Hunchback – Causes and Treatments

Spine, Upper Back, Blog, / By Winsen Citra


It is known by many as hunchback, roundback, humpback, or dowager’s hump. They are all essentially the same condition. It is a condition where there is excessive curvature int he upper back. In medical terms, this is called thoracic hyperkyphosis or kyphosis. Though hunchback is quite often postural in origin, it can also be caused by structural defects in the spine. The structural defects may come from osteoporosis, a spinal fracture, or even congenital defects in the spine.

If you have hunchback, you may have a noticeable hump, protrusion, or rounding that is visible when someone views you from the side. A rounded shoulder is a common side-effect to having a hunchback. If hyperkyphosis left untreated, normal tasks such as bathing, getting out of a chair, bending, or walking may become difficult. Patients can also experience balance changes that may result in falls and injury. As the condition progresses, some patients may feel pain in the upper back and eventually the condition may cause a fracture in the spine.

Types of Hunchback

Thoracic Hyperkyphosis
Increased Curvature of Thoracic Spine

Scheuermann’s Disease

This condition affects mainly teenagers. It is caused by an uneven growth in the spine where the posterior aspect of the spine grows larger than the front. This causes a “wedging” effect on the spine which in turn presents as a hunchback.

Postural Kyphosis

Caused by poor posture, this is the most common cause of kyphosis. As a result of our sedentary desk-bound lifestyle, we have weakened muscles and spinal ligaments which contributes to this condition. In worrying trend, we are seeing younger office workers coming in with conditions which results from kyphosis.

Congenital Kyphosis

Bone defect which comes from birth. No known cause for it. This angle of the kyphosis will increase over time if not treated.

Structural Kyphosis

As opposed to postural kyphosis, sufferers of strucural kyphosis cannot consciously try to straighten their spine. This is because their hunchback is caused by a structural defect in the spine such as a compression fracture or other ongoing spinal deformity which prevents them from straightening up. These patients often have ongoing back pain and leg pain associated with their hunchback. Older patients are more prone to getting structural kyphosis than younger patients.

Other Causes

Any condition that reduces the height of the front of the spine can cause hunchback. Examples of such conditions are degenerative disc disease, other spinal fractures, or even bone tumours.


Treatments for hunchback varies depending on the patient’s age, severity of the curvature, and the cause of the condition. Most patients are with kyphosis are often first observed to see the progress of the condition. Stable kyphosis where the curve does not increase overtime are usually referred to physiotherapy to strengthen the spinal muscles and improve posture. If the curvature grows over time, then more aggressive treatments may be prescribed.

For mild kyphosis, physiotherapy is very effective in managing the condition, though treatment is not always required. A combination of manual therapy and spinal manipulation often helps with the pain and stiffness that results from kyphosis. An exercise routine is also often prescribed to patients to maintain their core muscle strength. Pilates is a recommended form of exercise that helps with awareness of your spine positioning while strengthening your muscles at the same time.


This is treatment that is often used for patients who are still growing. Adolescents and kids benefit from bracing. However, bracing is not useful in adults. The aim of bracing is to help straighten the spine and prevent the curvature from developing. This is a similar treatment that is used for patients with scoliosis, though the type of brace and its location may be different.


While most patients do not require surgery, it is recommended for patients whose curvature continue to progress despite non-invasive treatments. Surgery is usually a treatment that is done for patients whose curvature is above 80°. At such angles, breathing starts to become affected by the spinal curvature and hence surgery becomes necessary. Another cause why surgery often becomes the choice of treatment is when the curvature causes compression of the nerves.

We hope this article has been useful to you. Check out the video below, our therapist Peh Chia is sharing a quick exercise to help you stretch and reduce your hunchback.  As always, should you have questions or need more information, feel free to contact us. For more information related to the spine, click here. We also have a YouTube channel where you will find our therapists sharing useful exercises which you can do at home.