Kyphosis (Dowager's Hump)

Kyphosis is a spinal condition characterized by an excessive forward curvature of the thoracic spine, leading to a lunched or rounded upper back. This curvature results in a slouched posture or what is sometimes called a humpback, hunchback, dowager's hump, round back, or arched back.

This condition can affect posture, mobility, and overall quality of life. Treatment options vary based on severity and underlying causes, and may include bracing, medication, physical therapy, or surgery.

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• What Is Kyphosis?
• What Are the Symptoms of Kyphosis?
• How Do You Diagnose Kyphosis?
• How Do You Treat Kyphosis?

What Is Kyphosis?

Kyphosis is a spinal condition characterized by an excessive forward curvature of the thoracic spine, leading to a hunched or rounded upper back. While some curvature is normal, kyphosis occurs when the rounding exceeds 50 degrees.

This condition can affect people of any age, but is most commonly seen in older adults due to age-related degeneration of the spine.

What are the types of kyphosis?

Kyphosis can be classified into different types based on its cause and severity. Types of kyphosis include:

Congenital kyphosis

Present at birth, congenital kyphosis occurs due to improper spinal development in the womb. This form can worsen over time and may require early medical intervention.

There are two types of congenital kyphosis, including:

• Failure of formation — The spine does not develop completely, leading to progressive deformity.
• Failure of segmentation — The vertebrae do not separate properly, restricting spinal growth.

Postural kyphosis

The most common type, postural kyphosis results from poor posture. It is typically mild and correctable with physical therapy and posture training.

Scheuermann's kyphosis

Also known as juvenile kyphosis, this form develops before puberty due to abnormal vertebral growth, causing wedge-shaped vertebrae. The cause is unknown but may be linked to genetic and developmental factors.

What causes kyphosis?

Kyphosis may be caused by:

• Arthritis — Degeneration of spinal joints.
• Compression fractures — Collapsed vertebrae due to aging or injury.
• Osteoporosis — Weakening of bones that leads to spinal fractures.
• Poor posture — Slouching or incorrect sitting and standing habits over time.
• Spinal trauma — Injury to the vertebrae.

Kyphosis risk factors and complications

Kyphosis risk factors

Kyphosis risk factors include:

• Gender — Higher prevalence in females, particularly after menopause.
• Genetics — Family history of spinal deformities.
• Low bone mineral density (BMD) — Increases the risk of spinal fractures.
• Over age 40 — More common in older adults.
• Sedentary lifestyle — Weak back muscles contribute to spinal misalignment.

Complications of kyphosis

Potential complications of kyphosis include:

• Chronic pain — Causes persistent discomfort in the upper back.
• Neurological impairment — Nerve compression leading to weakness or numbness.
• Reduced mobility — Difficulty standing or walking for extended periods.
• Respiratory issues — Reduced lung function due to pressure on the thoracic cavity.

How can I reduce my risks of kyphosis?

Kyphosis can be managed or prevented through physical therapy and practicing proper body mechanics and posture. A physical therapist can give you a regimen of exercises or stretches to follow.

How common is kyphosis?

Kyphosis is a common age-related condition that normally occurs after age 40. An estimated 20-40 percent of adults over age 60 have hyperkyphosis, a severe form of kyphosis.

Women are at a greater risk of having kyphosis, particularly during menopause. Age-related kyphosis is often a sign of another underlying issue, such as osteoporosis.

Scheuermann disease is far less common, affecting an estimated 0.4-0.8 percent of people in the United States. This condition is twice as likely to affect young men than women. Scheuermann disease is commonly diagnosed between ages 13 and 16.

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What Are the Signs and Symptoms of Kyphosis?

The most common kyphosis symptom is pain in the middle or lower back.

Other symptoms may include:

• Back pain, stiffness, and tenderness.
• Breathing difficulties, in severe cases.
• Muscle fatigue.
• Reduced spinal flexibility.
• Rounded or hunched upper back.

When should I see a doctor about my kyphosis symptoms?

You should seek medical attention for kyphosis symptoms if:

• Back pain is persistent and affects daily activities.
• The curvature is visibly worsening.
• There are signs of nerve compression, such as numbness, weakness, or loss of bladder/bowel control.

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How Do You Diagnose Kyphosis?

A healthcare provider will look for signs of kyphosis by performing a physical exam and reviewing your medical history. Additional tests may include:

• Pulmonary function test — Assesses breathing capability in severe cases.
• MRI or CT scan — Identifies soft tissue and nerve involvement.
• X-ray — Measures spinal curvature and detects fractures.

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How Do You Treat Kyphosis?

Kyphosis treatment depends on the severity, symptoms, and underlying causes. Treatment options include nonsurgical management and surgical intervention.

Nonsurgical treatment for kyphosis

Bracing

Braces can help correct kyphosis or reduce discomfort by guiding proper spinal growth. Braces are typically worn for several hours daily until growth is complete.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) may help with pain and inflammation. Osteoporosis medications may be used to prevent further spinal fractures in people with age-related kyphosis.

Physical therapy

Physical therapy strengthens back and core muscles to improve posture and spinal alignment. It includes targeted stretching and mobility exercises.

Lifestyle modifications

Lifestyle modifications may include:

• Maintaining good posture and ergonomic support while sitting and standing.
• Regular exercise to improve spinal strength and flexibility.
• Weight management to reduce spinal strain.

Surgical treatment for kyphosis

Surgery is only considered for severe kyphosis cases that cause pain, breathing problems, or neurological issues. Surgical procedures include vertebroplasty and kyphoplasty, which are minimally invasive procedures that involve injecting bone cement into fractured vertebrae. These procedures help restore vertebral height and relieve pain in compression fractures.

Is kyphosis treatment right for me?

Selecting the right kyphosis treatment is based on your age, the severity of your condition, and its impact on your daily life. Nonsurgical approaches often improve mild to moderate kyphosis, and surgery is reserved for severe, debilitating cases.

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Why Choose UPMC for Kyphosis Care?

UPMC spine care experts are experienced at providing kyphosis care using the latest tools and techniques. Our team also provides comprehensive spine care for people diagnosed with osteoporosis to prevent future spine fractures and improve overall health.

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By UPMC Editorial Staff. Last reviewed on 2025-05-16.