– the spine has 3 natural curves
1. the cervical (neck) spine curves slightly inwards (lordosis)
2. the thoracic spine (chest level) curves slightly outwards (kyphosis) and
3. the lumbar spine curves slightly inwards (lordosis)
This pattern allows even weight distribution and allows the spine to withstand all types of forces.
What is it?
Scheuermannʼs kyphosis is a ʻdevelopmentalʼ type of kyphosis (outward curve), which means that it happens when our bones are growing. This develops in adolescents while their bones are still growing. It typically affects the thoracic spine and upper lumbar spine (T10-L4). The vertebral bodies may wedge forward slightly. If the front of the vertebrae wedges closer together in a triangular shape, the spine can curve forwards more than usual.
What causes it?
The causes of Scheuermannʼs kyphosis has not been discovered although there are several theories about its development. Scheuermann was a Danish radiologist who proposed that the problem started because cartilage of the spinal boneʼs ring was damaged by an interrrupted blood supply during growth.
He proposed that this interrrupted bone growth during development led to wedging of the affected vertebrae.
Most spinal research agrees that there is some sort of damage to the growth area of the vertebrae, this starts the process and it is this abnormal growth which causes wedging of the vertebrae which eventually leads to kyphosis. Some research also suggests that it can be due to problems with the mechanics of the spine (the way it is structured and works together).
Some research suggests that muscle abnormalities may be responsible too. It also seems to have a high genetic predisposition (it appears to occur within families). Some spine specialists believe that tightness of a spinal ligament (ligaments connect bone to bone) called the anterior longitudinal ligament (that runs along the front of the spine) may be responsible for increasing the spinal curve, as the thickened tight ligament puts strain on the front of the spine, leading to more growth on the back of the vertebrae and less in the front, resulting in one or more wedged vertebrae.
Generally develop around puberty between the ages of 10 to 15, with possible pain and fatigue in the mid or lower back.
How is it diagnosed?
A examination, followed by x-ray or scans will confirm it. To apply the diagnosis you must meet a number of criteria:
• thoracic spine >40 degrees (normal 25-40 degrees)
• thoracolumbar spine>30 degrees (normal 0 degrees) and
• at least 3 adjacent vertebrae demonstrating wedging of >5 degrees
What treatment will I have?
This is largely dependent on the degree of kyphosis:
<50 degrees: stretching and postural treatments
50-75 degrees: bracing
>75 degrees: surgery is only recommended if there is >75 degrees
• aims to calm pain and inflammation
• improve spinal mobility
• learn correct posture and body movements to counteract the effects of kyphosis • maximise your range of motion and strength
• to encourage aerobic fitness
• learn ways to self-manage your back
How can we help you at Physiotherapy Bangor?
We provide a wide range of physiotherapy and massage treatments targeted at the management of Scheuermann’s symptoms.
We hope to see you soon at Physiotherapy and Massage | Bangor Clinic!
Call 07779363613 or click here to request an appointment