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Kyphosis or hyperkyphosis, as it is scientifically known, 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 too inclined to front.
Hyperkyphosis can be the only serious spinal change, however it can also occur as a way to compensate for other postural changes, such as hyperlordosis 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.
Main symptoms
In addition to the curvature in the spine that causes the appearance of a "hump", hyperkyphosis can also cause other symptoms such as:
- Back pain, especially in the upper spine;
- Difficulty in keeping body straight;
- Difficulty breathing;
- Weakness or tingling in the arms and legs.
Hyperkyphosis tends to worsen with age when no treatment is performed and, therefore, it is common for the person to worsen symptoms.
How to confirm the diagnosis
The diagnosis of hyperkyphosis is made by the orthopedist based mainly on the observation of the curvature of the spine. In addition, imaging exams, such as lateral X-rays, are usually requested to check the Cobb and thus, one can 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 vertebrae C7 to T12 must be considered.
Possible causes
Some of the causes that can favor the occurrence of hyperkyphosis are:
- Bad postural habits, such as sitting with your 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 accidents or falls;
- Vertebral compensation fracture;
- Congenital defects, which may be associated with neurological syndromes;
- Psychological problems, such as low self-esteem or depression;
Hyperkyphosis is more common in adolescents who grew very fast and are taller than their peers of the same age, and also in the elderly, due to bone changes, such as arthritis or osteoporosis, for example.
How the treatment is done
The treatment of hyperkyphosis should be directed according to its severity, and it is necessary to perform an image exam to check the degree of change in the curvature of the spine.
Depending on the severity and cause of the hyperkyphosis, the doctor may recommend the following forms of treatment:
1. Practice of physical exercise
Physical exercise is 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.
Some examples of these exercises are:
- Bodybuilding: the person can use machines, like the "flyer" that help to work the chest muscles and, that help to correct the posture.
- Localized exercises: to strengthen the abdominal muscles;
- Swimming, water aerobics or rowing: they are good exercises for kyphosis as they help to strengthen the back muscles and improve physical conditioning, helping to put the shoulders back.
These exercises should be performed 2-3 times a week and achieve excellent results, but maintaining good posture in everyday life is also important. Stretching exercises are indicated at the end of training to promote spinal flexibility and relieve back pain due to poor posture.
2. Physiotherapy for kyphosis
In order to treat moderate kyphosis, physiotherapy sessions are recommended with the assistance of a professional, at least once a week for 1 hour. Kinesiotherapy exercises should be performed, using targeted training methods, such as global postural reeducation, pilates and isostretching, for example. Best results are seen when 2-3 sessions per week are performed.
The physiotherapist should also guide the person to maintain the proper posture on a daily basis, which he must maintain in all positions: sitting, lying down and walking. Spinal manipulation techniques may also be indicated to release the movement of the spine, but they must be performed with caution in elderly people due to the risk of fracture due to bone weakness.
Know some examples of exercises to correct kyphosis that the physiotherapist can indicate.
3. Use of orthopedic vest
The vests for hyperkyphosis should only be used when indicated by the orthopedic doctor. Stretch fabric vests that are bought in underwear stores, for example, are not recommended. These can even impair posture because the pressure exerted by the vest can apparently improve posture instantly, but this posture is inadequate and does not correct the position of the head and lumbar curvature, and over time, there may be worsening of pain in the back.
4. Kyphosis surgery
When kyphosis is severe, the orthopedic doctor may recommend spinal surgery to correct the deviation. Surgery is usually done in case of congenital kyphosis, even during childhood or adolescence. It is also recommended in the case of Scheuerman's disease over 70 degrees at the Cobb angle. Surgery can be done with the technique such as arthrodesis, where the 2 vertebrae above and below hyperkyphosis merge.