Dorsal hyperkyphosis (kyphosis): what it is, causes and treatments

Kyphosis is a deviation in the spine that causes the back to be in a "hunchback" position and, in some cases, can cause the person to have the neck, shoulders and head very tilted forward, becoming also called dorsal hyperkyphosis.

Hyperkyphosis can be the only serious spinal change, however it can also occur as a way to compensate for other postural changes, such as lordosis or scoliosis. Therefore, it is important that each case is evaluated by the orthopedist by the physiotherapist so that the treatment is done according to the characteristics presented by the person.

Hyperkyphosis tends to worsen with age if no treatment is performed and there may be back pain, spinal deformity, and difficulty keeping the body upright and the head turned up or back. In addition, kyphosis can impair breathing by decreasing lung expansion and spinal flexibility.

Main causes

According to the cause, kyphosis can be classified into:

• Congenital, when the baby is born with this spinal deformity and the deformity tends to worsen over time, often requiring surgical intervention in the first years of life; Acquired, when it happens as a consequence of diseases like osteomyelitis, osteoporosis or trauma, for example; Postural, which happens due to bad postural habits, being possible its voluntary correction when standing up in a good posture. The treatment of this injury is through postural correction, muscle strengthening of the extensors and diet in case of excess weight.

Thus, some of the causes that may favor the occurrence of congenital, acquired or postural hyperkyphosis are:

• Psychological problems such as low self-esteem or depression; Bad postural habits, such as sitting with the body bent forward; Lack of physical conditioning that causes weakness of the paravertebral muscles, located next to the spine and abdominal muscles; Spinal trauma due to an accident; Vertebral compensation fracture; Due to diseases such as ankylosing spondylitis, senile osteoporosis or tumors; Congenital defects, which may be associated with neurological syndromes.

Hyperkyphosis is more common in adolescents who grew up very fast and are taller than their peers of the same age, causing feelings like shame, and also in the elderly, due to bone changes, such as arthritis or osteoporosis, for example.

How is the diagnosis

The diagnosis of hyperkyphosis is made by the orthopedist based mainly on the observation of the curvature of the spine, being necessary for this that the person stands aside so that the doctor can better observe if there are changes. In addition, it is usually requested by the doctor to perform imaging tests, such as lateral X-ray to check the Cobb angle and, thus, to know the severity of the change.

The normal angle of thoracic kyphosis varies between 20-40 degrees, with no consensus on the absolute value, and treatment is needed when there is more than 50 degrees of kyphosis. For this measurement, the angle between the C7 to T12 vertebrae must be considered.

How the treatment is done

The treatment of hyperkyphosis should be directed according to its severity, being necessary to perform an image exam to check the degree of alteration of the curvature of the spine. Depending on the severity and cause of the hyperkyphosis, treatment can be performed with physiotherapy and surgery, in the most severe cases.

1. General exercises for kyphosis

Physical exercises are recommended for cases of mild kyphosis, when the person has pain or discomfort in the middle of the back, with the shoulders being slumped forward.

In these cases, the most suitable exercises to correct kyphosis are swimming, weight training or water aerobics, as they help to strengthen the back muscles and improve physical fitness. See also some examples of exercises to improve posture.

2. Physiotherapy for kyphosis

Physiotherapy for kyphosis can be done with measures that bring pain relief, such as the use of hot compresses and stretching exercises, for example. In addition, spinal manipulation techniques and specific exercises for kyphosis must be guided by the physiotherapist, according to the needs of each person.

The best kinesiotherapy exercises for kyphosis are RPG, global postural reeducation, and clinical Pilates and water pilates, isostretching and hydrotherapy exercises, guided by the physiotherapist. These achieve excellent results in correcting kyphosis and correcting posture.

3. Kyphosis surgery

Surgery is particularly indicated for people who have congenital kyphosis, which is when the deformity has been present since birth, usually associated with some genetic syndrome. It can also be an option for people who have persistent neurological symptoms or pain in the middle of the back, as in Scheuermann's disease, a common disease in male adolescents, whenever it has more than 70 degrees of kyphosis, because when the angle is smaller, the treatment with physiotherapy achieves great results.

Does kyphosis cure?

Kyphosis is curable and can be achieved through treatment, which must be done according to its severity, and which can include physiotherapy sessions, regular exercise, maintenance of good posture, and in the most severe cases, if you resort to surgery to get the vertebrae aligned.

In addition, the use of orthopedic mattresses, posture vests and custom-made insoles help in the treatment and are beneficial to obtain better treatment results.