If you’ve started to notice the development of a hump at the base or back of your neck, you may be focused on how strange it looks and think it’s a result of bad posture. Sometimes called a “dowager’s hump “or “hunchback,” this hump in the back of your neck is known medically as Thoracic Kyphosis, and it could signal an issue larger than forgetting to sit or stand up straight. “This hump typically affects the area of the spine called the upper thoracic spine,” says Dr. James E. Dowdell III, MD, spine surgeon at Hospital for Special Surgery. “When you have this condition, your head appears to jut forward because the upper thoracic spine has an excessive curvature.” If you have a hump on the back of your neck, you may experience symptoms such as back pain or stiffness, fatigue, tight hamstrings, and rounded shoulders. And although Dr. Dowdell notes that everyone has a natural curvature to their spine, there are certain reasons and causes that you may have a worsening of this curvature. Here’s everything you need to know.
What causes thoracic kyphosis?
While there may be multiple factors at play for the hump to form, one stands out amongst the rest. “The number one cause of the hump is bad posture,” says Dr. Dowdell. “Unfortunately, this becomes a chicken and egg scenario as bad posture places more pressure on the spine, which can cause worsening of the curvature which further reinforces the existing bad posture.” Other causes include:
Osteoporosis (bone disease): “This can change the shape of bones (wedging of vertebral bodies) if they are not strong enough,” says Dr. Dowdell. “This wedging of the vertebra creates kyphosis in the thoracic spine.“Arthritis: “Arthritis in the lower neck may cause the head to automatically lean more forward in order to keep the arthritic areas in a more comfortable position,” says Dr. Rahul Shah, MD, board-certified orthopedic spine and neck surgeon at Premier Orthopaedic Spine Associates in Vineland, New Jersey. This leaning forward will cause a cascade of changes that make the hump more evident.Scheuermann’s Kyphosis: While the normal curvature of the spine is anywhere from 20 to 40 degrees, a congenital problem called Scheurmann’s Kyphosis creates a curvature between 45 and 75 degrees, according to the University of Maryland Medical Center.Muscle weakness: If the muscles of the upper thoracic spine are not strong enough, it places additional pressure on the spine, which can contribute to the development of this curvature, which according to Dr. Dowdell is more common now due to office work/computers/smartphones.Aging: With age, you may lose significantly more mass in the spine vertebra (either in the neck or the thoracic bones), which can create posture changes can accentuate the hump, says Dr. Shah.Extra tissue deposits from extra fat stores: This can be caused by certain medications, steroids, medical conditions like Cushing syndrome, as well as obesity, notes Dr. Shah.
How to fix thoracic kyphosis
“In my view, the most important thing about the hump is to identify the root cause,” notes Dr. Shah. “If one has a hump, I would recommend following up with your physician to identify the underlying cause so that the solutions may have a high chance of working.” Lifestyle changes are the mainstay of treatment. These can include:
Physical activity. “Regular cardiovascular exercise, back strengthening exercises, and yoga can help,” says Dr. Dowdell. “A prescription for physical therapy may also be offered to help guide this treatment, including attention to good posture and proper ergonomics.“A back brace. “If your condition is more advanced at a young age you may even be prescribed a brace to prevent worsening of your condition,” says Dr. Dowdell.Pain medication. “If pain is significant, typically the first-line medication is an anti-inflammatory medication,” says Dr. Dowdell.Adjusting medication. “For example, if one has the hump as a result of fatty tissue deposits, adjusting different medications may work, or even consideration of removal of the tissues directly with surgery can be helpful,” says Dr. Shah.Treatment of underlying conditions. “This is also important to prevent further worsening–osteoporosis is the major condition that can worsen kyphosis if untreated,” says Dr. Dowdell.Spinal surgery. “Only in severe cases of kyphosis would surgery be offered. Sometimes kyphosis can contribute to spinal cord compression, and it could potentially even lead to issues with organ dysfunction (lungs/heart) if the kyphosis is severe enough. In these situations, surgery can be performed to decrease the curvature in the spine. This would be a spinal fusion operation.
Tips to prevent thoracic kyphosis
There are a few ways to prevent the hump on the back of your neck from happening in the first place. Here are four things to keep in mind:
Practice proper posture
“This prevents further stress being placed on your spine, decreasing the likelihood of degeneration and worsening of your hump,” says Dr. Dowdell. “For every inch forward your head juts, your spine sees 10 pounds of extra force.” For example, carrying something heavy with your arms extended or away from your body, and then carry the same thing with your arms close to your body. “Your muscles fatigue faster when your arms are far away from the body,” says Dr. Dowdell, and the same goes for your neck.
Exercise
“Exercise directly toward strengthening the muscles around the neck and upper chest may be helpful in order to preserve the integrity of the neck muscles and maintain horizontal gaze,” says Dr. Shah. “Lifting weights or other strength training exercises can help to increase bone density over time. Yoga can also help with posture, alignment, and flexibility.”
Focus on bone health
“If you have osteoporosis, make an appointment to see an endocrinologist to improve your bone health, and take calcium or vitamin D,” says Dr. Dowdell. Besides supplements, a healthful, well-balanced diet rich in calcium and vitamin D will also help keep your bones strong, notes Dr. Shah.
Adjust your workspace
According to Dr. Shah, try not to slouch forward or round your shoulders, even when sitting at a keyboard or watching television on the couch. “Optimizing your workspace is also ideal; try to keep the head level over the pelvis and the neck is not craning forward will be a good start,” says Dr. Shah. Next up: The Best Sleep Position to Avoid Back and Neck Pain
Sources
Dr. James E. Dowdell III, MD, spine surgeon at Hospital for Special SurgeryDr. Rahul Shah, MD, board-certified orthopedic spine and neck surgeon at Premier Orthopaedic Spine Associates in Vineland, New Jersey
