Kyphosis: what it is, types, causes, symptoms and treatment

Every spine has gentle natural curves. In kyphosis the curve at the top of the back is bigger than usual. The NHS says a spine with kyphosis has a bigger curve at the top compared with a spine without kyphosis, which is why the upper back and sometimes the shoulders look rounded.

The NHS notes that treatment may not be needed unless it is severe or causing problems, so a rounded back is not automatically a medical problem.

The NHS says kyphosis is often caused by bad posture or a problem with the structure of the spine. It can also sometimes happen after a spinal injury or as a result of conditions like arthritis and osteoporosis. It lists 3 main types.

The NHS says the main symptom is a hunched or rounded upper back, and sometimes rounded-looking shoulders. If the top part of the spine is only slightly curved you may have no other symptoms.

If the curve is more noticeable or gets worse, it can cause back pain and stiffness. A severe curve can cause more serious problems, such as very bad back pain and difficulty breathing.

The NHS says to see a GP if you think you or your child might have kyphosis. A GP may refer you to a specialist (an orthopaedic surgeon) who will do tests. The specialist may examine your back while you are bent forwards to see how severe the curve is and how flexible you are, and may check your arms and legs. You may have an X-ray and an MRI scan to look at the spine in more detail.

The NHS says treatment is usually only needed if kyphosis is causing problems. If it is needed, it depends on the cause and how severe the curve is. A child may have regular hospital appointments to check whether the curve is getting worse, and the NHS says it may get worse until they have stopped growing.

• Paracetamol or anti-inflammatory medicine to ease back pain; check with a GP or pharmacist which type of pain relief is most suitable.

• Physiotherapy to help improve posture and relieve back pain and stiffness.

• A brace (a rigid support worn around the torso) to help straighten the spine if a child has mild to moderate Scheuermann's kyphosis. The NHS says a brace should only be worn under the supervision of a specialist such as an orthopaedic surgeon.

• Surgery to straighten the spine if the curve is severe, getting worse or causing very bad pain. The NHS says spinal surgery is usually only done if the benefits outweigh the risks.

The NHS says you should be able to exercise with kyphosis, and that strengthening the core muscles, the muscles around your tummy and lower back, can help. It advises speaking to a healthcare professional before starting if you are new to exercise or have not exercised for a while.

If you have physiotherapy you may be given specific exercises to reduce back pain and stiffness. The NHS is clear, though, that they will not improve the curve in your spine or stop it getting worse. The NHS also points to its back pain pilates video workout and the Chartered Society of Physiotherapy's video exercises for back pain.

Kyphosis is sometimes confused with scoliosis, but they are different. The NHS describes scoliosis as the spine twisting and curving to the side, most often starting in children aged 10 to 15, with signs such as a visibly curved spine, uneven shoulders or one shoulder or hip sticking out. Kyphosis is a forward rounding of the upper back.

The NHS says that in around 8 in every 10 cases the cause of scoliosis is unknown, and that scoliosis is not thought to be linked to bad posture, exercise or diet. For kyphosis, by contrast, the most common type is related to posture.

On the NHS, kyphosis is usually first assessed by a GP, who may refer you to an orthopaedic specialist for examination and imaging. Physiotherapy may be offered through the NHS, and in many areas you can refer yourself to NHS community musculoskeletal services without seeing a GP first.

Private orthopaedic and physiotherapy services are also available on a self-paid or insured basis. If a child needs a brace, the NHS says it should only be worn under the supervision of a specialist.