General info

Data about the condition – kyphosis

Kyphosis is an exaggerated curvature of the upper (thoracic) spine that creates a hunchback appearance. It can result from developmental problems, degenerative diseases (such as arthritis) and trauma to the spine.


Symptoms can range from mild, requiring no treatment, to severe. Depending on the underlying cause of the condition, typical symptoms include one or more of the following:

  • A hunched forward appearance, usually most pronounced when viewed from the side as the patient is bending forward
  • Mild to severe back pain
  • Loss of height
  • Difficulty standing straight upright, worsening over the course of a day
  • Fatigue


  • Fractures. Broken or crushed vertebrae (compression fractures) can result in curvature of the spine. Mild compression fractures often don’t produce noticeable signs or symptoms.
  • Osteoporosis. This bone-thinning disorder can cause spinal curvature, especially if weakened vertebrae result in compression fractures. Osteoporosis is most common in older women and people who have taken corticosteroids for long periods of time.
  • Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
  • Scheuermann’s disease. Also called Scheuermann’s kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than girls.
  • Birth defects. Spinal bones that don’t develop properly before birth can cause kyphosis.
  • Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Ehlers-Danlos syndrome and Marfan syndrome.

The objectives of the Recovery Program

  1. Relaxation of shortened muscles.
  2. Stimulation of elongated muscles.
  3. Balancing postural muscles.

The content of the Recovery Program

Mirror image

For this exercise, simply do the opposite movement of the posture that you’re trying to correct.

  1. Stand tall, against a wall if needed.
  2. Tuck your chin slightly and bring your head back directly over your shoulders.
  3. Feel as if you’re bringing your shoulder blades back and down. Hold this position for 30 seconds to 1 minute. Take a break if you begin to feel pain.

Head retraction

This exercise is done lying on the floor and is great for the muscles of the neck that are often stretched out and weak.

  1. Pull your chin back toward the floor, as if you’re trying to make a double chin.
  2. Hold for 15 seconds. Repeat 5 to 10 times.


Lying on your stomach, extend your hands in front of your head.

  1. Keeping your head in a neutral position, looking toward the floor, lift your arms, and legs up toward the ceiling.
  2. Feel as if you’re reaching far away from your body with your hands and feet. Hold for 3 seconds and repeat 10 times.

Life extension

The goal of this exercise is to stretch the tight muscles of the chest and strengthen the weak muscles of the back.

  1. Begin standing tall, knees soft, core engaged, chest upright, and shoulder blades back and down.
  2. Once you find yourself in an ideal posture, raise your arms up into a Y position with your thumbs pointed behind you.
  3. In this position, take two to three deep breaths, focusing on maintaining this posture on exhale.

Thoracic spine foam rolling

  1. Lie on the floor with a foam roller under you, across your mid back.
  2. Gently roll up and down on the foam roller, massaging the muscles of your back and thoracic spine.

Methodical Indications

Physiotherapy for thoracic hyperkyphosis, including manual therapy, taping and bracing, should be implemented in an early stage and is regularly a first-line treatment.

The main goal of any therapy for patients with thoracic hyperkyphosis is to reduce the excessive antero-posterior curvature as well as improve the physical function and decrease the pain.

Recognition and treatment of hyperkyphosis could contribute to a reduced risk of falls, fractures, and functional limitations.

Did you know that?

  • The prevalence of hyperkyphosis increases with age in women and men, with the greatest change in the angle of kyphosis occurring among women age 50 to 59 years.
  • Studies have reported kyphosis increases by about 9 degrees per decade.
  • Level of kyphosis increases with age. Often after the age of 40.
  • Difference in gender, namely, hyperkyphosis appears commonly more rapidly in women than in men.

You can also read about Cervical hernia.

1.University of Maryland Medical Center, Updated 2003. Accessed October 26, 2010.

2.Sorensen KH. Scheuermann’s Juvenile Kyphosis: Clinical Appearances, Radiography, Aetiology, and Prognosis. Copenhagen: Munksgaard, 1964.

reports. 2004 Jan 1;3(1):47-52.

Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC musculoskeletal disorders. 2010 Dec;11(1):39.

 Britnell SJ, Cole JV, Isherwood L, Stan MM, Britnell N, Burgi S, Candido G, Watson L. Postural health in women: the role of physiotherapy. Journal of obstetrics and gynaecology Canada. 2005 May 1;27(5):493-500.

Zane MK. Physical Therapist’s Guide to Hyperkyphosis (Humpback) in Adults. American Physical Therapy Association. 2014;188.

Zaina F, Atanasio S, Ferraro C, Fusco C, Negrini A, Romano M, Negrini S. Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease. Eur J Phys Rehabil Med. 2009 Dec 1;45(4):595-603.

Culham EG, Jimenez HA, King CE. Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine. 1994 Jun;19(11):1250-5.

Greendale GA, Nili NS, Huang MH, Seeger L, Karlamangla AS. The reliability and validity of three non-radiological measures of thoracic kyphosis and their relations to the standing radiological Cobb angle. Osteoporosis international. 2011 Jun 1;22(6):1897-905.

D’Antoni AV, Terzulli SL. Federico di Montefeltro’s hyperkyphosis: a visual-historical case report. Journal of medical case reports. 2008 Dec;2(1):11.

El-Khoury GY, Whitten CG. Trauma to the upper thoracic spine: anatomy, biomechanics, and unique imaging features. AJR. American journal of roentgenology. 1993 Jan;160(1):95-102.

Naidich TP, Castillo M, Cha S, Raybaud C, Smirniotopoulos JG, Kollias S. Imaging of the Spine: Expert Radiology Series, Expert Consult-Online and Print. Elsevier Health Sciences; 2010 Aug 27.

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