What is Hunched Back (Kyphosis)?

 

Hunchback or Hunched back is a condition where there is exaggerated forward rounding of the upper back. Hunchback can occur at any age; however, it commonly affects older women, where this deformity is termed as a dowager's hump. Patients having osteoporosis develop age-related hunchback. There are some types of Hunchback which affect the infants or teens. Mild hunchback may not cause any problems, but severe hunchback can be very detrimental where it affects the lungs, nerves, tissues and organs resulting in other medical problems. Treatment depends on age, cause and the effects of the Hunchback.

Hunchback: Causes, Symptoms, Treatment, Good Posture, Stretching Exercises

Causes and Risk Factors of Hunchback

Hunchback results when the vertebrae in the upper back become increasingly wedge-shaped and the cause for this can be various problems such as:

  • Osteoporosis.
  • Disc degeneration.
  • Cancer and treatment for cancer.
  • Scheuermann's disease.
  • Congenital/birth defects.

Risk Factors: There are certain groups of people who are at increased risk for developing hunchback such as:

  • Adolescent girls who have a poor posture.
  • Boys aged between 10 and 15 are at increased risk of developing Scheuermann's kyphosis.
  • Older patients suffering from osteoporosis are at a higher risk for spinal fractures which can contribute to Hunchback.
  • Patients having connective tissue disorders (Marfan syndrome) are more prone to developing Hunchback.

Signs and Symptoms of Hunchback

  • Patient may not have any signs or symptoms if the Hunchback is mild.
  • Abnormally curved spine.
  • Stiffness in the back.
  • Pain in the back.

Investigations for Hunchback

  • Physical exam.
  • Neurological exam to check reflexes and muscle strength.
  • X-rays to determine the degree of curvature and to detect deformities of the vertebrae.
  • Computerized tomography (CT scan) for more detailed images.
  • Magnetic resonance imaging (MRI) to rule out tumor or infection.
  • Nerve tests are done if the patient is experiencing any muscle weakness or numbness to check the nerve impulses.
  • Lung function tests are done for severe hunchback to check if the curve is affecting the patient's ability to breathe.

Treatment for Hunchback

Treatment depends on the cause of the condition and the symptoms of the patient.

  • OTC pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve) can be given. If these are not effective then stronger pain medications are prescribed by the doctor.
  • If the patient has osteoporosis, then drugs for osteoporosis such as bone-strengthening drugs are given to prevent fractures of the spine which may worsen the hunchback. In many patients, Hunchback is the first indication that they have osteoporosis.

Other Therapies Which Are Beneficial for Hunchback Are

  1. Exercises such as stretching exercises are help in improving the flexibility of the spine. Exercises which help in strengthening the abdominal muscles also help in improving the posture.
  2. Bracing can also be used especially in children suffering from Scheuermann's disease to help halt the progression of hunchback. These children can wear a body brace to prevent the hunchback from getting worse while their bones are still growing.
  • Surgical procedures are done if the curvature of the spine is exaggerated such as seen in severe hunchback and especially if it is pinching the spinal cord or the nerve roots. Surgery helps in reducing the degree of the hunchback curvature. The most common procedure done is called spinal fusion where two or more of the affected vertebrae are permanently connected. The complications for spinal surgery are quite high and include: Infection, bleeding, pain, arthritis, nerve damage and degeneration of the disc. A second surgery may be required if the initial surgery has failed to rectify the problem.

Good Posture for Hunchback: How to Fix Your Posture

Good posture is very essential to maintain a healthy mind and body. It helps in aligning the spine with itself. Having a good posture also helps in alleviating common problems like back or neck pain, headaches and fatigue. Other than improving your health, a good posture also boosts your self-confidence and your carriage. The steps to develop a good posture are:

  • Identifying a good posture: The first step is identifying a good posture i.e., a straight back, squared shoulders, chin up, chest out, stomach in. In a good posture, you should be able to draw a straight line from your earlobe through your shoulder, hip, knee, to the middle of your ankle. With the help of a mirror, align your ears, shoulders, and hips. These points should make a straight line; however, spine curves naturally in a slight 'S' shape. If you are experiencing pain, then look at your side view to see if you're forcing your spine into an unnatural position. The two natural curves in the spine need to be maintained. These are known as the 'double C' or 'S' curves and are found from the base of the head to the shoulders and the curve from the upper back to the base of the spine. Make sure that your weight is evenly distributed on your feet when standing upright.
  • Training or exercising your muscles: The next step in improving your posture is to do exercises which will help in strengthening the muscles across the upper back and shoulders so that you naturally and unconsciously maintain a correct posture all the times without feeling any fatigue.
  • Pretend to be a penguin by placing your elbows at your sides and touching your shoulders with your hands. Keep your hands on your shoulders with your ears aligned. Raise both the elbows and lower them back again.
  • Practicing yoga is extremely beneficial in developing a good posture. Yoga also helps in improving balance; strengthening the core muscles and helping you maintain a proper body alignment.
  • Standing Posture: A proper standing posture can be achieved by finding your center. A proper standing posture also gives you an air of confidence.
    1. Keep your feet shoulder width apart and stand up straight. This is the key to a good standing posture and should be repeated till you develop good posture habits such that it becomes a second nature for you.
    2. Place your weight on the balls of your feet. When you are resting on your heels, you will tend to slouch; however, stand up and try to stand on the balls of your feet. Observe the way your rest of the body follows suit. Now tilt back so that your weight shifts to your heels and observe how your entire body shifts into a "slouchy" posture again.
    3. Always keep your shoulders squared and stand up straight. Initially it may feel unnatural especially if you do not have good posture habits, but keep practicing till it becomes second nature to you.
    4. Pull your head backwards and upwards such that you are reaching for the ceiling and keep your head square on top of your neck and spine while doing this. This technique will not only improve your posture, but will also make you look taller and leaner.
  • Teach your body how a good posture feels like by standing with your back against a door or wall such that the back of your head, shoulders, and your butt are lightly touching the wall. Continue practicing this for a good posture.
  • Walking Posture: A good walking posture can be achieved by a good standing posture, as walking with a good posture is simply an extension of standing with a good posture. While walking, always keep your head straight up, shoulders back, chest out, and eyes looking straight ahead and always avoid pushing your head forward.
  • Sitting Posture: For a developing a good sitting posture always, sit up straight. Following are some basic guidelines for developing a good sitting posture especially if you are working at a desk all day long.
    1. Always use a chair that's ergonomically designed for giving proper support and is according to your height and weight. You can also use a small pillow for lumbar support.
    2. Keep your back aligned with the back of the office chair, as this will help in avoiding slouching or leaning forward.
    3. When sitting, always keep your shoulders straight and squared, your head upright, and your neck, back, and heels should be in alignment.
    4. Always keep both feet on the ground. You can use a footrest if your legs don't reach the ground.
    5. Your chair should be adjusted such that your arms are flexed and not straight out.
    6. Always take standing breaks in between even if you have a good sitting posture. Stand up in between, walk around and stretch a little for a few minutes.
  • Driving Posture: A good driving posture is achieved by developing a good sitting posture.
    1. Rest your back against the seat and the head rest.
    2. Adjust your seat such that there is an appropriate distance from the pedals and steering wheel. The following are the indications that you're too far away: If you're leaning forward, reaching for the wheel or pointing your toes. The following are the indications that you're too close: If you are sitting huddled up with your chin on top of the steering wheel.
    3. Adjust the head rest so that the center of your head rests against it. You can adjust the head rest as required. There should be a distance four inches/10 cm (and not more) between the back of your head and the head rest.
  • Sleeping Posture: It is difficult to maintain a specific posture when sleeping; however, the way you sleep has a bearing on your posture when you wake up.
    1. A firm mattress helps in giving a good back support.
    2. Sleeping on the back helps in keeping the shoulders straight and is more comfortable than sleeping on the stomach.
    3. When sleeping on your side, keep a small, flat pillow between the knees. This helps in keeping the spine straight and aligned.
    4. A good pillow should be used to provide the required support and alignment for the head and shoulders. Don't use too many pillows, as your head will be bent in unnatural position resulting in a bad posture with you feeling stiff, sore and groggy upon waking up.

Hunch Back: Stretching Exercises for Good Posture

  • This stretch vastly helps if you are suffering from a sore neck or back.
  • Stretch or tilt your head in all four directions (forward, back, left, right). Don't roll in a circle, as it can cause additional strain.
  • Massage your neck gently.
  • Get on your hands and knees and bend your back upwards (cat stretch). Do the opposite next.
  • Repeat a few times daily. This stretch, when done in the morning, helps in relieving the sleep induced muscle lethargy. If done regularly throughout the day, it helps in boosting your energy levels.

Exercises to Improve your Posture

Stay in shape by keeping your entire musculoskeletal system modified to support your posture. For this the following exercise are helpful:

  • Lie on your back with your feet on the floor and flex your legs to about 90 degrees at the knee.
  • Pull your belly-button in towards your spine and hold it at the end for 10 seconds.
  • Repeat eight times daily.
  • Always keep a proper posture even if it is tiring and other muscles, like the back or butt, are not being used.
  • Breathe normally when doing this exercise, because you are trying to train your core to maintain this position when doing daily normal activities.

The following exercises can be done with or without hand weights:

Exercise 1:

  • Keep your head upright and shoulders squared so that the ears are in alignment over the shoulders.
  • Lift both the arms straight out, palms up and alongside your ears.
  • Bend the forearms in and backwards, towards the shoulders while trying to touch your shoulder blades with your fingertips.
  • Repeat 10 times with both arms.
  • Do alternate ten reps for each arm individually.

Exercise 2:

  • Keep your head upright and shoulders squared so that the ears are in alignment over the shoulders.
  • Lift both the arms sideward at shoulder height.
  • Hold this pose for 10 seconds.
  • Now slowly bring the arms to the sides while counting till ten.
  • Again, slowly lift arms back to shoulder height while counting to ten when raising your arms.
  • Do 10 repetitions while checking your alignment with each rep. You should be able to feel mild tiredness in the shoulder muscles.

Posture Brace: What is a Posture Brace?

A posture brace is a simple garment which is used to provide support and stability to the body. It acts as a guide for correct alignment of the muscles in the shoulders and neck, upper and lower back. A posture brace helps in pulling and keeping your shoulders back and compels your back to stay upright or straight. It can be used by individuals of all ages who have problems related to a bad posture or improper alignment. These braces are usually sold over-the-counter and are available for men, women and children with different levels of support for various muscle groups. Some braces are made for those individuals who suffer from weak muscles surrounding the spinal column caused due to sitting at a desk all day long. While, some braces are especially designed for those individuals whose job entails heavy lifting or walking around carrying heavy objects. Braces help by artificially strengthening the core of the body and help in keeping the spine properly aligned. This relieves pressure on the neck, shoulders, back and abdominal muscles which leads to reduced pain and discomfort. Using a posture brace also vastly reduces the chances of injury.

Posture braces should be used intermittently, like when the symptoms flare up or when a person is not able to do daily activities of life. They can also be used as a preventative measure to avert any injury or to develop good posture habits. A posture brace should never be worn frequently or for long periods of time, as they may cause weakening of the muscles due to lack of their use resulting in worsening of symptoms and posture problems. A person should always bear this in mind that a posture brace is not a substitute for treatments like physical therapy, rehabilitation, losing weight, eating healthy or exercising. If the patient has suffered an injury, then he/she should visit a doctor immediately instead of trying to treat themselves with a posture brace.

Articles On Other Postural Deformities:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: April 26, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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