A hunchback or kyphosis is a gentle forward bend in the spine that elderly people develop.
“Kyphosis is an exaggerated anterior curvature of the thoracic spine,” says Dr Ananya Das, consultant, geriatric medicine, Manipal Hospital, Bengaluru.
Causes of hunchback in elderly
“Compression fracture (when bones in the spine weaken and crumple) of the vertebrae, degenerative disc diseases, weakness of the muscles in the upper back and poor posture are the common causes of a hunchback,” says Dr Das.
Dr Bishwaranjan Das, physiotherapist, Kasturba Medical College Hospital, Mangaluru, Karnataka, tells Happiest Health that weak bones and a sedentary lifestyle can also cause kyphosis. “It is seen more in people who have a sitting job and those who spend lots of time on gadgets,” he points out.
Experts say that hormonal changes during menopause and osteoporosis (common in women), put women also at a higher risk for developing kyphosis.
Hunchback in elderly: symptoms
“For mild kyphosis, there are no symptoms. However, the affected person develops physical deformity because of a hump in the upper back. As far as severe kyphosis is concerned, people may experience pain or stiffness in their back, gait imbalance (walking disorder), fatigue, bladder and bowel incontinence, and shortness of breath if the spine compresses against the lungs,” points out Dr Das.
“A hunchback is usually noticed by family members of the person. Loss of height is also a symptom,” says Dr Jayant Arora, director, Bone and Joint Institute, Fortis Memorial Research Institute, Gurugram, Haryana.
An X-ray of the spine in a standing lateral position is done to diagnose a hunchback. Sometimes further tests like bone density checks, blood tests or an MRI scan may be required.
“The severity and time of occurrence of hunchback must be evaluated properly,” says Dr Bishwaranjan.
“Hunchback developed at a young age can be cured as the spine retains its flexibility. However, the bones start to get weak as a person grows old. With age, spine flexibility also reduces. It is ideal to treat hunchback at an earlier stage. In 90 per cent of cases, the condition can be reversed by correcting the posture and following the ergonomics,” adds Dr Bishwaranjan.
Treatment and lifestyle changes
“The first-line treatment is physiotherapy. If the patient has severe pain or physical disability limiting the quality of life (like breathing difficulty), then surgery has to be done,” informs Dr Das.
“Hunchback occurrence can be minimised by maintaining a good sitting posture, good bone health and doing regular weight-bearing exercises. If the cause of hunchback is osteoporosis, then monitoring the bone density in post-menopausal women every two to three years and taking appropriate treatment for osteoporosis is recommended,” adds Dr Arora.
Taking calcium and vitamin D supplements also help, says Dr Bishwaranjan.
“Sometimes in severe hunchback deformity, a procedure called kyphoplasty can partially correct the deformity,” says Dr Arora.
According to Dr Das, a hunchback can be prevented by certain lifestyle modifications like maintaining a good posture, an ideal body mass index (less than 30 kg/m²) and avoiding smoking.
Exercise can help manage kyphosis
Dr Das highlights the benefits of exercise. “Exercises can benefit people by keeping the muscle strength optimum and improving the muscle tone. Yoga helps in strengthening the back and abdomen muscles.”
According to Dr Bishwaranjan, yoga pranayama and asanas can be practised for spine flexibility; asanas related to forward and backward bending, stretching and rotation can be practised as they help with flexibility.
Experts recommend simple exercises like neck rotations and shoulder stretches like shoulder shrugging that can stretch the muscles around the shoulder blades.
Cycling, swimming and hydrotherapy are also recommended for treating a hunchback.
Dr Bishwaranjan recalls the case study of a 68-year-old man suffering from ankylosing spondylitis — an autoimmune disorder which affects the spine. “Because of this, the senior citizen developed a hunchback over a period. He faced lots of difficulties in managing his day-to-day chores,” says Dr Bishwaranjan. He explains that the man managed his pain by doing simple neck and shoulder stretches.
“The focus was to reduce the pain and make the neck muscles strong as the deformity couldn’t be corrected in him. He learnt to live with his hunchback. But exercises like stretches helped him a lot; they helped him manage his day-to-day activities and cope with the pain,” says Dr Bishwaranjan.