The human spine has four curvatures. A child is born with a completely straight spine, which in the process of development acquires such curves: two concavities, called lordosis of the neck, lower back, two protuberances - sacral kyphosis, thoracic.
Lordosis and kyphosis are physiological curves of the spine.
Life with a straight vertebral column would be impossible, the curvature plays the role of a spring, alleviating the load on the vertebrae, distributing them to all departments, preventing rapid wear of the disks. Physiological disorders normally have an angle in the range from 15 to 30 degrees.
The health of the person as a whole depends on the condition of the back, nerve conduction from the spine to all organs, their work.
The thoracic region affects the functioning of the organs in it: the heart, lungs. It is necessary to monitor your health. What is physiological kyphosis?
By this name they mean a normal curvature, but by this same word they also mean a pathological curvature of the spinal column, exceeding 45 degrees.
By the age of seven, the child forms a certain shape of the spinal column. Kyphosis is present in the thoracic, sacral region.
The condition of the muscles, the skeleton affects the shape of the back of the child. A good posture of the child will be when the elasticity of the column is able to resist the occurrence of pathology in its bends.
Posture is considered normal when the axis of the body vertical extends from the middle of the crown to the middle of the feet, through the hip joint line. In these cases, it is considered that the thoracic kyphosis is normal.
To maintain the correct position, it is necessary to regularly load all muscle groups with a sufficient load, to maintain good nutrition.
Both the muscles of the back and the chest must fully participate in the work of the whole organism, atrophy occurs without movement, which leads to the pathology of the normal kyphosis of the thoracic region.
Most often, the violation of posture occurs at school age. When children sit at the desk incorrectly, and adults are not watching it enough, pathological changes are intensifying. This happens most often in 11 - 16 years.
What is physiological thoracic kyphosis? This is a normal position, it is in every person.
Pathology develops slowly, over the years, unnoticed. An exception would be a congenital or post-traumatic change.
Symptoms of pathological distortions:
- Stoop in the sternum.
- Pain, stiffness, increasing with the beginning of the movement.
- The decline of force in the lower limbs, the change in their sensitivity.
- It is difficult to raise the shoulders, the head.
These symptoms indicate that normal chest flexure is enhanced.
Severe illness makes breathing difficult, chest pain appears.
The main task of the patient is to pay attention in time to the state of his back, to seek help from doctors, to start treatment as soon as possible in order to prevent the development of irreversible deformity.
When it is diagnosed that the physiological kyphosis of the thoracic region is strengthened, this means that the person has developed a pathological posture: a stooped back.
With slouching, the pelvic tilt is still slight, as is the lumbar lordosis. Round back occurs as a result of increased lordosis of the waist.
- Lack of load on the back, sternum. The weakness of the muscle corset leads to disastrous changes.
- Insufficient development of muscles, their elasticity. Stretching forward of the shoulder girdle occurs, physiological kyphosis increases.
- In case of imbalance in the development of the muscular corset, when the chest develops faster than the back, dragging the shoulders forward.
- Insufficient intake of vitamin D in the body of a child at an early age.
Curvature of the spinal column exists in cases where the patient suffered from such diseases: tuberculosis, ankylosing spondylitis, rheumatic, vertebral fractures.
The resulting pathology can affect the whole body or manifest locally in the upper or lower part of the sternum.
Problems arise in the case of straightening physiological curvature, which creates a flat back. In turn, this leads to scoliosis.
The axis of the body passes through the spinal column, the chest becomes flat, the shoulder blades bulge, the stomach retracts. All this suggests that the physiological kyphosis straightened.
Correct posture implies a uniform manifestation of physiological bends when they have the right balance. Violations are functional and structural.
In the first case, there are changes in the muscles, but the skeleton bones are not affected. In the second case, the changes occurred in the bones, joints, and their treatment requires a long period of time.
When the kyphosis is preserved, this means a good interaction of the shoulders and lower back, their good tonus, mobile interaction of the vertebrae.
Violation of posture can be determined by the form:
- The round shape is an increase in the curvature of the sternum with simultaneous straightening of the waist.
- The shape is round with concavity. Occurs due to the increase in four bends.
- Flat. Four spinal curvatures less than normal.
- The form is flat with concavity. The curvature of the sternum is reduced, lumbar lordosis is increased.
In the absence of the above forms of the back in humans, it can be said that the normal kyphosis of the thoracic region is preserved.
Initially, nature gives people a healthy back. Wrong way of life, too lazy to exercise often lead her in a deplorable state.
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Why does nature have kyphosis
Physiological thoracic kyphosis
Considering what a physiological thoracic kyphosis is, you should definitely understand why it is provided and what benefits it provides to the body.
Such bends are needed for depreciation, they relieve the vertebrae and reduce the pressure exerted by them on the intervertebral discs. Thanks to its S-shape, the spinal column acts as a spring. If it were perfectly smooth, it would be difficult for the disks to bear each other’s weight, and besides, the possibility of a safe exit from the spinal cord of nerve endings would be excluded. It is through the intervertebral discs that the nerve fibers pass and transmit signals in the body to all vital organs, regulating their work.
Also conceived by nature, the irregularity of the spinal column helps in maintaining balance.
Kyphotic changes, characteristics and species
Physiological is understood to mean kyphosis, which is represented by a C-shaped bulge back of 15 degrees and no more than 30. This condition is slightly noticeable in a standing position and is completely smoothed out during tilting forward.
Under the influence of some factors, there is often a condition in which the physiological kyphosis is enhanced, i.e. has an angle of 30-31 degrees and above. In this case, the doctors say about the beginning of the development of pathological kyphosis, its arc remains clearly visible when tilting forward. If natural curves are a very important feature for an organism, pathological curvatures become a real problem: they spoil the appearance (the neglected stages are characterized by the formation of a hump on the back) and worsen the work of many organs (heart, respiratory system). In addition, they are accompanied by pain in the pathological area, limited movement, cause fatigue even after slight physical exertion. With excessive bending of the vertebra in the lumbar or sacral area, numbness and weakness are observed in the lower extremities.
Who is at risk and what is the prognosis
Under physiological kyphosis refers to the natural curvature of the spine behind. In this case, the maximum angle of curvature is 30 degrees. If this value is greater, then the kyphosis is enhanced and experts diagnose the pathological kyphosis. The disease is associated with a large number of clinical symptoms and threatens the patient with disability. A strong tilt leads to the destruction of intervertebral cartilage and a decrease in the volume of the chest.
There is another type of this disease. When it is strengthened lumbar lordosis, and the back is flat-concave. This pathology leads to an inclination of the pelvis more than 60 degrees. External signs are a flat chest and a belly sticking forward. This type of pathology often develops in children with poor health, who have to spend most of their time in bed.
Why does curvature appear in the thoracic spine? There are many factors that trigger this disease:
- Weak muscles and poor elasticity of the spine.
- Bad food.
- Lack of load on the muscular corset of the back and chest.
- Incorrect body position while sitting, walking.
Physiological kyphosis at the level of the thoracic region is present in every person and this is considered normal, but over time it can be strengthened. Symptoms of pathology progression:
- sensitivity changes in the lower limbs, weakness appears,
- there is stiffness and pain when making movements,
- it becomes difficult for the patient to lift the head and shoulders.
If the listed symptoms are observed, then you need to contact a specialist to undergo a diagnosis and a correct diagnosis. When the curvature becomes severe, severe chest pain occurs and it becomes difficult to breathe. It is important to start treatment in time to prevent irreversible deformity.
The physiological kyphosis is strengthened - such a diagnosis is made in the case when the patient has a slouch.
Causes of pathology:
- imbalance in the development of the muscular system in the chest and back,
- lack of muscle development and poor elasticity,
- the child’s body is deficient in vitamin D.
Spinal cord arching may appear as a result of a vertebral fracture, tuberculosis, or previous ankylosing spondylitis.
Deformation can cause damage locally in the affected area or affect the entire body.
Diagnosis of the disease
Testing can be done independently at home. To do this, you need to press your back to a flat vertical surface and try to reach it with the back of your head. This can be done near a wall or cabinet. If there is a kyphosis, it is difficult for a person to pull his head to the support.
In addition to this check, the curvature of the thoracic spine can be identified by the following method: stand up straight and bend forward so that an angle of 90 degrees is formed between the body and the legs. Standing in this position, you need to try to touch the floor with your hands. This test allows you to identify kyphosis of three varieties:
- In the middle part of the back there is a strong curvature of the column. This indicates the arcuate development of pathology.
- The body is smooth, starting from the base of the neck and ending with the middle part. There are no bulges. This is a normal physiological kyphosis, which every person has.
- Diagnosed strong curvature in the region of the cervical spine. This is an angular deformation, the hump begins to form.
These types of tests are part of a physical examination. In addition to examining the spine, the doctor checks the neurological function. This is important for detecting changes in sensitivity. Further, a study of respiratory function can be conducted. Against the background of the curvature often develop problems with respiration. To confirm the diagnosis, the doctor refers the patient to a laboratory and instrumental examination.
Based on the data, the doctor develops a scheme of therapeutic interventions.
Methods of treatment of physiological kyphosis
To reduce pain and prevent further progression of this disease, two types of therapy are used: operational and conservative.
The first method is used in extreme cases when the deformation affects the state of the internal organs and threatens the patient with a disability. During surgical intervention, the defect is first eliminated at the level of the thoracic spine, and then the pole is stabilized with connecting rods and screws. Parts for such operations are made of heavy-duty materials, such as titanium. These metals are recognized as safe and do not cause a response in the body.
Operational intervention solves the following tasks:
- protects nerve structures from damage,
- eliminates existing kyphosis,
- splices pathological areas,
- frees the spinal cord and nerve roots from compression
- stabilizes the curvature process.
In other cases, the patient is shown conservative therapy with the use of physical therapy, medical treatment and massage.
Drugs are prescribed for intensive pain syndrome in the thoracic region. Initially, weak-acting pharmaceuticals are used. If the pain is strong and does not recede, then non-steroidal anti-inflammatory injections and tablets are treated. They eliminate inflammation in the damaged area and improve the quality of life.
Manual therapy is prescribed to improve posture, restore muscle carcass tone and eliminate pain syndrome. Medical manipulations are carried out with a break of 1-3 days. Regular massages can not be done, because the ligaments and muscles of the spine requires time to strengthen in the new position. Patients often experience discomfort at the site of exposure. This is a normal reaction of the body, indicating the beginning of work of the massaged muscle group.
An important part of the restoration of the thoracic region of the back, in which the kyphosis has developed, is the carrying out of physiotherapy exercises.
For classes you will need a horizontal bar and a stick for gymnastics.
Warm up: take your hands back and place a stick between your elbows, which fits snugly to your back. Shoulders stretch back until the entire surface of the spine is level. Stay in a fixed position for 5-10 minutes.
№1. Shoulders align and bend forward so that the torso is parallel to the floor. 10-30 times.
№2. Hold on with one hand, which has the shoulder lowered below, behind the horizontal bar and hang quietly until the pain appears.
№3. Lean in the direction of the shoulder, located above. The body is straight, buttocks and press tense. Work slowly. 10-40 slopes. The stick comes to the middle of the leg.
For the prevention of disease progression, it is recommended to wear a corset, in which the spine is kept in the correct position.
If the kyphosis of the thoracic is strengthened, the wearing time can be increased up to 20 hours a day.
Causes and differences of enhanced and smoothed thoracic kyphosis
Kyphosis of the thoracic spine - posterior physiological curvature of the spinal column with a curvature angle (assessed by lateral radiographs) of no more than 30 degrees. When the bend is strengthened (angle of more than 30 degrees), pathological kyphosis (hyperkyphosis) is formed. It is accompanied by multiple clinical symptoms and can lead to disability.
Causes and types of pathological deviations
Pathological kyphosis can be congenital and acquired.
Congenital form occurs due to abnormal vertebral structure (defects of the arches, spinous processes, impaired body formation).
Acquired form is more common congenital. It is formed by the following reasons:
- Infectious - tuberculous and bacterial lesion of the vertebral bodies,
- Vascular - lack of blood supply in the spinal column and the muscular frame of the back,
- Compression - excessive exercise leads to damage to the intervertebral discs and the displacement of the axis of the spine,
- Mobile - weakness of the back muscles leads to the fact that a person slouches, the spinal column "warps",
- Rachitic - lack of vitamin D leads to the "weakness" of the bone structure. Under the influence of physical exertion, vertebrae with a weak skeleton quickly deform,
- Senile - develops on the background of age-related changes in the muscular frame of the back and intervertebral discs,
- Total - in this form, there is a kyphotic arc throughout all parts of the spine.
Depending on the appearance of the pathology is divided into:
When the angular form of the external concavity has an acute angle in the region of the apex of curvature. With an arc-shaped analogue, the curvature has a gentle appearance.
The classification of kyphosis by severity:
- Grade I - light (with a concavity angle greater than 30 degrees),
- II degree - moderate kyphosis of the thoracic spine (angle of 30-60 degrees),
- Grade III - heavy (characterized by the angle of curvature of more than 60 degrees).
It is necessary to treat this pathology depending on the degree of its manifestation and the reason that led to the development. If the physiological kyphosis is smoothed and there is a violation of posture, strengthening of the muscular frame of the upper back is required. When there is an increase, on the contrary, it is necessary to increase the muscle tone of the chest.
With the first degree of pathology, effective treatment can be carried out without wearing a corrective corset. At this stage, the correction of the axis of the spine is carried out using:
- Physical therapy,
- Appointment of symptomatic agents
- Massage and osteopathy.
Daily gymnastics allows you to strengthen the muscular corset of the back, which will support the spine axis in the correct position.
If drug therapy does not bring the desired effect, doctors resort to surgical treatment.
Indications for surgical treatment of thoracic kyphosis:
- Low efficiency of conservative methods,
- Severe pain, which is not eliminated by painkillers,
- Progressive spinal deformity,
- Ulcerative defects in the chest,
- 3 degree of reinforcement convexity.
The operation takes place in 2 stages. In the first step, it is necessary to eliminate the deformity by restoring the normal position of the vertebrae. The second step is to stabilize the position of the spinal column with a metal pin, rods and screws (transpedicular systems).
Complex corrective exercises
To strengthen the muscles of the chest back every day it is recommended to perform the following list of exercises:
- Touch shoulders with brushes, lying on your stomach. When inhaling, try to throw your head back. At the same time lift the chest up. In the process of doing the exercise, try to climb high. At the exit, return to the recumbent position,
- To perform the second exercise you need a gymnastic stick. Put it on the shoulder blades, lying on your stomach and hold with your hands on both sides. Raise your head and flex your spine. Fix the position for 6-8 seconds, and then go down. The number of repetitions - 8-10
- Get on all fours and bend the chest down, elbow joints to the side. In this position, try to walk 50 steps,
- Take a gymnastic stick and spread your legs shoulder-width apart. Put the stick behind your back so that it touches the shoulder blades. Sit on the exhale and stand on the inhale
- Position your legs shoulder-width apart while standing. Put the stick behind your back and press it to the shoulder blades. When inhaling, lift it up and tilt back your head. On the exhale, return to the starting position.
If you daily perform the above set of exercises, you can prevent further curvature of the axis of the spine.
Thus, the kyphosis of the chest in the initial stages is not accompanied by severe clinical symptoms due to the low mobility of the chest. The second and third degree of curvature leads to serious complications, so the treatment of the pathology should be carried out as early as possible.
What is kyphosis of the thoracic spine: how it is treated
The spine of a person in connection with erect posture has physiological curves, which help to distribute the load. The forward bend is called lordosis, and the backward bend is called kyphosis. As a result, when viewed from the side, the spine is S-shaped. Marked lordosis in the cervical and lumbar and kyphosis in the thoracic and sacral segments.
It happens that these bends become more pronounced or smoothed. One of these conditions is enhanced (pathological) kyphosis in the thoracic spine.
Why does kyphosis appear
Kyphosis of the thoracic region may be due to genetically, in this case, a family history of this pathology is revealed. Occurs congenital curvature due to developmental abnormalities with fusion of the vertebrae, changing their shape and position.
Acquired form of kyphosis is more common and can be caused by various reasons:
rickets in early childhood, leading to changes in bones and muscles,
weakness of the muscular system of the back at a young age, leading to the development of postural kyphosis (stoop),
degenerative-dystrophic changes of intervertebral discs,
bone tuberculosis with the destruction of the vertebral bodies,
compression pathological fracture of altered vertebrae,
with joint pathology between processes (ankylosing spondylitis, ankylosing spondylitis),
effects of spinal or chest surgery,
age-related changes of the musculoskeletal system,
partial paralysis of paravertebral muscles in case of neurological diseases (poliomyelitis, cerebral palsy, muscular dystrophy, etc.).
Primary may be the change in the shape of the vertebral bodies, when they are destroyed or become wedge-shaped. The resulting uneven load on the intervertebral discs and ligaments leads to their degeneration and deformation. If at first there are changes in the discs and joints, then gradually developing dystrophic disorders in the vertebrae reinforce this process. So, both bone and cartilaginous structures always take part in the onset of kyphosis of the thoracic region.
Kyphosis of the thoracic spine may have varying degrees of severity. At establishment of the diagnosis estimate the bend angle (KU or a kyphosis angle). To calculate it, it is necessary to draw 2 tangent lines - one around the II-III and XII thoracic vertebrae. Normally, KU is 15-30º, and the tip of the physiological kyphosis should be located approximately at the level of the V thoracic vertebra. With pathological curvature, this angle increases.
The severity of thoracic kyphosis:
I degree, light, KU 31-40º,
II degree, average, KU 41-50º,
III degree, expressed, KU 51-70º,
IV degree, strongly pronounced, KU more than 70º.
By type of deformation distinguish arcuate and angular.
By the presence of compensatory bends in the adjacent parts of the spine, there are compensated and uncompensated kyphosis. If only the thoracic section is involved, and the shoulders and the pelvis are in the same vertical plane - they are talking about a compensated form. With more severe lesions, the shoulders are retracted, and the pelvis is moved forward with over-bending of the hip joints and an increase in lumbar lordosis.
By localization kyphosis can be thoracic (the VI-X thoracic vertebrae are involved) and the lumbar-thoracic (affected X-XII thoracic and I-II lumbar vertebrae).
The classification by etiology includes the following pathological forms:
Features kyphosis of the thoracic
Meanwhile, spinal curvature is not always normal. In particular, in medicine, kyphosis is divided into:
In the first case, this is a normal curvature, not exceeding, according to one of the methods, 30 degrees. It is easy to determine which kyphosis is physiological or pathological, if you turn to a specialist.
However, there is a way to pre-check for the possible existence of a problem at home using simple tests. For example, stand in front of the mirror sideways, lean forward and look at your display. Pathology from this perspective will be quite noticeable.
There is another test - you need to stand with your back to the wall, leaning against her shoulders. Then you should touch her head - if it works without problems, then everything is fine. Accordingly, if you experience difficulties with this exercise, you can almost accurately state the presence of pathological kyphosis. However, for an accurate diagnosis is best, of course, consult a specialist. It should be emphasized that this should be monitored very carefully. Under the influence of a number of factors, the physiological kyphosis can develop into a pathological one, and the problem will gradually only get worse.
If there are painful sensations with location in the thoracic spine, which have a tendency to spread to the entire back, or with a noticeable change in posture, then a specialist should be required. These signs suggest that kyphosis from the physiological to the pathological.
In other words, instead of the normal, natural state, we are talking about a disease. That is why it is important to consult a specialist as soon as possible. Probably everyone knows that any disease is most easily treated at its initial stage. There is no exception and kyphosis. If you manage to catch the problem at the initial stage, not allowing the disease to develop, there is every chance to get by with a little blood. Normal posture in this situation can be corrected with a set of simple exercises.
I would like to note another important point. The best option for getting rid of health problems is not their treatment, but prevention. Agree, it is much easier to look after yourself and your own health than to go to the hospital for various kinds of procedures.
All the above applies, in particular, to kyphosis. It is best to prevent the situation when it turns from physiological to pathological. Speaking about the prevention of kyphosis, first of all it is necessary to emphasize the need for regular physical exertion. Otherwise, the muscles may weaken, and problems will gradually begin to appear. In this case, the load should not be excessive, because in such a situation, you only provoke the development of pathology. The correct position during the holidays is also very important. The surface on which you sleep should be fairly solid.
Watch your weight too. Here, at the forefront should be put proper nutrition, rejection of excessive absorption of food harmful to our body. In addition, do not allow yourself to slouch, hunch. After all, the spine may eventually get used to this position, and the result will be kyphosis of more serious stages. For proper posture must be monitored constantly.
By the way, this also applies to parents. They should certainly pay attention to the posture of their child, especially during the period when the spinal column is being formed - this usually happens by the age of 7 years. If you feel any discomfort while trying to straighten your shoulders, or if complaints of this kind are heard from a child, then there are all reasons to go through the appropriate testing.
Once again I want to emphasize that even the initial stages of pathological kyphosis of the thoracic spine is a serious problem, which has all the makings of a further progression and acquisition of the chronic form. In addition, very unpleasant complications can occur, such as an increase in pressure on other parts of the spine and a negative effect on organs located not only in the chest, but also in the abdominal cavity.
There are a number of risk factors for the development of physiological kyphosis in the pathological. These include, in particular, diseases of the spine that have arisen, including those outside of the thoracic region, hard physical labor, as well as sports activities associated with excessive exercise. Contribute to the further development of kyphosis and obesity, transferred in childhood rickets, which has arisen in the body, and nutritional deficiencies. Another risk factor is a sedentary lifestyle, due to which the muscular corset of the back and ligament apparatus are weakened. A metabolic disorder can also provoke a worsening of the problem.
If you bring the situation to the transition of kyphosis from physiological to pathological, then this problem will have to be fought with more serious methods than prevention. In particular, conservative or operative therapy is currently used to prevent further progression of curvature. Medications can be prescribed if the patient has pain in the chest area. At the same time, the weakest analgesics are always used first. If they do not help, the doctor may decide to change the dosage or change the drug. There are situations when the pain is only getting worse. Here anti-inflammatory drugs can be prescribed both in pills and injections.
To restore the muscle tone of the skeleton, and to correct the posture, the patient is prescribed manual therapy. As a rule, they are held with a break, which, depending on the situation, can be from 1 to 3 days. Therapeutic gymnastics is another very important point, which is an integral part of therapy. If we talk about surgical intervention, it is used only in the most extreme cases, when using other methods to eliminate the progression of the disease is impossible. Here, the surgeon is faced with the task of stabilizing the spinal curvature process that has begun, eliminating excessive kyphosis and protecting nerve structures from damage. Such a treatment option can be chosen for a number of reasons, including due to unforeseen circumstances, such as injuries received.
In any case, the treatment option is chosen by the doctor after the examination of the patient who applied to him. Here it is important not only to establish the fact of the transition of kyphosis from physiological to pathological. It is also necessary to understand the reason why this process began. Naturally, the main effort in therapy will be aimed at its elimination. In parallel with this, attempts will be made to return the correct posture to the patient, as well as to relieve him of all unpleasant symptoms. To make sure that the diagnosis is correct, the doctor also sends the person who applied to him for a laboratory and instrumental examination, and also checks the neurological functions. The latter is needed in order to identify possible changes in sensitivity that have arisen in a patient due to progressive kyphosis.
Denial of responsibility
The information in the articles is intended solely for general information and should not be used for self-diagnosis of health problems or for medical purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know exactly the cause of your health problem.
Types of kyphotization of the spinal column
Based on the cause of the occurrence of the following types of curvature:
- congenital - arises due to the violation of the structure of the vertebral bodies,
- genotypic - an identical form is passed from generation to generation,
- compression due to traumas of the vertebral bodies causing a decrease in their height,
- mobile (postural) - bending of the spinal column occurs due to the weakness of the spinal muscles. This type of pathology can also provoke the presence of incorrect posture. It is more common in adolescence, in the period of rapid development of bone tissue and the whole organism. Eliminated by methods of conservative treatment,
- Scheuermann-Mau disease - the etiology of onset is not clear. Developed in adolescents 14-16 years. It is hereditary,
- rachitic - kyphotic spinal deformity in children suffering from rickets, aged six months,
- senile (senile) - kyphotization of the thoracic region in elderly people, resulting from age-related destructive processes in vertebral cartilage and vertebrae, as well as lowering the tone of the dorsal muscles,
- total - arcuate bend throughout the spinal column is observed in infants,
- tubercular - due to the destruction of the vertebral bodies in tuberculous spondylitis,
- paralytic - caused by paralysis of the back muscles as a result of diseases of the nervous system.
Stages of thoracic kyphosis
The magnitude of the bending angle and the severity of the disease distinguish 3 degrees of spinal kyphosis:
- I degree of the disease is characterized by an angle of concavity from 300 to 400, externally manifested in the form of a small stoop. It is considered the initial stage of the disease mild. In the case of a diagnosis at an early stage of development, kyphosis of the thoracic spine, grade 1, is effectively treated by methods of conservative medicine. After eliminating the signs of pathology, it is important to continue to maintain in tonus the muscular frame of the back.
- The II degree of the disease is considered moderate kyphosis of the thoracic, in which the bend angle varies from 400 to 600. The stoop is more pronounced (Earlier we wrote how to correct the stoop and advised to add the article to the bookmarks). For the treatment of pathology at this stage, a set of exercises to strengthen the muscles is recommended, as well as physiotherapeutic procedures, vitamin intake, the use of corrective corsets (We have previously written about the corset for the thoracic spine and recommended adding the site to bookmarks).
- Grade III with a bending angle of more than 600 is characterized by serious disturbances in the structure of the spinal column and is fraught with grave consequences for the body. Visually marked strong curvature of the spine, accompanied by a weakening of the abdominal muscles and hypertonicity of the back muscles. Because of the compression of the roots of the spinal cord, the activity of the internal organs innervated by them is disturbed. This is a rather complicated thoracic kyphosis, the treatment of which may require surgical intervention.
Important: Depending on the degree of kyphosis of the thoracic spine, an appropriate complex of therapeutic measures is prescribed. If no measures are taken to correct the spinal column and prevent the occurrence of complications, the disease will progress and cause irreparable harm to the human body.
General information about breast kyphosis
A healthy human spine has 4 physiological bends. Curvature, facing the convex side of the anterior, are called lordosis (cervical, lumbar), and curvature toward the back are called kyphosis (thoracic, sacral).
The physiological arches of the spinal column may increase due to various factors. There are cervical, thoracic, lumbar strengthening of kyphosis. The maximum number of cases of kyphotic deformity occurs in the thoracic region. This is due to the significant bending of the spinal column.
The physiological curvature of the spine in the thoracic region acts as a cushioning of the spinal column during mechanical action on the vertebrae and discs, preventing compression of the nerve roots. Violation of physiological bending is abnormal thoracic kyphosis, expressed in increasing the angle of concavity of the thoracic spine.
Important: Thoracic kyphosis is easier to cure in the early stages of the disease, so patients should know what causes kyphosis of the chest, what it is and how to prevent it.
In the presence of congenital pathology, spinal kyphotization occurs even in infants. More often the disease is diagnosed in children and adolescents due to a violation of posture. It can also be provoked by the development of an abnormal lifestyle, a lack of physical activity, and a weak muscular system.
Signs of Kyphosis
Increased thoracic kyphosis, depending on the severity of the disease, is manifested by a number of characteristic symptoms. Pathological curvature in the early stages can be identified by the following external features:
- round back (hunched). With a significant curvature, a hump appears,
- shoulders shifted forward
- there is a narrowing of the chest cavity,
- the shoulder blades protrude from behind
- due to the weakening of the abdominal muscles, the abdomen bulges out.
Depending on the features of the manifestation of external signs, the pathology can be angular or arc-shaped. In the case of angular kyphotization, concavity with an acute angle is observed in the zone of the deformation tip. The arcuate shape outwardly looks like a uniform sloping curvature of the spinal column.
The progression of kyphosis causes wedge-shaped deformation of the vertebrae of the thoracic region, atrophy of cartilage. There are destructive changes in the structure of the chest, reducing the mobility of the ribs and the functionality of the intercostal muscles. The result is a violation of the process of respiration.
Why abnormalities occur
Increased physiological kyphosis can be caused by different reasons, and the changes may be congenital or acquired.
In the first case, they can be triggered by failures during fetal development, as well as those associated with heredity (in a child, one of whose parents is prone to such a disease, the risk of suffering a pathology is much higher).
In the second case, the cause of the increase in the bending angle of the spinal column (pathological kyphosis) is:
- injuries suffered
- some diseases (rickets, tuberculosis, cerebral palsy, poliomyelitis, osteochondrosis),
- poor posture (especially with prolonged static loads),
- muscle hypotonia,
- metabolic disorders and obesity.
Clinical symptoms of kyphosis
After evaluating X-ray images, it is good if the doctor's opinion says that the chest kyphosis is preserved. What does it mean? This conclusion suggests that you have a normal physiological bend, it is desirable and further supports it in this state.
Kyphotic changes are manifested by 3 sets of symptoms:
- compression myelopathy,
- vertebrates (vertebral),
Due to the fact that the thoracic spine has the lowest mobility, myelopathy is observed in it quite rarely. The ribs are firmly articulated with the vertebrae, the frequency of compression of the nerve roots in this area is small. In addition, the inner surface of the vertebrae is protected by the chest cavity, which makes them even more resistant to damage.
Important: 2 degree of kyphosis of the chest is characterized by local pain syndrome, localized along the line of the spinal column. Very rarely, with compression myelopathy, there is a feeling of numbness in the hands and a decrease in tactile sensitivity.
With severe pinching pain can give to the intercostal space, peritoneum and groin.
When kyphosis occurs with compression myelopathy, caused by the excitation of structures of the sympathetic nervous system, there is a feeling of arching pain. Disturbances in the functioning of the internal organs of the pelvis, paresis of the arms and legs with a disorder of deep and superficial sensitivity are observed.
Sometimes the vertebral signs of kyphosis occur due to pathological processes in the radiculo-medullary arteries feeding the spinal cord. Thrombosis of these vessels in combination with kyphotic deformity causes muscle spasm in the lower back.
Myofascial pain syndrome occurs due to impulses from receptors, due to structural changes in the vertebral joints.
How to suspect the deviation and the types of its diagnosis
It is possible to suspect the increase in physiological kyphosis on your own, after passing a small test at home: you need to stand with your back to the wall, leaning tightly against it, straighten your shoulders, press shoulders and touch the surface with the back of your head. If you have even the slightest difficulty, you should consult your doctor for an accurate diagnosis of pathology.
- computed tomography
- magnetic resonance tomography (if necessary).
All of these procedures will help you choose the most effective treatment, which with small changes is carried out much easier and faster.
Features of physical therapy in kyphosis
Kyphosis of the thoracic spine, exercises in which are aimed at strengthening the muscles and normalization of posture, identified at an early stage is completely correctable.
The video shows exercises for kyphosis of the thoracic spine
Basic exercises in thoracic kyphosis:
- Lying on the stomach, arching the body with a gymnastic stick pressed to the shoulder blades in the bent arms. When performing, spinal kyphosis is corrected.
- Standing on all fours with the chest bent downwards, head lifted and arms bent at the elbows, crawling for at least 50 steps.
- Take the dumbbells in the arms to the sides or down and unbend the body while lying on the stomach.
To maintain the positive effect of physical education classes must be performed correctly and be permanent.
The presence of enhanced kyphosis of the thoracic with the help of special techniques is determined by the orthopedic surgeon. To confirm the diagnosis, side radiography is performed. To identify the causes and decide how to treat kyphosis of the thoracic spine, they also perform an MRI or CT scan.
Kyphosis is physiological and pathological. Not all patients understand what this means and how to decipher these concepts. Physiological kyphosis of the thoracic spine is a bend, the angle of which does not exceed 45 °. This is a normal form that allows a person to withstand daily loads. Pathological kyphosis is diagnosed if the angle of deformity exceeds 45 °.
The disease most often develops from birth. It manifests stooping in the early stages or a hump in the later. Kyphotic deformity is located in the upper back, in the area of the shoulder blades.
Types of thoracic kyphosis
Depending on the origin, the following types of thoracic kyphosis are distinguished:
- Functional. It develops due to improper posture, prolonged sitting in a hunched way, etc.
- Dorsal. It occurs during puberty, more often in male adolescents. Manifested by a change in the shape of the vertebrae, in which they become triangular. The angle of curvature can reach 70 - 80 °.
- Congenital. Develops in the period of fetal development in the womb. Infringement of spinal cord formation in the unborn child is possible after infections that the mother has suffered.
- Paralytic. It is caused by paralysis of the spinal muscles in diseases of the nervous system in a child, for example, poliomyelitis, cerebral palsy.
- Post-traumatic. Occurs after spinal injury as a result of mechanical injury.
- Degenerative. Curvature provoke diseases that are characterized by degenerative-dystrophic changes in bone structures (osteochondrosis, osteoporosis).
- Senile. It occurs as a result of aging and destruction of the vertebra and surrounding muscles.
- Genotypic. May occur in children if close relatives suffer from thoracic kyphosis.
- Rachitic. Kyphotic curvature appears in young patients after suffering rickets.
- Total. Peculiar to babies up to 12 months, is manifested by a uniform bending of the whole arc of the spinal column.
Reference. Often, with total kyphosis, the spine is bent in the lateral plane; this is a manifestation of kyphoscoliotic posture. Then the spinal nerves are restricted by displaced vertebrae.
Depending on the angle of inclination, a strengthened or smoothed kyphosis is isolated. If doctors say that thoracic kyphosis is enhanced, then this means that an increase in the angle of curvature is observed. In that case, if the thoracic kyphosis is smoothed, then the angle of inclination is minimal. If the curvature is increased, then it is easy to identify during visual inspection. Pathology of this form leads to functional disorders of the respiratory organs, cardiovascular system, neurological problems, diseases of the musculoskeletal system.
Smoothed kyphosis cannot be detected during visual inspection. This form of the disease is accompanied by comorbidities, for example, scoliosis, intervertebral hernia, lumbar segment lordosis (the bend of the lumbar region is strongly forward).
Depending on the severity of the thoracic deformity, there are 4 degrees of kyphosis:
- 1 degree - the angle of curvature 31 - 40 °.
- 2 degree - the angle is 41 - 50 °.
- 3 degree - the angle exceeds 60 °.
- 4 degree - an angle of more than 70 °.
The easiest way to treat 1 degree of pathology. Grade 2 disease can be cured by conservative methods, in some cases, surgery is needed. Kyphosis grade 3–4 is treated with surgical methods, but surgery does not always help to restore the natural bend.
More information about the features of the course and treatment of kyphosis of different degrees can be found in this article.
Externally, kyphosis is manifested by such signs:
- At first a slight slouching appears, over time, if untreated, a hump forms or the back of the thoracic region becomes arcuate.
- Shoulders protrude slightly forward, leaning down.
- The blades are retracted.
- The chest is narrowing.
- The abdomen bulges slightly, the back muscles and abdominal muscles are weakened.
Patients complain of a aching character in the upper back, limiting the mobility of the spine. These symptoms indicate excessive muscle tension around the affected area, compression of the internal organs and the gradual destruction of the intervertebral discs. The pain may radiate from the back to the neck, lower back.
When the spinal nerves are compressed, a sharp pain appears, the sensitivity of those areas for which the affected nerves are responsible is disturbed. In advanced cases, a compensatory response is observed, which is manifested by increased lordosis at the site of the cervical and lumbar segments. Then the curvature becomes more pronounced, and the patient gets tired even faster with minimal physical activity.
When the kyphosis is narrowed chest, lung volume decreases. Then there is shortness of breath, frequent colds, which are complicated by inflammation of the bronchi, lungs. The displaced spine disrupts the heart, then the heartbeat quickens, blood pressure rises. Due to the pathology, functional disorders of the digestive tract organs appear, which is manifested by decreased appetite, belching, disorders of the stool, etc.
Therapies for Bending Strengthening
If a slight excess of the angle of natural kyphosis is found, the doctor will select the appropriate course of conservative therapy. At the initial stage, this is massage and physical therapy (and it is recommended to attend physical therapy classes in groups and do special exercises at home).
Individually, depending on the degree of bending amplification, can be included in the treatment program: wearing an orthopedic corset, manual therapy, physiotherapy.
What preventive effects are provided
If the physiological kyphosis is preserved and not strengthened, this does not exclude the need for prophylaxis, especially if the patient is at risk because of a professional activity (for example, accountants) or with a possible hereditary tendency to pathological changes.
Prevention of physiological kyphosis abnormalities
To maintain normal physiological kyphosis of the thoracic spine, it is necessary to carefully monitor the correct posture and perform special exercises. There is the easiest and most effective way to work out the correct formulation, for this: put a book on your head and move around the room for about 10 minutes, trying to keep so that it does not fall. It is recommended to include exercises with a gymnastic stick (bends, turns and squats, holding the stick behind your back) in the complex of daily gymnastics or warm-up exercises (for example, during long work at the computer).
The preservation of the physiological kyphosis in normal bends and the improvement of general health are facilitated by swimming and fitness. The only thing that should be considered: with a tendency to pathological deviation is not recommended for such sports as boxing.