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Humpback - causes, symptoms and treatment
contents
- definition
- Illness and accidental kyphosis
- symptoms
- diagnosis
- therapy
- Conservative therapy
- home remedies
- Medicinal herbal treatment
- Medical therapy
- Operative therapy
definition
It may not be immediately obvious to everyone, but the human spine is relatively prone to deviations in its upright posture. This is due to the comparatively short time humans had to develop their upright corridor in the course of evolution. The basis for ensuring upright gait is still the correct functioning of the spinal musculature today. An extremely sensitive support mechanism, because the muscles in the spine should be weakened by certain factors, a curvature of the spinal column is hardly averted.
A hump (kyphosis) can not only be very painful, but is often also a mental burden. Despicable terms such as widow's or witch's hump are still common in many. (Image: olly / fotolia.com) The kyphosis now refers to such an unnatural curvature of the spine. In detail, it is a strong expression of the physiological spinal curvature in the thoracic and lumbar region with a backward (dorsal) curvature tendency. The natural S-shape of the spine is thereby greatly imbalanced, so that the upright posture without targeted countermeasures is hardly possible. There are different degrees of kyphosis:
- Postural kyphosis - The most common type of kyphosis is characterized by a "slightly" curved posture. It is usually due to poor posture and usually still relatively easy to treat. May be affected by postural kyphosis both young and elderly.
- Scheuermann's kyphosis (Scheuermann's disease) - a much more complicated kyphosis variant, also known as Scheuermann's disease, which results in a very extreme curvature of the spine. It is much harder to treat than postural kyphosis.
- Congenital kyphosis - This kyphosis is usually the result of congenital malformations of the spine and consequently pronounced in infancy. A treatment in the early stages of the disease is very important here, in order to mitigate the further course of the disease as much as possible.
- Nutritional kyphosis - a kyphosis, which results from malnutrition in childhood and is therefore due to nutrient deficiency caused growth disorders of the spine.
- post-traumatic kyphosis - Post-traumatic kyphosis is the name given to the kyphotic curvature due to accidental vertebral fractures.
It can be seen that there are many causes of a hump, which are either innate or acquired and can be treated better or worse depending on the severity.
Permanent postural defects as the main cause
The saying "to work crooked and hunchbacked" is no coincidence. In the past, extreme physical work, combined with the continued lifting of heavy weights or a stooping posture, was one of the main reasons for the development of a kyphosis. This was more likely to occur in old age, when the consequences of working life on a severely worn and curved spine became apparent. In modern times, however, kyphoses have become more common in younger generations.
Puncture injuries in adolescence are on the rise and in particular favor a postural kyphosis. The starting point for their formation in this context is usually a decline in the core muscles, which is mainly responsible for the stability of our midsection. This in turn promotes premature wear of the intervertebral discs and vertebral joints. This results in pain that leads to a further protective or incorrect posture. A vicious circle that can lead to a hunchback at an early age without early countermeasures.
Previously, extreme physical work, combined with the sustained lifting of heavy loads or a stooping posture, was one of the main causes of kyphosis. (Image: industrieblick / fotolia.com) Regardless of changes in the average age of patients with postural kyphosis, it should be noted that today's lifestyle does not only increase the risk of humpback in young people. Basically, the modern everyday life for old and young keeps more and more situations ready, the muscle weaknesses in the support apparatus favor by malpractice or lack of exercise and thus contribute to a kyphosis. Which includes
- seated occupations (e.g., office or computer work),
- seated recreational activities (e.g., computer or console games),
- Muscle tension due to stress,
- forward weight bearing due to obesity,
- and unhealthy eating habits (nutritional kyphosis).
Illness and accidental kyphosis
When it comes to disease-related kyphosis, it is first necessary to mention genetically determined undesirable developments of the spinal column. The congenital kyphosis often has its origin in undesirable developments of the vertebral bodies, for example in so-called semi-, wedge or block vortices. Likewise, congenital nerve diseases such as cerebral palsy may be responsible for kyphosis in infancy.
In childhood and adolescence congenital kyphosis usually take a difficult course without suitable treatment. In addition, however, other forms of kyphosis can easily manifest themselves at this age, as the child's spine is still growing and therefore particularly sensitive to disturbing factors.
For example, pronounced malnutrition in early childhood can lead to nutritional kyphosis. Malnutrition is not only a food shortage, but also a deficiency of the spine with important nutrients such as vitamin D or calcium. In adolescence, in addition to postural defects, illnesses such as osteochondrosis play an important role in the development of a hump. The disease is a disorder in the conversion of cartilage to bone mass and is the most common cause of Scheuermann kyphosis.
Another bone disease that can cause kyphosis is osteoporosis. In the course of this disease there is a decrease in bone density, which can also extend to the vertebral bodies. If the vertebral bodies lose bone mass as a result of the degradation processes, they can ultimately collapse under the weight that the vertebrae must carry (so-called sintering fracture). If several superimposed vertebrae are affected, kyphosis results. Usually osteoporosis manifests itself in older age, which makes a corresponding hunchback especially to a suffering of older persons.
Osteoporosis as a cause of kyphosis: Due to the decrease in bone density, the vertebral bodies may collapse (so-called sintering fracture). If several superimposed vertebrae are affected, this results in a kyphosis. (Image: crevis / fotolia.com) Various inflammatory and rheumatic diseases such as, for example, ankylosing spondylitis or rheumatoid arthritis, can also lead to kyphosis and, moreover, cause a more or less pronounced course of the disease. Furthermore are
- accident trauma,
- tumors
- and metastases
in the area of the bony spine do not rule out as a cause. They usually cause significant instabilities of the vertebral bodies or trigger edema, which in turn favors the kyphosis.
symptoms
Of course, a hump falls naturally through the visually perceptible, extreme curvature of the spine. Patients thereby often feel disfigured and try to conceal their kyphosis reflexively by restraint, which in many cases not only aggravates the curvature, but also indicates the mental suffering of the patients. The pattern of outsiders, as well as the partially derogatory behavior of strangers towards those affected is an all too often underestimated source of mental problems in kyphosis patients who are very often struggling with self-insecurity, social anxiety and depression.
In addition, of course, there are other physical symptoms, such as the severe pain that causes a round back in the long run. Also to be reckoned with movement restrictions, which manifest themselves in particular in a reduced freedom of movement of the shoulder blades and in this context often provoke unpleasant muscle tension in the neck muscles. Overall, the following symptoms can be observed in the case of a kyphosis:
- clearly curved back,
- attitude problems,
- Limitations of movement (especially in the area of the shoulder blades),
- vertebral inflammation,
- strong back pain,
- neck tension
- a headache,
- sleep disorders,
- sensory disturbances,
- Disorders in organ function (e.g., heart and lung),
- depressions,
- social fears,
- lowered self-esteem.
There are many symptoms of kyphosis: from back and headaches to insomnia to disorders in the organ function of z. Heart and lungs. (Image: ALDECAstudio / fotolia.com) Danger: In particularly severe cases of kyphosis, dislocation of the vertebrae can damage the spinal cord or the nerve roots. Sensory disorders, including nerve paralysis, are a real danger to patients!
diagnosis
The diagnosis of the hunchback is usually already visually striking by the typical image of a back-arched spine, the stocky-looking neck and the forward falling shoulders. To ensure the diagnosis and the estimation of possible causes, various imaging methods are available, with particular emphasis on X-ray examination, computed tomography and magnetic resonance tomography. The treating orthopedist also uses various equipment, such as protractors, which can determine the degree of hyperkyphosis on the basis of the so-called Cobb angle. In addition, inflammatory parameters and rheumatoid factors in blood samples can be determined by laboratory techniques.
therapy
The therapeutic measures for round backs are strongly oriented to the causal process. They are designed to maintain the quality of life of the person affected as long as possible, to reduce pain and to avoid consequential damage. In addition, since the spinal column, through its connection with the thorax, is closely related to the respiratory mechanics and cardiovascular system, measures must be taken to stabilize cardiac and pulmonary function.
Conservative therapy
Conservative therapy is the cornerstone in the treatment of cervical spine. It advances both the drug and the operative treatment strategy and must be continued in the home environment as well, since only then is a quality of life assured. The conservative approach to therapy consists of several components from physiotherapy and occupational therapy as well as orthopedics. Special muscle training should help to strengthen the core muscles and prevent muscle tension, which helps to reduce pain. In addition, a targeted training of the back, abdominal and trunk muscles can improve posture. Another support in this context is the use of adapted orthoses.
Therapeutic breathing training also falls into the conservative treatment range. Targeted breathing exercises improve respiratory mechanics and ensure lung function. Also conceivable is professional relaxation training, for example in the form of yoga or autogenic training, which once again benefits the relaxation of the muscles.
Conservative therapy is the cornerstone in the treatment of cervical spine. So helps z. B. a targeted training of the back, abdominal and trunk muscles to improve posture. (Image: Printemps / fotolia.com) home remedies
Kyphosis, in its mild form, may have causes that sufferers are able to repair themselves. A reduction of obesity, for example, takes additional strain off the spine. Control of the workplace with regard to back-friendly office chairs, a reasonable height adjustment to the desk or a back-friendly way of working, which aims at an upright posture, also contribute much to the improvement of the hump. When dealing with technical devices such as smartphones, tablets, computers and game consoles, it is additionally particularly important to regularly check the sitting posture, as you tend to curl your back relatively quickly when using it. Last but not least, a good lying position should also be respected during sleep. Special back-friendly mattresses and pillows are recommended for this purpose.
When it comes to lack of exercise in everyday life, the only effective countermeasure is, of course, more exercise. Regular physical activity is definitely recommended for people with kyphosis. Often, there are also special offers such as aqua gymnastics, which can be addressed increasingly on the complaints of patients.
Medicinal herbal treatment
For the supportive treatment of back problems, the medicinal plants devil's claw, comfrey and arnica have been successful in the past. If osteoporosis is the underlying cause, the supportive use of Schuessler salt Calcium phosphoricum has been proven. This salt supports the calcium metabolism involved in the development of osteoporosis.
Medical therapy
In the case of kyphosis, the medicinal approach includes, among others, the administration of painkillers and relaxants. The latter help to loosen existing muscle tension and thus minimize the aggravation of the hump by restraint. Also used are anti-inflammatory drugs (e.g., cortisone) for the treatment of inflammatory processes and rheumatic disease causes. In the case of malnutrition, dietary supplements such as calcium or vitamin D3 supplements are also conceivable.
Important: The mentioned groups of drugs serve only for the palliative treatment of a kyphosis. Unfortunately, there is no drug that can cure the kyphosis.
Operative therapy
If conservative and drug therapy does not (more) produce the desired result, spinal surgery is often indicated. The goal here is to stabilize, straighten and possibly stiffen the affected parts of the spine. Various techniques are used to insert wires, plates, pins and screws into the vortices.
Indications for a necessary operation are provided by the attending physician, as interventions on the back are always at an increased risk due to their proximity to the spinal cord and should therefore not be carried out carelessly.
Diseases associated with kyphosis: abnormal vertebral body development, cerebral palsy, deficiency symptoms, osteochondrosis, osteoporosis, ankylosing spondylitis, Scheuermann's disease, rheumatoid arthritis, tumors. (Ma)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)