Widespread disease back pain – Almost every fourth German suffers regularly from pain in the back. One cause may be the so-called hunchback, i.e. a back curved backwards, which is particularly widespread in industrialized nations.
What is a hunchback?
The hunchback, in medicine called hyperkyphosis that derives from the Greek “kyphos” for “hump” as well as “hyper” for “over”, refers to an extreme curvature of the spine backward. A kyphosis in the area of the thoracic vertebra and a smaller one at the level of the coccyx (sacral kyphosis) are completely normal and natural. Only when there is an extreme bulge, which is clearly visible when standing upright, is there a hunchback, which is then referred to as “hyperkyphosis”. A distinction is made between congenital hunchbacks and those that develop after birth. In the long term, hyperkyphosis can also lead to organ damage and psychological stress.
Causes
The main reason for a hunchback is a lack of exercise combined with incorrect or unnatural postures when sitting, standing or walking. These incorrect postures, along with muscles that are often too weak, mean that they are no longer capable of maintaining a correct, upright posture. As a consequence, the vertebral oscillations can collapse, gradually curving the back. If these faulty conditions persist over a long period of time without being counteracted by building up muscles or a more active lifestyle, this will inevitably lead to the development of a rounded back. In older people, a vertebral fracture, which can be triggered by osteoporosis, for example, can also be causative for the development of a hunchback. Furthermore, degenerative diseases such as arthritis can also lead to the formation of a round back.
Symptoms, complaints and signs
Hunchback can be associated with many symptoms. Depending on the severity, these are not only symptoms in the area of bony structures, but also in the area of internal organs. However, the clearest sign of the hunchback is, of course, the curvature of the upper back beyond the normal level. The kyphosis that the thoracic spine normally has is far more pronounced than is physiological. This is easily seen not only from the side, but also from the front, as the affected person has a more or less visibly constricted chest space with shoulders that often drop forward. It is this narrow chest space that ensures that the hunchback can also show itself in symptoms on the internal organs, which have less room to function. Heart function may be affected, as well as lung function, since the space for breathing is limited by the hunchback. The stomach may also be affected in its natural activity. However, the main symptoms of the hunchback are in the area of the support and movement system. Back pain, neck pain and also headaches can be the result. Due to the shortened muscles in the chest area and the weakened muscles in the upper back area, a muscular imbalance occurs, which can also lead to pain conditions in muscles, tendons, ligaments and nerves.
Diagnosis and course
Diagnosing a hunchback is one of the easier tasks for orthopedists and physical therapists, as it is usually already visible to the naked eye. To obtain complete clarity, an x-ray of the spine can also be taken. The consequences of an untreated hunchback are manifold and should not be underestimated. For example, in addition to more harmless symptoms such as mild headaches and back pain or a restricted range of motion, more serious sequelae such as sleep disturbances, which can lead to psychological problems and even depression, can occur. In addition, the hunchback can impair the unrestricted function of important organs such as the heart or lungs, as these can be affected by the curvature of the chest. Without specific treatment, the curvature of the spine continues to increase and can lead to damage to the spinal cord and secondary damage in other areas of the musculoskeletal system.
Complications
A hunchback is always accompanied by overstretching and compression, which inevitably leads to damage to muscles, tendons, vertebrae and connective tissue.This is associated with painful tension, but also disc damage and signs of wear and tear. The lower spine area is stressed the most – pain in the lumbar and sacral vertebrae and restricted movement occur. In the shoulders, a hunchback can cause inflammation in the bursae. When the nerves are affected, functional disorders occur in various regions of the body. Numbness or tingling occurs in the arms and legs, and complications such as incontinence or urinary retention occur in the bladder and rectum. A hunchback thus has a negative effect on performance and well-being. Chronically ill patients therefore often also suffer from psychological complaints. Treatment also involves risks. Surgical intervention, for example, is associated with the risk of nerve injury, bleeding and infection. Wound healing disorders and secondary bleeding delay the healing process and can occasionally cause major complications. Prescribed painkillers can trigger isolated complaints such as headaches, pain in the limbs or gastrointestinal complaints. Interaction with other medications or diseases may sometimes cause further problems.
When should you see a doctor?
A hunchback should be treated by a doctor. If left untreated, it can lead to further complications that can significantly limit and complicate the affected person’s daily life. Early diagnosis with subsequent treatment has a positive effect on the further course of the disease and can prevent further complaints or complications. A doctor should be consulted if the back shows an unnatural curvature. In most cases, friends or family of the affected person can point out the hunchback to the patient. Since the hunchback also gives the internal organs less room in the body, damage to these organs can occur. Often, persistent pain in the back or neck indicates this condition, and the affected person may also suffer from severely weakened muscles. The pain often spreads to neighboring regions as well. In the case of a hunchback, a general practitioner can be consulted first. However, further treatment is then carried out by a specialist.
Treatment and therapy
In most cases, the first treatment option for a hunchback is physical therapy. This involves targeted training and building up of both the back and chest muscles. In addition, there is the learning and independent application of special breathing techniques, which are intended to relax and relieve the incorrectly loaded musculature. In addition, there is the possibility of wearing a corset, which can be adjusted to the respective degree of severity of the hunchback through various possibilities of adjustment. In particularly severe cases, surgery may even be necessary. In the case of a hunchback caused by a vertebral fracture, for example, a so-called kyphoplasty is performed, in which the fractured vertebrae are re-stabilized by the use of bone cement. A hunchback caused by lack of exercise and incorrect sitting postures can best be prevented by regular exercise and correct posture when sitting. Most fitness studios nowadays offer courses in which exercises are performed that are specifically designed to stabilize the spine and strengthen the back muscles. Regular jogging or walking is also beneficial to the back muscles and correct posture, and can counteract the development of a rounded back.
Prevention
The hunchback is a common phenomenon and should not be underestimated because of its possible consequences. However, various therapies and options for prevention and avoidance, such as exercise, can counteract an already existing hunchback or prevent it from becoming a problem in the first place.
Aftercare
Aftercare is often required for a hunchback if it was previously severe and surgery had to be performed because of it. In this case, follow-up care takes place in collaboration with a specialized orthopedist and physiotherapist. The patient’s cooperation also plays an important role. Thus, he should consistently continue the physiotherapeutic exercises, which he learns in physiotherapy, in his own home. The physiotherapeutic exercises serve to gently stretch the shortened chest muscles.This, in turn, allows to treat the unhealthy curvature leaning in the anterior direction. In addition, the exercises strengthen the upper back region, which promotes the physiological straightening of the spine. In rehabilitation sports, training sessions on equipment are possible, which stimulate targeted strengthening of the muscles. Bed rest is not necessary after an operation on the hunchback. Thus, the patient is allowed to get up again a few hours after the operation with accompaniment, moving normally. However, a short-term fitting of a corset is considered advisable. To counteract the pain after the operation, the patient receives a special pain catheter. This remains on the body for a few days. Regular performance of isometric exercises to strengthen the trunk muscles is important for post-operative care. Furthermore, in order to assess the postoperative consolidation of the round back, clinical control examinations are performed and X-rays are taken.
What you can do yourself
Patients suffering from a hunchback can perform various gymnastic exercises. They should contact a physiotherapist and work out appropriate measures. Proper exercise can improve the health of the spine. Posture can usually only be corrected to a limited extent. It is therefore all the more important to avoid further damage by adopting appropriate movement strategies. No strenuous physical activities should be performed after surgery. It is important to take care of the back and to contribute to recovery by means of targeted physiotherapy. In consultation with the specialist, natural remedies can be used to alleviate any pain. This not only relieves immediate discomfort, but also facilitates a straight gait. This reduces poor posture and prevents secondary damage such as joint wear. Hyperkyphosis can also be treated with breathing exercises. Targeted training increases breathing volume and alleviates the shortness of breath that accompanies the widow’s hump. If these measures are followed consistently, an increase in the hunchback can be avoided. In addition, further postural damage can be prevented by gymnastics and an active lifestyle. Older patients in particular need to remain active to counteract hyperkyphosis.
