By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
Hunched back can occur in all ages. However, majority occur in elderly. Here are the causes of hunched back in young to old people.
- Congenital Kyphosis – this occurs when the bone is not formed properly in children. It usually is progressive meaning it gets worse as the child grows taller
- Ricket Kyphosis – this occurs in children who have vitamin D deficiency. Without adequate vitamin D, the bones become soft and easily deformed. It can cause hunched back .
- Scheuermann Kyphosis – This occurs when a few consecutive vertebra in the thoracic spine are wedge in shape. This causes hunched back mainly in the upper back.
- Degenerative Kyphosis – With wear and tear, the disc becomes thinner and thinner. If it involves many levels and the thinning is significant, it can cause hunched back posture. This usually occurs in elderly.
- Tuberculosis in Spine – When the spine is infected with tuberculosis, the spine becomes soft and easily deformed. This can cause a very severe hunched back which is localised in one area. This deformity is called gibbus
- Ankylosing Spondylitis – This is an inflammatory condition of the spine. It causes the bones to join up together. With time, the posture becomes more hunched. Severe kyphosis from ankylosing spondylitis needs surgical treatment to correct the spinal deformity
- Post Traumatic Kyphosis – When the spine is unstable due to fracture, the treatment is surgery to stabilise the fracture. If it is treated without surgery, this can cause progressive hunched back due to spinal instability
- Osteoporosis Kyphosis – The bone is soft in osteoporosis. This causes progressive wedging. If it involves a few bones, this can cause hunched back.
- Kyphosis Secondary to Spinal Stenosis – In spinal stenosis, the nerve is compressed. Bending down posture can relieve the nerve compression. Patients with spinal stenosis are more comfortable with hunched back posture. Over a prolonged period of time, the hunched back posture becomes fixed and will never get better unless the nerve compression is freed up with surgery.
The treatment of hunched back depends on the cause. It is not enough just to know someone has a hunched back. The cause of hunched back must be identified so that it can be appropriately treated. Mild cases can be treated without surgery. Severe cases require surgical treatment to correct the deformity in the spine.
Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.