What Causes a Hunchback (Kyphosis)? Symptoms, Diagnosis, and Treatment Tips

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When you hear the term hunchback, perhaps your mind wanders to the 1831 novel The Hunchback of Notre-Dame by famed author Victor Hugo or the animated Walt Disney film of the same title featuring the fictional character Quasimodo.

Kyphosis, the medical term for hunchback, is a real condition represented by a severe curvature of the spine. It can have a debilitating effect on a person’s life as well as their health. We will investigate the causes, possible hunchback treatment, and the signs that lead to a diagnosis of kyphosis.

A hunchback syndrome condition is the abnormal forward curving of the upper back portion of the spine. Regular positioning of the spine has a slight curve, and in today’s world of modern technology, we often are slouched over a keyboard or smartphone. Just as your mother may have told you to sit up straight to avoid bad posture, by maintaining a rounded back position, the spine may endure stiffness that attributes to a hunchback.

What Causes a Hunchback?

Our spine is formed by bones referred to as vertebrae. These vertebrae are lined in a column resembling a cylinder. Kyphosis is evident when these bones transform into a wedge shape. A hunchback is often seen in elderly women, known as a dowager’s hump, but can develop in anyone of any age. There are cases of infants and youth with hunchbacks. When, and to whom, kyphosis occurs is dependent on various factors.

1. Osteoporosis

This disorder is seen with compressed vertebrae as the bones weaken and the tissue deteriorates. This can cause a collapse of the bones, and the spine rounds forward and shortens. It commonly results from prolonged corticosteroid use and the aging process. Osteoporosis-related kyphosis is seen in more women than men.

2. Disc Degeneration

As part of the natural aging process, the soft discs that absorb shock movement of the vertebrae, dry and draw back as they begin to diminish in density. This is known as degenerative kyphosis. The wearing on the spine is often caused by spinal arthritis.

3. Birth Defects

Kyphosis can begin in the womb with the improper development of the spine. If performed early, alignment surgery may resolve this congenital form of kyphosis, to stop further curving of the spine.

4. Scheuermann’s Disease

A childhood disease, Scheuermann’s targets the growth spurt that develops before puberty. As the child continues to grow, the spine curvature may become more rounded. This is seen more often in males. Scoliosis is a disorder commonly associated with Scheuermann’s disease.

5. Nutritional Deficiency

Another form of kyphosis seen in childhood is caused by a nutritional deficiency such as a lack of vitamin D.

6. Posture

One of the more common hunchback causes in both young and old is poor posture. We can easily slip into a slouched position while sitting at a table or watching television. Postural kyphosis is seen in more females than males.

7. Medical Syndromes

The abnormal curvature of the spine can also be linked to various health disorders and diseases. These may include Marfan syndrome and Prader-Willi syndrome. Neuromuscular kyphosis is seen in youth with related disorders of cerebral palsy, muscular dystrophy, and spina bifida.

8. Cancer

With a cancer diagnosis and resulting treatments of radiation and chemotherapy, the vertebrae may become weak and brittle. This can lead to a hunchback posture.

9. Surgical Complication

Kyphosis may happen as a result of a spinal surgical procedure, and is referred to as iatrogenic. Of the various procedures, a post-laminectomy kyphosis is most common following removal of the intervening ligaments, laminae, and spinous process posterior spine elements.

10. Trauma

A hunchback position of the spine may be a result of an injury to the spine. This can develop from a direct hit, fall, or auto accident that causes a fracture of the vertebrae or damage to the ligaments.

Hunchback Risk Factors

The forms of kyphosis are caused by both internal and external factors, and certain groups of people face a higher risk of developing issues with the spinal column.

  • Males between the ages of 10 and 15 have a high risk of developing spinal problems during their growth.
  • Female teenagers with poor posture while sitting, standing, and even at rest may develop a hunchback.
  • Elder males and females diagnosed with osteoporosis face increased risk, as the disease may lead to fractures of the vertebrae.
  • Males and females with connective tissue disorders and diseases such as Marfan syndrome.

Hunchback Symptoms

Kyphosis comes in many forms and varying degrees of severity. Over time, the kyphosis of spine condition may worsen, causing the hump in the spinal column to overextend. Rare but extreme cases of kyphosis can result in compression on the nerves, causing a loss of bowel and bladder functions, weakness, and a loss of sensation. If the vertebrae bend forward too much, the chest cavity may be reduced in size. This may lead to chest pains and shortness of breath from pulmonary and cardiac issues. Pulmonary and heart failure may occur.

Mild cases of a hunchback condition may not show any signs or symptoms. Cases that do present indicators may show:

  • Extreme curvature of the spine
  • Hump in the middle of the upper back
  • Dull or severe pain in the back
  • Muscle fatigue
  • Lethargy
  • Stiffness in the back
  • Poor posture
  • Loss of height
  • Standing difficulty

Hunchback Diagnosis

Diagnosing the kyphosis condition is not as easy as looking for a hunchback or hump in the middle of the upper back. There are various diagnostic tests that can confirm  a diagnosis and determine the severity of any damage to the vertebrae.

The medical history of the patient as well as any family history is noted, followed by a complete physical examination. A neurological examination will help check the reflexes and any potential loss of muscle strength. If there is any muscle weakness, further nerve tests may be ordered.

For a more extensive assessment, doctors may order X-rays of the spinal column and chest cavity. These will show any distortion of the spine and the severity of the curvature. When a hump is found to have an extreme degree of curvature, a lung function test may be ordered. In some cases, doctors may conduct a computerized tomography scan for further investigation. A magnetic resonance imaging test may be necessary if your physician suspects infection or a growth tumor.

Hunchback Treatment

Kyphosis treatment is not unlike other medical issues, where the symptoms and any underlying cause is treated either before or along with the hump of the middle back.

1. Pain

Any pain associated with the condition may be treated with prescribed or over-the-counter pain relievers, depending on the severity of discomfort. Living a healthy lifestyle may also help with pain management. This entails regular exercising and maintaining a healthy weight for the patient’s body frame.

2. Preserving Bone Density

Kyphosis can be linked to poor bone density caused by a nutrient deficiency, history of bone fractures, and family history of osteoporosis. Prevent bone weakness by having a sufficient amount of vitamin D and calcium in your daily diet.

3. Stretching Exercises

Any exercise focused on stretching the muscles helps to keep the spine flexible. This can include core exercises that target the abdominal muscles to maintain good posture.

4. Brace Use

A body or back brace is commonly used on children with Scheuermann’s disease to prevent the kyphosis from worsening. This allows their growing bones to form the proper alignment of the spine.

5. Surgery

Severe cases of kyphosis may require surgery. Cases of extreme curvature need to be corrected or stopped to prevent progression of nerve compression of the spinal cord. Spinal fusion is the most frequently used procedure to connect the vertebrae permanently. This form of surgery, while successful, comes with complications of bleeding, nerve damage, disc degeneration, infection, and excruciating pain. Complications may also involve a need for a second surgery.

Kyphosis affects the position of the spine, and is characterized by a hump in the middle of the upper back, widely known as a hunchback. The degree of the curve causing the hump varies, and is caused by issues with the vertebrae of the spinal column. Whether bone development problems, medical conditions, or trauma is to blame, kyphosis may present mild-to-severe symptoms. A confirmed diagnosis goes beyond a physical examination, as nerves of the spinal cord may be involved. Treatment is based on the condition and curvature of the spine.

Also read:

“Health Check: can bad posture give you a hunchback?” The Conversation, May 16, 2016; http://theconversation.com/health-check-can-bad-posture-give-you-a-hunchback-56068, last accessed July 28, 2017.
“Hunchback: Causes, Symptoms, Signs, Investigations, Treatment, Exercises, Posture Brace,” ePain Assist; https://www.epainassist.com/back-pain/upper-back-pain/hunchback, last accessed July 28, 2017.
“Kyphosis,” Mayo Clinic; http://www.mayoclinic.org/diseases-conditions/kyphosis/basics/definition/con-20026732, last accessed July 28, 2017.
Spivak, J.., MD, “Kyphosis Causes And Treatment,” Spine Health, December 21, 2010; https://www.spine-health.com/conditions/spinal-deformities/kyphosis-causes-and-treatment, last accessed July 28, 2017.
Eck, J., DO, MS, “Kyphosis,” Medicine Net; http://www.medicinenet.com/kyphosis/page2.htm#what_are_the_symptoms_of_kyphosis, last accessed July 28, 2017.
Spivak, J., MD, “All About Thoracic Kyphosis: Forward Curvature of the Upper Back,” Spine Health, December 21, 2010; https://www.spine-health.com/conditions/spinal-deformities/all-about-thoracic-kyphosis-forward-curvature-upper-back, last accessed July 28, 2017.