Cookies on this website

We use cookies on our website. If you continue without changing your settings, we'll assume that you are happy to receive all cookies on the NHS Direct Wales website. However, if you would like to, you can change your cookie settings at any time.




Kyphosis is a condition in which the top of the back is excessively curved and appears more rounded than normal. 

While some degree of curvature is normal, a curve of more than 60 degrees would be considered a sign of kyphosis.

Kyphosis doesn't usually cause any symptoms other than your back appearing slouched or hunched. Some cases may cause:

  • back pain and stiffness
  • tiredness

What causes kyphosis?

In kyphosis, the middle section of vertebrae (the thoracic vertebrae) is curved out of position. There are a number of reasons why this might happen, including:

  • poor posture (postural kyphosis) – slouching, leaning back in chairs and carrying heavy bags can stretch supporting muscles and ligaments, which can pull the thoracic vertebrae out of their normal position
  • abnormally shaped vertebrae (Scheuermann’s kyphosis) – if the vertebrae do not develop in the right way, they can end up being out of position
  • abnormal development of the spine in the womb (congenital kyphosis) – if something disrupts the spine's normal development, two or more vertebrae sometimes fuse together

Kyphosis can also develop as a result of a spinal injury.

Read more about the causes of kyphosis.

Treating kyphosis

Your course of treatment for kyphosis depends on the extent of the curve, whether there are additional symptoms such as back pain, as well as the underlying causes.

Mild cases in children often don't require any treatment as many children grow out of kyphosis as their body matures. Alternatively, it may be possible to correct the spine using non-surgical treatments such as bracing.

More severe cases will need surgery to correct the spine.


Older children with kyphosis may become concerned or embarrassed about the effect the condition has on their appearance, or the fact that they have to wear a back brace.

These concerns can affect different children in different ways. Some children can become socially withdrawn and they may be reluctant to take part in activities, such as PE, where their condition may be exposed.

There are no easy answers to these problems. However, it can often help to reassure your child that their condition is only temporary and will improve with time.

Read more about the complications of kyphosis.

Can kyphosis be prevented?

Postural kyphosis can be prevented by being aware of your posture and by taking care of your back. You should encourage your child to:

  • avoid slouching
  • sit correctly – sit upright, ensuring that the small of the back is supported
  • avoid carrying heavy schoolbags that can pull on the back muscles and ligaments; the best schoolbags are well-designed backpacks
  • take regular exercise to help strengthen the back and keep it flexible; activities such as swimming, running and walking are ideal for helping to prevent back problems


The outlook for many cases of kyphosis is good as symptoms tend to improve as a child grows older.

More severe cases do carry a risk of causing complications, such as breathing difficulties or urinary incontinence, but these sort of complications would usually only occur if the condition was left untreated.

^^ Back to top


To better understand the potential causes of kyphosis, it's useful to learn more about the structure of the spine.

The spine

Your spine extends from your skull to your pelvis. It's made up of 24 individual rectangular-shaped bones called vertebrae, which are stacked on top of one another.

The vertebrae are separated by soft pads, or discs, which act as shock absorbers.

The vertebrae are also held together by tough bands of tissue called ligaments. Together with the spinal muscles, the ligaments give the back its strength.

In cases of kyphosis, the middle section of vertebrae, which are known as the thoracic vertebrae, are curved out of position.

There are several reasons why these vertebrae can be affected in this way. They are discussed below.

Bad posture

Poor postural habits in childhood, such as slouching, leaning back in chairs and carrying heavy backpacks and schoolbags, can cause stretching of the ligaments and, in some cases, the muscles that support the vertebrae. This in turn can pull the thoracic vertebrae out of their normal position, resulting in kyphosis. 

Kyphosis resulting from bad posture is medically known as postural kyphosis.

Abnormal-shaped vertebrae

Kyphosis can be caused when the vertebrae don't develop in the right way. They take on a wedged, triangular shape rather than a rectangular, box-like shape. This leads to the vertebrae being out of position. It's known medically as Scheuermann’s kyphosis.

The ligaments in people affected by Scheuermann's kyphosis also appear to be thicker than normal. This may contribute further to the condition.

It's unclear exactly what disrupts the normal formation of the spine. One idea is that the blood supply to the vertebrae becomes disrupted, affecting the growth of the vertebrae.

There also appears to be genetic factors associated with Scheuermann's kyphosis as the condition runs in families.

Congenital kyphosis

Congenital kyphosis is caused when something disrupts the normal development of the spine before birth. In many cases of congenital kyphosis, two or more of the vertebrae fuse together.

It's often unclear why certain children are affected in this way. But some cases of congenital kyphosis run in families, so it seems that genetics also play a role in this type of kyphosis.

Conditions that cause kyphosis

Conditions that can cause kyphosis include:

  • osteoporosis
  • spondylosis – a medical term used to describe the general ‘wear and tear’ that occurs in the bones, discs and ligaments of the spine as a person gets older
  • spina bifida – a birth condition where the spine hasn't formed properly
  • Paget's disease – a condition in which the development of new bone cells are disrupted, leading to the weakening of the bones
  • neurofibromatosis – a genetic disorder that affects the nervous system
  • muscular dystrophy – a genetic condition that causes progressive weakening of the muscles
  • tuberculosis – a bacterial infection that mainly affects the lungs but can sometimes spread
  • cancer that develops inside the spine or spreads to the spine from another part of the body

Kyphosis can also develop as a result of an injury to the spine.

^^ Back to top


Your GP should be able to diagnose kyphosis by making a physical examination of your (or your child’s) spine.

During the examination, your GP may ask you to perform a number of exercises to assess the impact the condition has on your balance and range of movement.

You may also be asked to lie down so that your GP can see if the curve is caused by bad posture or by a structural problem with the spine.

Although it's not always the case, if the spine straightens when you lie down it's likely that kyphosis is due to poor posture (postural kyphosis).

But if the spine stills curves while you're lying down, it's likely that kyphosis is due to a problem with the structure of the spine, as found in the Scheuermann's or congenital types of kyphosis.

An X-ray can usually confirm the diagnosis and determine the cause of the kyphosis.

Further scans would normally only be required if complex treatment, such as surgery, were being planned, or you had additional symptoms that suggested that the nervous system has been affected, such as numbness in the arms or legs.

These scans would probably involve:


If you develop kyphosis in adulthood then it's likely that you'll need additional tests to determine the underlying cause.

The tests that you'll be referred to will depend on what additional symptoms you have. They may include:

  • blood tests, which can be useful for checking for infections such as tuberculosis
  • a bone density scan, which is a special type of X-ray used to assess how strong your bones are – this can be useful in diagnosing conditions that cause weakening of the bones, such as osteoporosis or Paget’s disease
  • CT and MRI scans
^^ Back to top


Most cases of kyphosis don't require treatment.

Kyphosis that's caused by bad posture (postural kyphosis) can normally be corrected by improving your posture.

And kyphosis that's caused by abnormally shaped vertebrae (Scheuermann's kyphosis) will usually improve once you're fully grown.

Mild to moderate kyphosis

Over-the-counter painkillers such as ibuprofen or paracetamol can also help relieve symptoms such as back pain.

Regular exercise and a course of physiotherapy may also be advised to help strengthen the muscles in your back.

Teenagers with mild to moderate kyphosis may have to wear a back brace (a piece of equipment that supports your back). A brace will stop the curve from getting worse, and it's worn while the bones are still growing.

You'll probably find wearing a brace restrictive at first, but most people get used to them with time. Modern braces are designed to be as convenient as possible, so you should be able to still take part in a wide range of physical activities.

The brace will have to be worn until you're fully grown, which is usually around age 16 for girls and 18 for boys.

(Bracing isn't usually recommended for adults who have stopped growing as it won't correct the position of the spine).


Surgery can successfully correct the appearance of the back and relieve symptoms of pain. However, it carries quite a high risk of complication. This means that surgery would only be recommended in more severe cases of kyphosis. And only if it were felt that the potential benefits of surgery outweighed the risks.

Surgery would normally be recommended if:

  • the curve of the spine is very large (more than 70 degrees)
  • the curve is causing persistent pain that can't be controlled with medication
  • the curve is disrupting other important functions of the body, such as breathing and the nervous system
  • without surgery it's likely that the structure of the spine would become even more deformed

Surgery is also normally recommended for babies who are born with congenital kyphosis.

A technique called spinal fusion is usually used to treat kyphosis. This involves joining together the vertebrae that are responsible for the curve of the spine.

Spinal fusion is carried out under general anaesthetic (you're asleep throughout the procedure). An opening is made in your back, the curve in your spine is straightened using metal rods and hooks, and the spine is fused into place using bone grafts (a sample of bone taken from another place in your body – usually the pelvis). This surgery takes between four and eight hours.

You'll need to stay in hospital for around two weeks following the operation. Normally, you'll have to wear a cast or back brace for up to nine months. This is to support your spine while it heals.

You should be able to return to school, college or work after four to six weeks, then be able to play sports about a year after surgery.

Complications of spinal fusion surgery include:

  • post-operative infection
  • excessive bleeding at the site of the surgery
  • accidental damage to the discs of the back
  • accidental damage to the nerves that run through the spine, which could then affect some of the functions of the body such as bladder control (urinary incontinence)

You should discuss the benefits and risks associated with spinal surgery with the doctor in charge of your care.

^^ Back to top


Body image

A common complication of kyphosis in older children is that they become concerned or embarrassed about the effect of kyphosis on their appearance or the fact that they have to wear a back brace.

Teenagers are naturally more sensitive and self-conscious about their body image. Anything that makes them 'stand out from the crowd’ can be an issue of concern.

These concerns can affect children in different ways, such as:

  • becoming socially withdrawn
  • being reluctant to take part in activities that may expose their back or the fact that they have to wear a brace
  • they become moody
  • they become reluctant to discuss issues around their treatment, or perhaps, argue that they don't need any more treatment

There are no easy answers to these problems. But it can sometimes help if you try to reassure your child that their condition is temporary and will improve with time.

Other complications

Other complications of kyphosis usually only occur in more severe cases. They include:

  • persistent pain that can't be controlled with medication
  • breathing difficulties that are caused by the spine compressing the lungs and airways

Occasionally, people with kyphosis can have difficulties when the nerves that run through the spine become compressed or pinched. This can disrupt nerve signals and cause symptoms such as:

If you develop these more serious complications then surgery would normally be recommended.

Read more about the surgical treatment of kyphosis.

^^ Back to top

Selected links

NHS Direct Wales links

Back pain


External links 

Arthritis UK: back pain FAQs


^^ Back to top

The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 07/01/2014 11:23:52

Please leave your rating

Thank you for your rating
Average Rating
based on 2 ratings

0 rating
0 rating
0 rating
0 rating
2 ratings
Please leave your rating

Average Rating
based on 2 ratings
0 rating
0 rating
0 rating
0 rating
2 ratings
| Share
1000 Lives Campaign health challenge wales Twf change for life stonewall