By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Middle Back Pain


Kyphosis - excessive kyphotic curve

Kyphosis is a term we use to describe the curve in the middle of your back. Viewed from the side it is the area in your back that curves outwards.

When you look at the side profile of the spine it has three curves and should naturally form a gentle S-Shape . The lower back curves inwards, known as a lumbar lordosis . The middle back, known as the thoracic spine, curves outwards and is known as a kyphosis, and finally the neck curves inward at the top of the spine in a lordosis again.

We must not confuse a kyphosis with a scoliosis. Scoliosis is where there is you see a curve in the spine as you look at it front-on and can be as a result of a congenital condition arising from birth, or the result of a twist in your spine arising from injury..

Back to kyphosis!

The degree of kyphosis should be in proportion to the degree of lordosis in your spine, normally a gentle S-shape. Sometimes your kyphotic curve can be excessive and this can lead to a “round back” or “hunched back” posture. This dysfunction place abnormal pressure on other areas of your spine. The degrees of curvature in your spine need to be correct to ensure an even distribution of load throughout your spine and pelvis.

If you have an increased thoracic kyphosis, it may result in excess pressure on your neck, resulting in upper back pain or neck pain or lower back pain in dysfunctional movement and pressure distribution. The end result is often pain.

Causes of Kyphosis

I consider that there are two types of kyphosis - structural kyphosis and functional kyphosis.

  • Structural kyphosis is generally genetic or deformities that develop during the growth process.
  • Functional kyphosis is more common both in general and in my clinic. Functional kyphosis is generally caused by poor postural habits, in other words slouching when you sit or stand will lead to the development of kyphosis over time. It is worth noting that a functional kyphosis may develop into a structural kyphosis over time.

Treating Kyphosis

I am often asked at my clinic how to treat an excess kyphosis.

Well, treating Kyphosis problems can be difficult.

In all situations prevention is better than cure. If you are aware that you have an increased thoracic kyphosis you should have a physiotherapist/phyisical therapist have a look at it before it becomes a problem. Although most kyphosis cannot be reversed or reduced, correct posture and exercises can prevent it from worsening over time and can also prevent associated injuries.

Postural positioning can improve the faulty weight transference through your spine and pelvis - and appropriate strength exercises in the form of Pilates can further improve your alignment and movement patterns. All in all, these approaches will typically reduce the complications associated with an increased thoracic kyphosis.

The younger you start the better, but it is never too late to work at it!

If you have an increased kyphosis, your neck and lower back may be under pressure while you sleep. When you lie down the increased curve may cause excess strain on the joints of your lower back and neck. Using an orthopaedic pillow sized correctly for you may reduce this strain and prevent any pain associated with poor sleeping posture. Again, a physiotherapist will advise you on this.

However, be warned that using a pillow that is not the correct size for your spinal curves may worsen your condition over time.

Another form of kyphosis occurs as a result of sitting poorly over long periods of time. I regularly see clients who have back and neck pain associated with having an increased thoracic kyphosis as a result of their poor sitting postures. If you have a desk or driving job and sit in a certain way then an increased thoracic kyphosis can result. When treated and addressed early this curve can often be corrected. However, the longer it is left the more difficult it is to reverse and the more likely you are to get back and neck pain.

Finally, the thoracic spine is an area of the spine that has a tendency to get tight. Tightness combined with an increased thoracic kyphosis often causes excess pressure on your neck. So, if you have a stiff middle to upper back attend a therapist who will loosen it for you.

You will move and feel a whole lot better!


While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.

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