Kyphosis (Dowager's Hump)
Kyphosis, also known as Dowager's Hump, is an exaggerated forward curvature of the thoracic spine, located at the back of the torso of the body, which may cause difficulty breathing, middle back pain, and upper back pain.
The normal spinal curvature of the spine, beginning at the base of the skull, includes a forwards curvature at the neck, followed by a backwards arc from the base of the neck to the middle of the back, followed by another forwards curvature in the lower back. When the angle of these curves are optimal, the body is able to function normally, and to absorb weights placed on the body from sitting, and moving while standing. When these curvatures become exaggerated, patients may begin to experience difficulty moving, breathing, or living comfortably. When the angle of curvature increases beyond a healthy range in the lumbar spine (lower back), the condition is known as lordosis (swayback). When the angle of the curvature in the thoracic spine (torso or chest area of the body) becomes too severe to properly support the body, the condition is known as kyphosis. Kyphosis is also known as "swayback" or Dowager's hump. This condition is most often associated with age related changes to the vertebral bones of the spine, where the weight-bearing portions begin to collapse in on themselves, due to bone density loss. Elderly age, and bone density deficiencies associated with menopause in women, are the two most common causes of kyphosis, though other factors may cause this spinal deformity, including congenital abnormalities, injury, and disease. People who have a family history of this condition, and those who present with early signs, should take preventative measures against allowing this condition to progress. Moderate to severe signs of Kyphosis (Dowager's Hump) include a stooped forward posture, difficulty breathing, and middle and upper back pain.
Osteoporosis, the weakening of bones because of bone density loss, is the number one cause of Kyphosis. Osteoporosis afflicts men and women as they approach and progress into old age. Osteoporosis is more likely to affect women in general, and especially women with menopause. As women approach menopause, drops in hormone levels, such as estrogen and progesterone, cause the bone mineral density to decrease, making them more vulnerable to fractures and compression fractures. Compression fractures are often weight bearing bones that begin to buckle, or collapse in on themselves, then the bones are no longer dense and strong enough to support the weights that are pressed upon them.
Other causes of Kyphosis (Dowager's Hump) include trauma (injury), degenerative diseases (e.g. osteoarthritis, rheumatoid arthritis), and developmental problems such as Scheuermann's disease. Scheuermann's disease is a pediatric condition that causes the vertebral bodies of the spine to grow unevenly, so that one side is taller than the other.
Patients with a mild degree of abnormal forward curvature may not be affected, or they may have minimal disruption to their daily life and comfort levels. People with more extreme curvatures will be more likely to suffer from pain and disability. Signs and symptoms of this condition may change more than just the appearance and posture of affected people. Because the thoracic spine connects the ribs and forms the back wall of the thoracic cavity, where the lungs are, this bowing of the spine may affect a person's breathing and digestion. This condition may also cause spinal stenosis and nerve pain related to compression of affected nerve roots and nerve branches.