

Kyphosis can be classified by both morphology and cause. Understand:

Structural kyphosis

It is characterized by morphological changes, that is, the vertebrae and the spine have suffered deformations in the formation of their structure.

Postural kyphosis

It happens because of the posture that the person adopts in his day-to-day. It can be corrected through physiotherapy, as there is no compromise in the structure of the vertebrae. However, a postural kyphosis can, over time, become structural.

It is more common in adolescents, who spend a lot of time sitting in the wrong posture. In boys, height can be a risk factor for the development of hyperkyphosis, because adopting a bad posture helps to disguise their height, preventing the boy from standing out in front of peers of the same age.

In the case of girls, when the growth of the breasts is abundant, they can try to hide the volume by bending the spine, leading to a postural kyphosis.

Primary kyphosis or idiopathic kyphosis

This type of kyphosis happens when there is no adjacent disease. This is the case of postural kyphosis, which occurs by itself through the habits of the individual.

It has a benign character and can be resolved, but when left untreated, its severity can worsen and there is pulmonary involvement.

Secondary kyphosis

The secondary type occurs at the expense of adjacent diseases and usually causes severe deformities. It is related to structural kyphosis.

Causes

Although the actual cause of hyperkyphosis is not well known, there are some factors that are closely linked to the development of abnormal spine curvature. Are they:

Bad posture (postural kyphosis)

The habit of maintaining a non-ideal posture can stretch the muscles and ligaments of support in the region of thoracic kyphosis, destabilizing the bones that are there. In this way, an exaggerated curvature is formed.

Bending over, leaning back badly on the back of chairs and carrying heavy bags are some examples of activities that can increase the chances of developing a postural kyphosis.

Age

As age advances, it is normal for the body to begin to wither. With bones, this is no different. Older people tend to have a more pronounced curvature in the spine.

Osteochondritis

Although poor posture is the main cause of kyphosis in young people, there is another condition that causes this problem in younger people.

Osteochondritis is characterized by inflammation of bones and cartilage together and is the main cause of severe deformities in young people.

Osteoporosis

The osteoporosis is a condition in which bones lose strength and may break (fracture) more easily. In the spine, this is especially complicated, as it can cause several postural changes, including hyperkyphosis.

Abnormal formation of vertebrae

When the bones of the spine (vertebrae) have malformations, they can end up leaving the ideal position and, as a result, cause an increased curvature of the thoracic kyphosis. One of the conditions that causes this malformation as a consequence is Scheuermann’s disease .

Abnormal development of the spine in the uterus (congenital kyphosis)

When the malformation of the bones of the spine occurs during the development of the embryo, it is called congenital kyphosis. In these cases, two or more vertebrae may end up merging, causing the spine to have no mobility and creating an abnormal angulation in thoracic kyphosis.

Neuromuscular and rheumatological diseases

There are several diseases that cause inflammation in the spine. When this happens very often, which is quite common in autoimmune diseases like rheumatoid arthritis and ankylosing spondylitis , the joints wear out.

As a result, the spine ends up gaining an abnormal angle.

Spinal trauma

Hyperkyphosis can also develop as a result of trauma to the spine. Damage to bones can cause them to calcify in abnormal ways, causing the vertebrae to shift and causing the arch to spine.

Tumors

Certain tumors can develop inside the spine or reach it through metastasis. This can destabilize the vertebrae, which in turn change position and cause greater curvature.

Groups of risk

The risk groups for the development of kyphosis are:

  • Children and adolescents: It is at this stage that the spine is developing and growing. If the parents do not teach the child / adolescent to stand upright, they may end up developing postural hyperkyphosis. At this age, too, certain conditions start to appear, such as Scheuermann’s disease;
  • Elderly: Due to the wear of the vertebrae and the loss of flexibility of the intervertebral discs, in addition to the weakening of the muscles, the elderly are a risk group.

Diseases that cause kyphosis

Some diseases that cause hyperkyphosis are:

  • Osteoporosis: Because of the weakness of the bones;
  • Spondylosis: A physiological wear and tear that occurs in the spine as the individual ages;
  • Spina bifida (myelomeningocele): When the spine does not develop correctly during pregnancy;
  • Paget’s disease: In this condition, the development of bone cells is interrupted, which results in weak bones;
  • Neurofibromatosis: It is a genetic disease that affects the nervous system and causes benign tumors in the brain, spinal cord and nerves;
  • Muscular dystrophy: Disease that causes the progressive weakening of muscles;
  • Tuberculosis: Bacterial infection that affects the lungs;
  • Rheumatoid arthritis: A condition that causes frequent inflammation in the joints, including the spine;
  • Ankylosing spondylitis: Disease that causes inflammation in the spine and that, if left untreated, causes the fusion of vertebrae;
  • Cancer: When a tumor develops in the spine, it can cause kyphosis.

What is the relationship between kyphosis and Scheuermann’s disease?

Scheuermann’s disease is one of the most common causes of kyphosis. This is a problem in the development of the patient’s spine, which causes painful bad posture.

It usually occurs at puberty, as it is the stage at which growth hormone levels rise, and the individual is abnormal in size compared to others of the same age.

The causes are unknown, however, one of the possible factors is the genetic. The diagnosis and treatment are the same as for hyperkyphosis, however, performed with more caution by the specialist.

What are the symptoms?

In general, kyphosis causes no symptoms other than poor aesthetics. However, there are reports of pain in cases of severe deformity or after intense physical activity.

In elderly people, the pain may appear due to the weakening of the bones that occurs naturally with age.

Diagnosis

As kyphosis has no symptoms, the patient should see a doctor if he / she notices any deformity in the body, such as:

  • Rapid deformity in some region of the spine;
  • Weight loss without a change in eating habits;
  • Sensitivity or weakness in the lower limbs.

The professional who will diagnose kyphosis is the orthopedist , a specialist responsible for treating diseases and deformities of bones, muscles, ligaments and joints. He may request radiographs or other imaging tests, such as:

Computed tomography (CT)

In this type of examination, X-rays build a three-dimensional image of the patient’s spine.

Magnetic resonance imaging (MRI)

For those who cannot use radiation, MRI may be an option. Through strong magnetic fields, the MRI machine is able to create clear images of the patient’s interior.

Bone densitometry

Bone densitometry is a specific type of X-ray used to determine bone density. The denser they are, the healthier and stronger they are.

This test helps in the diagnosis of adjacent diseases, such as osteoporosis, in which the density of the bones is very low and causes fractures easily.

Does kyphosis cure?

Yes, kyphosis can be cured by surgery to correct the spine. However, it is only indicated in special cases.

The patient can live with the disease by monitoring its clinical development. Improvement can be achieved through physical activities to strengthen and stretch the muscles and the back.

Treatment

The treatment for kyphosis is, in general, very conservative, that is, it seeks to treat the problem without resorting to invasive methods, such as surgery. In more severe cases, a surgical procedure can be done to correct and realign the posture.

Vertebral Vests

When hyperkyphosis is diagnosed in childhood, the doctor may order the use of spinal vests (orthoses) to improve posture and limit the progression of kyphosis as the child grows.

The treatment lasts until about 14-15 years, the age at which the spine finishes its development and stops growing. In adults, the vest is not recommended as it will not be able to change the position of the spine.

Hard mattresses and firm insoles can also be indicated in these cases.

Physiotherapy

In most cases, physiotherapy sessions are recommended, a type of therapy that seeks to improve or maintain the function of the different parts of the body, when they are already impaired.

In this context, physiotherapy tries to help the patient to acquire a correct posture, improving the curvature of the spine. Postural kyphosis can be treated only with physical therapy, but other types may also require this type of treatment.

A widely used technique is RPG (Globalized Postural Reeducation), which focuses precisely on the patient’s posture, educating all the muscles and joints of the body to generate a correct posture.

Diet

As the health of bones – and, consequently, of the spine – depends a lot on the diet, it is necessary that the patient with kyphosis adopt a balanced diet, rich in calcium and vitamin D.

Increasing your intake of milk and milk-derived foods can help replenish calcium, but vitamin D is needed to help absorb the nutrient from your bones. Therefore, the patient may also need vitamin supplements with high amounts of vitamin D.

Exercises

Another way to treat kyphosis is exercise, especially in cases of postural kyphosis. Some recommended exercises are:

Bodybuilding

Aimed at strengthening the muscles and correcting posture (such as the abdominals).

Swimming, water aerobics or rowing

Such exercises assist in strengthening the muscles, working the shoulders in order to correct posture.

Stretching

Often indicated even for those who have a healthy spine, the stretches work on the flexibility of the spine and relieve back pain from poor posture.

Yoga and Pilates

Although they seem just a fad, both yoga and pilates help to promote a correct posture. Therefore, they are quite valid alternatives for mild and moderate cases.

Chiropractic

The chiropractic is a type of physical therapy that directly manipulates the joints of patients and aligns the vertebrae and is highly recommended to treat spinal problems such as kyphosis.

Read more: Chiropractic: what is it and how much does it cost?

Surgery

Surgery is indicated in cases of severe, progressive and painful deformities, these cases being rare and special.

One of the techniques used to treat kyphosis surgically is vertebral fusion, in which two or more vertebrae are fused and stabilized using titanium screws and bars.

Recovery does not take long: the patient can return to daily activities (school, college or work) after 4 to 6 weeks of surgery. However, the practice of sports is only allowed after 1 year.

Risks associated with the operation include infection, excessive bleeding (bleeding) and accidental damage to the nerves that pass through the spine, resulting in paralysis, loss of bladder and bowel control.

Medicines for kyphosis

There is no specific treatment for kyphosis through drug administration. However, for elderly people it may be necessary to use remedies for osteoporosis, such as calcium supplements .

For cases of pain, which are rare, the doctor may recommend paracetamol and anti-inflammatory drugs such as ibuprofen , which will act to relieve pain.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Exercises to improve posture

If your type of kyphosis is postural, there are some exercises you can do at home to help improve posture.

However, it is recommended that you consult an orthopedist or physiotherapist first of all, to ensure that there is no problem in performing such exercises.

Exercise 1

This first exercise consists of aligning the spine with a straight surface, preferably a wall. To do this, just lean on the wall, touching all parts of the column on the surface.

Do the same with your arms, so that your shoulders are also aligned. It is necessary to remain in this position for 1 to 3 minutes.

Exercise 2

In the second exercise, you should stand in position 4, with your hands and knees on the floor. Then, just raise one arm to shoulder height and stretch one leg at the hip.

It is important that the limbs are mirrored, that is, if you raise your right arm, then you must stretch your left leg.

Stay in this position for at least 1 minute, and then switch your arms and legs. Do this 4 times.

Exercise 3

This exercise has 3 variations, but all are done with the body lying on a hard mattress, face up.

In the first variation, you should place a pillow under your back, press your knees against the mattress, squeeze your butt, open your chest and try to join your shoulders. Keep your palms facing up and try to press your head against the mattress.

Stay in this position for 20 to 30 seconds and take a deep breath. Then, relax your body and repeat 4 more times.

In the second variation, the difference is that the arms are up and are pressed against the mattress as well. In the third version, you should bend your knees and keep your arms open at a 90º angle. This time, only the head and arms are pressed against the mattress.

If you don’t have a hard mattress, you can do this exercise on a mat.

Exercise 4

One of the easiest and most intuitive exercises to do is to cross your arms behind your back. When you cross your arms in an X shape behind your back, the body automatically assumes a more upright posture.

It is recommended to perform this exercise for a few seconds several times a day.

Exercise 5

Another very simple exercise can be done with a simple broomstick. It consists of passing the cable horizontally behind the back and holding it with the fold of the arms. This will automatically align the spine, keeping it upright.

Complications

Although, in most cases, it is a benign condition, kyphosis can cause some complications, especially when very severe. Understand:

Emotional problems

The aesthetic discomfort caused by the curvature of the spine can lead the patient to have problems with self-image and self-acceptance. Thus, the condition makes the patient conducive to the development of mental disorders such as depression and other emotional problems.

Persistent pains

Another delicate complication of kyphosis is persistent pain, which, in turn, can also contribute to the development of emotional problems.

In cases in which the curvature is very accentuated, poor posture ends up putting pressure on nerves and hinders the functioning of other organs, causing pain that does not go away on its own.

Breathing difficulties

When the curvature of the spine is very sharp, the bones of the rib cage end up compressing the lung and the airways. Thus, there is not much room for the lung to expand and the patient experiences difficulty breathing.

Myelopathy

In the most severe cases, compression of some nerves in the spine can occur, a condition called myelopathy. In addition to pain, this complication impairs nerve signals and causes symptoms such as numbness or weakness of the limbs, problems with balance and loss of bladder and bowel control.

How to prevent kyphosis?

Certain causes of kyphosis cannot be prevented, such as when it arises because of old age. However, this does not mean that there are no measures to be taken to prevent the development of hyperkyphosis. Are they:

  • Maintain an upright posture when sitting;
  • See a doctor if you notice any strangeness in the spine;
  • Avoid using backpacks and heavy bags, which can pull the muscles and ligaments of the back;
  • Eat a diet rich in calcium and vitamin D, to prevent problems like osteoporosis;
  • Practice physical exercises regularly, as they help to maintain bone health;
  • Be careful when carrying heavy objects. Keep them close to the body, to decrease the force that the spine must make to support the weight;
  • Avoid self-medication when you feel pain, as this can delay the diagnosis and make it difficult to correct the problem;
  • Choose shoes very well, avoiding very high heels or, at least, alternating the types of shoes used on a day-to-day basis, as this helps to maintain the health of the spine.
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