Hyperkyphosis is excessive curvature of the thoracic spine, commonly known as the "dowager's hump." Although it is also referred to as kyphosis, the term kyphosis is meant to describe the sagittal convexity, or forward curvature, of the normal thoracic spine which can range from normal to abnormal. Kyphosis tends to progress with age .
The evaluation and treatment of hyperkyphosis is challenging due to the lack of standardized diagnostic criteria and evidence-based treatment options. Within the last several years, exercise programs, spinal orthotics, and other interventions have been studied that may help delay the progression of age-related kyphosis. However, stronger evidence of efficacy with improved clinical outcomes is needed prior to widespread use of many of these interventions.
This topic will focus on the etiology, evaluation, and management of hyperkyphosis in older adults. Hyperkyphosis in children and adolescents is discussed separately. (See "Back pain in children and adolescents: Overview of causes".)
There is no widely-accepted definition of hyperkyphosis, and therefore the prevalence of hyperkyphosis in older persons is not precisely known. However, current estimates range between 20 and 40 percent among community-dwelling subjects aged ≥60 years [2-4].
The prevalence of hyperkyphosis increases with age, with the greatest change in the angle of kyphosis occurring among women age 50 to 59 years .