Curezone Physiotherapy, Mississauga provides treatments in various musculoskeletal conditions including postural dysfunction including kyphosis. 

Kyphosis is an increase in forward curvature of the spine along the sagittal plane. Kyphosis can affect the cervical, lumbar, and thoracic spine, rounding out the back and pushing the head forward.

Slouching can increase the forward curvature, stretching and weakening the posterior extensor muscles and the posterior ligaments of the spine. In older individuals, the decreased muscle strength and bone density can result in wedge-like fractures along the spinal vertebrae. In adolescent individuals this condition presents itself as Scheunemann disease, juvenile kyphosis, or juvenile discogenic disease.

Kyphosis in various age groups

Kyphosis in adolescents

Scheunemann kyphosis (Scheunemann disease, juvenile kyphosis, juvenile discogenic disease) is commonly diagnosed after a postural abnormality and/or pain is noticed in the affected area. Postural kyphosis is common among adolescents and usually occurs before puberty. During this time, bracing can be used to help support and correct postural shifts.

Kyphosis in adults

Kyphosis among adults is commonly caused by osteoporosis and other instances of bone mass loss. In this age range kyphosis is more common in woman due to the loss of estrogen during menopause.

Kyphosis in elderly

A fall risk factor in older adults, resulting in injuries and serious harm. Kyphosis in the upper body (thoracic spine) can cause an excessive curve and may shift the body’s center of mass forward. If the lower body (lumbar spine and hip region) is not strong enough to compensate for this change, individuals will have a harder time maintaining proper balance while walking. Muscle weakness and decreased bone strength can lead to more severe injuries from falls.

Treatment

If left untreated kyphosis can place pressure on internal organs like the lungs, resulting in breathing problems, or the digestive tract, making it difficult to swallow food. Treatments can differ based on the amount of correction required, the magnitude of kyphosis, the location of interest and any nearby bones and organs. The goal of all treatments is to correct the sagittal curve of the spine and to restore balance to an acceptable range.

Surgical

Anterior approach

An anterior approach procedure is named such because it removes material from the front part of the spine, not because the incision for entry is made at the front of the body. The opening is generally made on a patient’s side at the side of the chest or abdomen. This method is more difficult to perform than the standard posterior approach but can allow for better bone grafting and maintaining the mobility of the spine.

Posterior approach

In a posterior approach, either lateral mass screws or pedicle screws can be used to help correct the spine. Several lateral mass screws may be drilled into the vertebrae, taking care to avoid important anatomical structures like arteries and nerves. Pedicle screws are placed above and below the fused vertebrae and connected with a rod to prevent movement while the bone graft heals.

Osteotomy

Some deformities may require removing of pieces of bone alongside the use of screws and stabilizing rods. Pedicle subtraction osteotomy targets areas are the facet joints at the back of the vertebra and the vertebrae above and below, the pedicle of the target vertebrae, the laminae, and a portion of the target vertebral body.  A circumferential osteotomy may be performed if the spine is very rigid and stiff. In this procedure, wedge shaped sections of the spine will be removed before supporting screws and rods are placed along the spine.

Exercise and Physiotherapy Management at Curezone Physiotherapy Clinic

Our Registered physiotherapist makes sure they make an appropriate treatment plan based on your needs and implement the program including home exercises.  

Manual Therapy and Modalities

Manual therapy like Maitland and Mulligan Techniques are used to increase spinal and joint mobility and for realignment of the spine. Modalities such as Ultrasound and Laser therapy help to alleviate the pain and inflammation caused due to postural dysfunction.

Muscle strengthening and stretching

Strengthening various muscles in the back and lower body muscles can help improve posture and provide stability to help correct improper posture. When used along with postural education, active participants have noticed decreased pain and strain and improved mobility. Exercise and muscles strengthening through the participation of 1-hour long stretching and exercise programs for 2 days a week has been shown to have positive effects in improving posture.

Focusing on the back extensor muscles, erector spinae, trapezius, levator scapulae and thoracic muscles can improve posture by widening the chest cavity and prevent slouching by helping to support the neck. This can be done with small-weight dumbbells, resistance bands, or using a light backpack.

Lower body muscles around the core such as the quads, ischiotibial muscles, and abdominal muscles can help stabilise the pelvis and lower back. Improving core stability will help keep the spine straight without having to slouch forwards and to maintain proper head tilt. This can help stop the progression of kyphosis and can help in the recovery to a more normal and natural spine curve. Exercise, ultrasound, and stretches can help relax and strengthen muscles in these areas. Lying and rolling over a ball or a foam roller can help with flexibility and range of motion issues.

Structured exercise and fitness

Exercise and fitness classes that focus on stretching, relaxation, and flexibility of the spine are also helpful in treating kyphosis. Yoga and Pilates classes focus on thoracic extension and general abdominal strengthening. Sessions that alternate between standing and kneeling/all-fours stances are generally the most effective because they help focus on mobility and the movement of the spine. Participating in these exercises for four hours each week have shown an increase in core strength, mobility, and stability.