Scheuermann’s kyphosis is a spinal condition that causes your back to take on a rounded shape as you grow. It results in a hunched look and is one of the most severe forms of kyphosis — a group of conditions that all result in a similar spinal shape.
It’s also known as Scheuermann’s disease, juvenile kyphosis, and juvenile discogenic disease. It’s present in one to eight percent of the U.S. population.
There are two main types of Scheuermann's disease. Type one only involves the middle portion of your spine — the portion between your neck and upper back. This is the most common version of the condition.
Type two involves both the middle and lower portions of your spine — respectively called the thoracic and lumbar regions.
What Causes Scheuermann’s Kyphosis
Scheuermann’s kyphosis tends to run in families — which means that part of the cause is genetic. It’s twice as common in biological males compared to females, but no one is sure why.
More research is needed in order to figure out which genetic variants are associated with this condition and how they’re transmitted from one generation to the next.
The hunched shape is caused by irregular growth patterns in the small bones that make up your spine — i.e., your vertebrae. Vertebrae are normally rectangular in shape. This allows them to stack on top of one another in a relatively straight line with gentle curves.
If, however, you have Scheuermann’s kyphosis, the inner — or front-facing — sides of your vertebrae grow slower than the back edges. This uneven elongation causes the backs of your vertebrae to curve up and out while the smaller inner edges curl in.
The process is metaphorically equivalent to stacking flat bricks compared to stacking slanted bricks with all of the slanted surfaces facing the same direction — inward.
It’s unclear how much these growth irregularities are caused by genetics as opposed to other factors — like your environment.
Scheuermann’s Kyphosis Diagnosis
Most people are diagnosed with Scheuermann’s kyphosis between the ages of 12 and 17 years old. Parents commonly bring their children in for testing when they start to notice the postural changes or back pain associated with the condition.
Your doctor will physically examine your spine — or your child’s spine — when you’re standing, bent over, and lying down. This is because the curvature is easier to see in particular positions — like when you’re bent at the waist.
X-rays will help quantify the degree of curvature in your spine. The more severe the curvature, the more likely it is that you’ll need surgery.
Scheuermann’s Kyphosis Symptoms
There are only two main symptoms associated with Scheuermann’s kyphosis.
The first is the change to your posture that’s caused by your spinal deformation. This is more of a cosmetic problem than a physical limitation. People with this condition are fully capable of engaging in most physical activities.
However, this symptom can have psychological ramifications. This is particularly relevant because the growth abnormalities become apparent during puberty — when people are already sensitive about their appearance.
The second symptom is back pain, though it’s only present in about half of all people with Scheuermann’s disease. In many cases, you’ll feel the worst pain in the middle portion of your back — where the deformities are the most pronounced. It tends to get worse with activity and feels better when you rest.
Scheuermann’s Kyphosis Treatment
The best treatment for Scheuermann’s kyphosis depends on the extent of the curvature in your spine. In general, you can take non-steroidal anti-inflammatory drugs (NSAIDs) — like ibuprofen — to help with the pain.
Otherwise, there are four common treatment techniques for this condition. These include:
- Regular observation. If your condition is mild, with minimal curvature or pain, then your treatment will require little medical intervention. You’ll have regular doctor's appointments while you continue to grow to make sure that your condition doesn’t deteriorate. The spinal changes should stop when you stop growing. Your condition should then remain relatively stable and not require as much monitoring.
- Wearing a back brace. You may need to wear a back brace if your doctor believes that your condition is progressing too quickly or is at risk of becoming problematic in the future. There are a few different types, but you can usually wear them underneath your clothing — like a tight jacket. The braces aren’t meant to fix any curvature that has already occurred and will likely not help any of your symptoms improve. Instead, they’re meant to slow or stop the condition from progressing any further so that your symptoms do not become worse.
- Physical therapy. Physical therapy techniques can sometimes help support your spine. Your therapist will focus on exercises that strengthen your core and back. This technique is most helpful for mild to moderate curvature.
- Surgery. This is the most extreme treatment option and is reserved for cases where you experience excessive pain or have a curvature that’s greater than 75 degrees. The surgery modifies the way that your vertebrae connect to one another. It can lead to both a decrease in your spine’s humped shape and a lessening of pain — but it’s unlikely that it’ll entirely eliminate your symptoms. There are potential postoperative complications that can occur.
There are also newer, specialized treatment programs that are only available at certain hospitals. One example is a halo traction technique. This is a slow, individualized treatment that requires a lengthy hospital stay.
This treatment method uses a pulley system to slowly stretch your spine. Weights are gradually added to a device that lifts your head up and forces your spine to straighten.
Talk to your doctor to see if there are any newer treatments that are right for you or your child.
What Is the Prognosis for Scheuermann’s Kyphosis?
The prognosis for this condition depends on the degree of curvature in your spine. For people with less than 60-degree curves, there are few long-term symptoms after you’ve stopped growing.
In fact, pain decreases in almost all cases once you’ve stopped growing, but people with Scheuermann’s disease are still much more likely to have chronic back pain than the general population.
What Other Conditions Could Be Causing Your Spinal Problems?
Your doctor will need to rule out other conditions before you’re officially diagnosed with Scheuermann’s kyphosis. Other conditions that cause somewhat similar spinal deformities include:
- Postural kyphosis
- Postsurgical kyphosis
- Ankylosing spondylitis
- Scoliosis