Age related changes of the spine and skeletal diseases that are more likely in seniors may contribute to a hunchback posture. This is due to an abnormality of the curvature of the upper spine which is medically known as kyphosis. It can adversely affect the quality of life in the elderly and significantly restrict freedom of movement. Kyphosis can occur in any age group but is rare in infants and adolescents. The various diseases that contribute to kyphosis more often occurs in the senior years.
Causes of Kyphosis in the Elderly
The spine is made of 33 bones known as vertebrae which are stacked one of top of the other. Each bone can articulate with neighboring bones thereby giving the spine its flexibility. Between these vertebrae are spongy discs known as the intervertebral disc. The spinal cord, which is the major communication relay between the brain and the rest of the body, is housed within these vertebrae.
A normal spine is not straight. It has several curvatures which is either concave or convex giving it somewhat of a S-shape. The upper spine (neck) is curved inwards, then curves outwards at the thoracic spine (mid back), inwards again at the lumbar spine (low back) and lastly outwards at the sacrum and tailbone (buttock). Excessive curving particularly at the thoracic spine causes the roundback or hunchback appearances known as kyphosis.
Common causes of kyphosis in the elderly includes :
- Osteoporosis leading to fractures of the spinal bones..
- Arthritis of the spine with degeneration of the bones and discs.
- Slipped vertebra.
- Injury to the back.
- Ankylosing spondylitis.
- Tuberculosis of the vertebrae (Pott’s disease) and other infections.
- Tumors either benign (non-cancerous) or malignant (cancerous)
A slouching posture even without spinal disease can contribute to kyphosis in the senior years and this is known as postural kyphosis. It is not as severe and may not be permanent as is often the case with the diseases that can cause kyphosis.
Signs and Symptoms
Sometimes the kyphosis can be so mild that it is only detected on an x-ray. At other times it causes a visible deformity as is typical of humpback. Disability associated with kyphosis depends on the severity of the condition and degree of slouching. Mild back pain is also common and may even be present despite there being no visible slouching. This can sometimes progress to severe pain that makes movement and activity almost unbearable.There may be stiffness of the spine further contributing to difficulty with movement. In severe cases there may be difficulty breathing and pressure on the spinal nerves can cause weakness or paralysis of the legs.
The underlying causes of kyphosis needs to be treated in order to halt the progress of the condition and sometimes restore the normal curvature although this is usually not a complete restoration. Anti-inflammatory medication may help with pain and reduce inflammation in conditions like arthritis which greatly eases the slouching. Postural kyphosis can be very effectively treated with back exercises and a back brace.
Surgery may sometimes be indicated for severe kyphosis where vertebrae are fused to reduce the degree of slouching. In cases where the slouching may be visible but is not causing any breathing difficulties or compressing spinal nerves, surgery may not be necessary. A mobility aid like a walking stick or medical walker may be necessary for severe slouching in the presence of other musculoskeletal diseases.
Last Updated: November 28th, 2011 by