Kyphosis: Curvature Of The Upper Spine Once Called A Dowager ...

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Dowager Hump: An Outdated Name for a Common Spinal ConditionMedically reviewed by Timothy Gossett, M.D.Written by Jill Seladi-Schulman, Ph.D. on September 17, 2019
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Outlook
  • Takeaway

Dowager hump is the not-so-nice name for kyphosis, a condition where you develop a bend or “hump” in your upper back. It’s more common now because of the way people use their phones and other devices.

Slouching or hunching over a computer of phone can cause kyphosis, formerly called a dowager hump.Share on Pinterest

You may have heard of a “dowager hump,” but this isn’t a medical term or even an acceptable term. It refers to a curving of the spine that can result in an upper back that appears rounded or hunched.

The appropriate medical term for this type of condition is kyphosis.

Continue reading as we explore more about kyphosis, what causes it, and how it can be treated.

Language matters

Many people find the word “dowager” offensive because it has been a negative and insulting way to refer to older women.

Using appropriate medical terms for health conditions is important because outdated and hurtful terms generalize and stereotype individuals with medical conditions. Kyphosis, for example, can actually affect individuals of any gender or age.

What are the symptoms of kyphosis?

The human spine has a natural curvature. These curves help us to stand upright and stay balanced while doing so.

Kyphosis happens when the angle of the spine is out of the typical range. The condition can vary in seriousness. Generally speaking, the greater the curve of the spine, the more severe the symptoms are.

The symptoms of kyphosis can include:

  • rounded shoulders or a hump on your back
  • back pain or stiffness
  • feeling tired or fatigued
  • tight hamstrings

Although rare, more severe symptoms can occur as the spine continues to curve over time and compress other parts of the body, such as the lungs, nerves, and digestive tract.

Severe complications of kyphosis can include:

  • persistent back pain
  • increased trouble with physical tasks such as walking, looking upwards, or getting up from a sitting position
  • feelings of numbness or tingling in the legs
  • shortness of breath or trouble breathing
  • digestive issues, such as trouble swallowing or acid reflux
  • problems with control of the bladder or bowels

What causes kyphosis?

A variety of factors can lead to the development of kyphosis. They include:

Poor posture

Poor posture can include things like:

  • slouching or hunching, such as at a computer or in front of a TV
  • leaning back in chairs
  • carrying heavy loads on your back, such as a backpack full of books

Postural kyphosis is a common form of kyphosis that’s generally mild. People with postural kyphosis can often correct the condition by practicing good posture.

Spinal injuries

Some spinal injuries, such as fractures, can damage the spine and affect its curvature.

Conditions affecting the bones or spine

Underlying bone or spinal conditions can also lead to kyphosis, particularly in older populations. Some examples of these conditions include degenerative disk disease and osteoporosis.

Aging

Curvature of the spine begins to increase naturally with age. It’s estimated that the prevalence of kyphosis in older adults ranges from 20 to 40 percent.

In addition to bone and spinal conditions, other factors that naturally occur with aging can contribute to the development of kyphosis, including:

  • Decreased mobility. This can affect the muscles and ligaments in the back as well as posture and positioning.
  • Muscle strength. Studies have reported that weakened back muscles, specifically the spinal extensors, are correlated with an increased kyphosis angle in women older than 60.
  • Sensory changes. Decreased input from the senses, which can include things like vision, touch, and spatial awareness, can also affect posture and positioning of the head or neck.

Developmental conditions

Sometimes kyphosis can occur as a congenital condition. This happens if the spine doesn’t develop properly prior to birth.

Kyphosis can also occur when the spine doesn’t develop properly during a growth spurt. This is called Scheuermann’s kyphosis. Instead of rectangular-shaped vertebrae, people with this condition have vertebrae that are more triangle-shaped. This causes increased spinal curvature.

Cancer

Cancer of the spine can lead to weakening of the vertebrae, possibly contributing to kyphosis. Additionally, chemotherapy and radiation treatments for cancer can have a similar effect.

How is kyphosis diagnosed?

To diagnose kyphosis, your doctor will first perform a physical examination. They’ll record your height, examine your back, and may also press on your spine to see if there’s any pain or tenderness.

Then, they’ll ask you to bend forward with your arms hanging down freely, like you’re reaching to touch your toes. This helps them to better see the curve of your spine.

You may also be asked to lie down. This can aid your doctor in determining if your kyphosis is caused by bad posture or by a structural problem in the spine. The spine may straighten while lying down in people with postural kyphosis.

An X-ray can help determine the amount of curvature in the spine. If your doctor wants more detailed images, they may also use a CT scan or MRI.

In cases of severe kyphosis, your doctor may perform other tests to see if your condition is affecting other parts of your body. These can include tests that evaluate lung and nerve function.

When to see your doctor

In some people, mild kyphosis may not cause symptoms. But if you start to notice an increase in pain, numbness or weakness, or spinal curvature, make an appointment with your doctor.

What is the treatment for kyphosis?

There are several treatment options for kyphosis, depending on your overall health and the severity of your condition. Your doctor will work with you to develop an appropriate treatment plan.

If you’re concerned about your kyphosis and don’t already have a primary care provider, you can view doctors in your area through the Healthline FindCare tool.

treatment options for kyphosis

Some possible treatment options include:

  • Proper posture. For people with postural kyphosis, attention to good posture, such as sitting up straight, can help correct the spinal curvature. Ergonomics may also help.
  • Exercise. Getting regular exercise can help strengthen the muscles in your back.
  • Yoga. Yoga can help you to increase flexibility and strengthen the muscles in your back and core.
  • Pain relief. Over-the-counter (OTC) pain medication can help to ease back pain that’s associated with kyphosis. If these don’t help with pain, your doctor may prescribe a stronger medication.
  • Treating underlying conditions. If you have an underlying condition such as osteoporosis, your doctor will focus on treating it to prevent your kyphosis from getting worse.
  • Bracing. Using a back brace can help keep spinal curvature from worsening, particularly in younger people who are still growing. Your doctor will let you know when and for how long you should wear the brace.
  • Physical therapy. Your doctor may recommend that you work with a physical therapist to perform exercises and stretches that can help improve your condition.
  • Surgery. People with severe kyphosis or complications from kyphosis may need surgery to reduce the curve in their spine. This is often performed using spinal fusion.

What’s the outlook for people with kyphosis?

The outlook for kyphosis can depend on several factors. These include your overall health, your age, and the severity of the condition.

If it’s detected early, many people who have kyphosis can go on to live active lives and may not require surgery. Regular doctor’s appointments may be necessary to monitor the condition and make sure that spinal curvature isn’t worsening.

Kyphosis can worsen with age, which is why early detection is so important. Severe kyphosis can cause complications, such as problems with movement or balance and breathing difficulties. These cases may require treatment with surgery.

The takeaway

Kyphosis is a condition where the spine curves at an increased angle, causing a rounding or hump to form around the upper back or shoulders. There are many possible causes of kyphosis, including aging, poor posture, and spinal conditions.

In the past, kyphosis was referred to as “dowager’s hump”. However, this isn’t a medical term and is no longer acceptable to use. Even though kyphosis is common in older adults, it can occur in people of all ages.

If identified early, kyphosis can often be managed without surgical intervention. If you notice an unusual curve in your upper back or shoulders that has increased over time, see your doctor to discuss your condition.

 

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
  • Alion T, et al. (2015). Progressive spinal kyphosis in the aging population [Abstract]. DOI:https://doi.org/10.1227/NEU.0000000000000944
  • Katzman WB, et al. (2010). Age-related hyperkyphosis: its causes, consequences, and management. DOI:https://dx.doi.org/10.2519%2Fjospt.2010.3099
  • Katzman WB, et al. (2013). Kyphosis and decline in physical function over 15 years in older community-dwelling women: The study of osteoporotic fractures. DOI:https://doi.org/10.1093/gerona/glt009
  • Kyphosis. (n.d.).https://www.srs.org/patients-and-families/conditions-and-treatments/adults/kyphosis
  • Kyphosis. (n.d.).https://www.sciencedirect.com/topics/medicine-and-dentistry/kyphosis
  • Kyphosis. (2018).https://www.nhs.uk/conditions/kyphosis/
  • Kyphosis (roundback) of the spine. (2016).https://orthoinfo.aaos.org/en/diseases--conditions/kyphosis-roundback-of-the-spine/
  • Mayo Clinic Staff. (2018). Kyphosis.https://www.mayoclinic.org/diseases-conditions/kyphosis/symptoms-causes/syc-20374205
  • Roghani T, et al. (2017). Age-related hyperkyphosis: Update of its potential causes and clinical impacts – a narrative review. DOI:https://dx.doi.org/10.1007%2Fs40520-016-0617-3
  • Weale R, et al. (2012). The dowager’s hump: An early start? DOI:https://doi.org/10.1159/000329828
  • Yaman O, et al. (2014). Kyphosis and review of the literature. DOI:https://doi.org/10.5137/1019-5149.JTN.8940-13.0

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Medically reviewed by Timothy Gossett, M.D.Written by Jill Seladi-Schulman, Ph.D. on September 17, 2019

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