Postural kyphosis is the most common form of atypical upper spinal curvature which is not linked to significant skeletal changes in most cases. Postural forms of kyphotic change can affect young and old alike and ironically are found in the greatest abundance at opposite ends of the age spectrum. About 20-25% of posture-related kyphosis patients are teens, while the rest are usually elderly. Very few cases fall in between these 2 ages. However, the condition can affect any age, depending on lifestyle and circumstantial factors.
This essay details posture-related kyphotic changes in the thoracic spine and how these may cause or contribute to painful expressions and functional limitations in some patients. We will also examine how to rehabilitate postural versions of kyphosis using conservative care practices.
True postural forms of hyperkyphosis are caused by slouching and may be exacerbated by the normal degenerative changes associated with age. Patients are characterized as having a bent forward posture with the head down and the shoulders rounded forwards. This poor posture can be demonstrated while standing or sitting.
There are sometimes minor skeletal changes causing the condition, or created by the condition, but postural types of kyphosis are usually soft tissue abnormalities which can be addressed successfully using physical therapy. The condition is rarely painful, although it is often blamed for enacting back pain, often through the theory of muscular imbalances.
Many cases of postural kyphotic change in the elderly are actually misdiagnosed. A number of these are actually nutritional kyphosis concerns related mostly to low bone density and osteoporosis issues.
In some cases, patients actually demonstrate compression fractures in one or more thoracic vertebrae which may be causing or contributing to the condition. In these circumstances, posture therapy is likely to fail, but dietary and pharmaceutical therapy may help to halt progression and even correct the condition.
While poor posture can create kyphotic change in the middle and upper back regions, posture which is too straight is equally damaging. An overly straight posture is a known contributor to some forms of muscle imbalances, military neck and straight back conditions.
In young people, this condition should be actively evaluated and treated using postural corrections and exercise as soon as it is diagnosed. The longer it remains untreated, the worse the condition may get and the harder it will be to resolve in the future.
In the elderly, true postural forms of kyphosis should be handled with physical therapy, posture therapy and lifestyle enhancements. It is crucial to make the patient realize that this is a preventable condition which can be reversed at almost any stage of life.
Most important of all is understanding that postural forms of kyphotic changes are not typically symptomatic and should not be used as scapegoats on which to blame chronic back pain, unless there is a verified pathological process occurring.