What is Kyphosis? - Symptoms, Causes , Types & Treatment

Kyphosis is a disorder of the spine. In this disease, the spine of the patient becomes curved, and this causes the rounding of the upper back. Sometimes this condition is called round back or hunchback (in severe cases). Kyphosis can occur to a person of any age, but older women are more likely to develop this condition. The most common types of kyphosis are Scheuermann's kyphosis, postural kyphosis and congenital kyphosis. 

Generally, kyphosis is caused in older age due to weakness in the bones of the spine. Due to weakness, the spine bone compresses or cracks. The kyphosis caused in children is due to the malformation of the spine or because of improper wedging of the spinal bones. 

Most kyphosis does not require treatment and can be reversed through improvement in posture and exercise. In cases treatment is needed, it depends upon the cause of the condition. Umlike kyphosis, which is an outward curvature of the spine, lordosis is the inward curvature in the lower back or neck and scoliosis is the lateral curvature forming a C-shape or S-shape.

Mild kyphosis may not show any kind of symptoms in the initial days. But, in some cases, it may show signs like 

1. Pain and stiffness in shoulder blades and back
2. Numbness, weakness, and tingling sensation in legs
3. Fatigue
4. Problem in balancing
5. Shortness of breath
6. Bladder and bowel incontinence

Generally, kyphosis is caused when the vertebrae in the spine become more wedge-shaped. The reasons behind the abnormal vertebrae may be any of the followings:

1. Fracture: Broken or crushed vertebrae can also cause the spine to bend. Often, mild fractures do not produce any strong signs and symptoms.
2. Osteoporosis: Osteoporosis can also cause the spine to change its curvature. 
3. Birth Defect: The bones of the spine that do not grow properly during the growing age can also cause a change in the curvature of the spine.
4. Syndrome: Certain syndromes like Ehlers-Danlos syndrome and Marfan syndrome cause kyphosis in children. 

The two most common factors that increase the chances of developing kyphosis are osteoporosis and having a family history of the condition.

Some other risk factors of kyphosis are:

1. Arthritis
2. An injury to the spine
3. Chronic disorders such as Paget's disease
4. Cancerous tumours and cancer treatment
5. Infectious disease conditions such as polio and tuberculosis
6. Spondylolisthesis (it is a condition in which one vertebrae slips in front of the other)

It is not possible to prevent kyphosis in all cases. But, we can reduce the chances of postural kyphosis by practising some of the following steps:

1. Maintain good posture
2. Perform exercises to strengthen the back and abdominal  muscles
3. Maintain a healthy body weight
4. Regularly do exercises to strengthen your body and stay flexible
5. Avoid slouching
6. Use a chair that has a good sitting posture
7. Stop smoking as it increases the risk of developing kyphosis
8. Either reduce or avoid alcohol consumption

Early diagnosis offers the best outlook for kyphosis. In most cases, people do not need any treatment. However, if it is not treated, it may lead to worsening of curvature and significant spinal deformity. The patients may have a loss of sensation and movement in the lower body. The best way to monitor kyphosis is to do exercises daily and do physical therapy to improve the body posture.  

1. The doctor will diagnose the kyphosis by performing a physical examination of the patient.
2. The doctor may ask the patient to perform some of the exercises. It is recommended to check the body balance and the range of motion of the patient.
3. Another prevalent evaluation test involves laying the patient on the ground, and during this, the doctor will examine the spine. If the spine is straight, it is diagnosed that the kyphosis is postural and not structural.
4. If the spine remains curved, it is said to be structural kyphosis.

The doctor may also recommend tests to diagnose the condition better. These tests may include:

1. CT Scan: CT scan provides a detailed scanned view of the internal organs of the body. It will help in efficiently diagnosing the curved spine.
2. MRI: MRI scan produces a more detailed image of the organs. It will help in detecting the infection and tumours in the body.
3. Nerve Tests: Feeling of numbness and weakness. This test determines how well the impulses are working in the nerves.
4. Bone Density Test: If a person has a low bone density, then the case of the kyphosis can be worsened.

How to prepare for a doctor consultation?

1. You should book the appointment through an online website. It will exempt you from the queue for registration. 
2. Prepare a set of questions that you want to ask the doctor. Your list may include questions like the adverse effects of the procedure and the precautions you need to take after the surgery. 
3. Do not forget to ask the doctor about the precautions you need to take after completing the surgery.
4. Accompany a family member or a close friend with you to the doctor's office if you need.
5. Always explain all the symptoms that you are experiencing in detail. It will help the doctor to diagnose the problem in a better way.

The treatment of kyphosis depends upon the severity and the type of kyphosis.

Surgery

1. People with congenital kyphosis or severe Scheuermann's kyphosis may be recommended for surgery. The main aim of surgery is to decrease the curve of the spine. Scheuermann's kyphosis is a rigid form of spinal kyphosis that affects the upper back and makes it rounded. About 50% of the patients with  Scheuermann's kyphosis experienced back pain.
2. Spinal fusion is the most common surgical method used to treat the spine curve (kyphosis). In this method, the surgeon inserts pieces of bones between the vertebrae. After this, the vertebrae are fixed together using metal rods and screws. These remain in place until the spine fuses.

Bracing

1. Milwaukee braces is a back brace used for the management of spinal curvatures. These braces consist of chin support, upright bars along with a neck ring. It stabilises the spine and prevents the spine condition from worsening. It can even correct kyphosis in growing-aged children. This brace is prescribed to be worn 23 hours a day until the adolescent period is completed. 

Exercises

1. Exercise is very beneficial in cases of postural kyphosis and for mild kyphosis. A daily exercise program that includes back strengthening exercises is advised for a few months. It is found to be successful in these types of cases.

1. Breathing Problems: Some kyphosis also puts pressure on the lungs.
2. Digestive Problems: In some cases of kyphosis, the digestive tract is also compressed. In these conditions, issues like acid reflux can occur.
3. Body Posture: The person suffering from kyphosis, especially children, develops a poor body posture due to the curvature of the spine.

When to consult a doctor?

1. You should consult a doctor if there is any noticeable difference (curve) in the spine or feeling any kind of pain in the shoulder region. The doctor will diagnose the condition, and if it is kyphosis, he/she will start the treatment of that condition. Postural kyphosis does not need any treatment because it does not involve any permanent spine changes. It can be fixed by doing specific exercises for a few months.