The medical term ‘Kyphosis’ sometimes is confusing as it’s also used to describe a spinal curve. People with healthy spines also have a kyphotic curve. The thoracic spine (mid-back region) ought to curve outwards, or have a kyphotic curve. If there is too much kyphosis in the thoracic spine though, this abnormality is called hyperkyphosis, problematic kyphosis, or abnormal kyphosis.

At times abnormal kyphosis (from here on: just ‘kyphosis’) is referred to as just plain slouching, but it is actually way more. It may change the way the spine works, and it can be very painful too if it develops to what is commonly called a ‘hunchback’. The practice of yoga asanas (yoga postures) can help in the prevention and treatment of kyphosis.

Anatomy of Kyphosis

To better understand kyphosis, let’s do a quick run through spinal anatomy:

Cervical Spine: This is the neck, which begins at the base of the skull. It contains 7 vertebrae, which are commonly labeled as C1 to C7. C1 is adjacent to the skull, while C7 is closest to the chest. The cervical spine has a lordotic curve, which means that it should curve outward. Kyphosis rarely affects the cervical spine, but there is a possibility that it may.

Thoracic Spine: a human’s mid-back has 12 vertebrae labeled T1 to T12. Vertebrae in the thoracic spine connect to the ribs, making this part of the spine relatively inflexible and stable. The thoracic spine is supposed to have a kyphotic curve, curve inward. However, it can start to curve too much, either because of poor posture or because of structural defects

Lumbar Spine: The low back has 5 vertebrae called L1 to L5. Some people have 6 lumbar vertebrae. These vertebrae are the largest and strongest vertebrae, responsible for carrying a major part of the body’s weight. The lumbar vertebrae are also the last “true” vertebrae; down from this region, the vertebrae are fused. In fact, L5 may even be fused with part of the sacrum. The lumbar spine has a lordotic curve (outward curve). Kyphosis can affect the lumbar spine, especially in a region called the thoracolumbar region—the area where the thoracic and lumbar regions come together.

Sacrum/Coccyx: The sacrum has 5 vertebrae that usually fuse by adulthood to form the coccyx – commonly known as the tail bone. The sacrum and coccyx are also part of your pelvis, and they should have a kyphotic curve (inward).
From behind, the normal spine appears straight. The spinal curves described above are visible when you view the spine from the side. These inward and outward curves help our back carry our weight and are also important for flexibility.
Humans are born with a kyphotic spine, this is called the primary curve. As we grow, we develop secondary curves: as infants, we develop a lordotic curve in the cervical spine to hold our heads up, and as toddlers, we develop a lordotic curve in the lumbar spine to walk.

In between the vertebrae, there are intervertebral discs. They act like pads or shock absorbers for your movements, and they also are part of the protective spinal canal. Every disc is made up of a tire-like outer band called the annulus fibrosus and gel-like inner substance called the nucleus pulposus.

The back also has muscles, cartilage, ligaments, tendons, and blood vessels. Muscles are strands of tissues that act as the source of power for movement. Cartilage is a hard but slippery substance that makes it easier for joints to move. Ligaments are the strong, flexible bands of fibrous tissue that attach the bones to the intervertebral discs, and tendons connect muscles to bones and discs. Blood vessels provide nourishment. These parts all work together to help move about, and they also help stabilize the spine.

Symptoms of Kyphosis

Kyphosis can occur due to constant slouching which eventually can cause the spine to become more curved. It may also occur because of bone depletion, obesity, or weak back muscles.
If a person has kyphosis, the easiest-to-recognize symptom is a rounded back. The extreme curve in the upper spine will cause forward hunching.

In addition to having a rounded back, other symptoms may occur:

  • Mild to severe back pain, also with movement
  • Chronic neck tension, as the head migrates forward
  • Fatigue
  • Tenderness and stiffness in the spine
  • Forward posture of the head
  • Chest pain or difficulty breathing as the collapsing chest compresses the diaphragm at the base of the rib cage, and the tightness of the intercostals restricts the lungs’ ability to expand.
  • Difference in shoulder height
  • Tight hamstrings (muscles in the back of your thighs)
  • Significant limitation in overall mobility

Prevention and Reversion of Kyphosis

Yoga may not only help prevent slouching – and the depression, shallow breathing, tension, and headaches that often come along with it. Because yoga emphases proper posture, yoga can in fact reverse kyphosis as bones are constantly growing and changing.

While a well-rounded yoga practice will gradually reduce kyphosis, it is advisable to include some asanas in the practice that will accelerate the process. The most effective poses to include are supported backbends, which stretch shortened chest and abdominal muscles and the front spine ligaments. In all these poses, it’s important to focus the stretch on the thoracic spine, stabilizing the lumbar and cervical spine so they don’t hyperextend and hence overwork.
Upper back bending poses will help reverse the “hunchback” curve as well as stretch the muscles on the front of the torso which often have become chronically tight in this condition.
Spine lengthening poses promote good posture and proper alignment of the vertebrae. Weight bearing back bends will strengthen the back muscles to assist the holding of a corrected posture.

It also makes sense to integrate the awareness of kyphosis into the rest of one’s practice. When standing in Tadasana, feeling one’s legs extend down into the earth and the spine lengthen up into the sky. Lifting the breastbone opens space in the upper lobes of the lungs. Thus the erector spinae is engaged to feel vitality, not hardness, in the mid back muscles.

Over time, this practice of opening the heart will contribute not only to changing posture and possibly curing kyphosis but also foster the development of compassion. The physical practice of asanas can alter a person’s outlook unto the world and thus change the way we interact with other beings.