Chiropractic Care for Kyphosis

If you have kyphosis, chiropractic can be a very good choice to diagnosing and treating the pain and stiffness that accompanies this condition. Kyphosis is characterized by a rounded (hump-like) middle back. The initial step in the chiropractic treatment of kyphosis is to carefully determine the cause of the abnormal middle back appearance.

Understanding Kyphosis
A complete history, and a consideration of the age and gender of the patient, gives the chiropractor important clues in determining the diagnosis of kyphosis.

Examination will yield important information and will determine for the chiropractor whether spinal x-rays are necessary. Kyphosis cannot be diagnosed solely on the basis of x-rays since the position of the patient can sometimes give false indications of abnormal spinal curves.

The simplest and often the most common reason for the appearance of a kyphotic curve in the middle back is poor posture, which occurs in both children and adults. Poor posture is a complicated condition that may be related to disturbed spinal mechanics, an underlying spinal condition, abnormal posture due to chronic pain, as well as depression and other social-psychological factors.

Sometimes an increased thoracic curve is secondary to an increased lower back "sway-back" (an increased lumbar lordosis).

Spinal fractures, either recent or healed fractures, can contribute to the appearance of kyphosis. Your chiropractor will determine from the history, examination, and x-ray studies whether a vertebral fracture is the reason for kyphosis.

Spinal conditions such as osteoporosis, rickets, osteochondritis, malignancy, and tuberculosis can cause kyphosis.

Degenerative spinal changes, including degenerative disc disease, especially seen in the older population, can lead to kyphosis with middle back spinal joint fixations, secondary soft-tissue inflammation, and pain.

Your chiropractor is highly trained in spinal diagnosis and understanding the cause of your kyphosis will determine the chiropractic treatment approach.

Chiropractic Care and Kyphosis
Chiropractors are doctors who specialize in the care of non-surgical conditions of the thoracic spine with gentle, time-saving approaches that address the mechanical and neurological causes of kyphosis.

Chiropractors are rigorously trained to diagnosis the different types of kyphosis. Your chiropractor will take an extensive history and provide a comprehensive examination to determine the cause of your kyphosis and present an appropriate treatment plan. Spinal conditions of an organic nature outside of chiropractic's conservative scope of care are referred to medical specialists.

Chiropractic care cannot eliminate or reduce the "hump" associated with kyphosis, unless there is a significant postural reason for the abnormal curve. A mid-back that is locked in a fixed position of kyphosis due to a past fracture, hereditary factors, degenerative changes in the spine, or disc disease injuries cannot be reversed using spinal manipulation, flexion-distraction, or non-force manipulation techniques.

The goal of chiropractic care is nevertheless a vital one for the patient with kyphosis. Chiropractic manipulation, including (when appropriate) gentle manual manipulation, and, more often, non-thrusting techniques such as flexion-distraction, is to optimize motion in the spine, reduce secondary muscular tension, and address inflammation secondary to disturbed mechanics.

Chiropractic care can aid the patient with non-organic kyphosis to maintain spinal health, treat chronic pain, and slow the process of degeneration in the middle back. Chiropractic care will optimize motion in the spine, treat the spinal discs, reduce muscle spasm, and improve muscular strength.

Chiropractors are specialists in spinal manipulation—an active, hands-on care that returns motion to the spine. The restricted motion and disturbed mechanics that characterize kyphosis are especially helped by spinal manipulation in patients who are considered good candidates for this approach.

How a Chiropractor Diagnoses Kyphosis
Even if you go to the chiropractor complaining of middle back pain following an accident or the chronic appearance of a rounded thoracic curve, he or she will evaluate your spine as a whole. The chiropractor will check your neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). It's important to examine the entire spine because even though it's just your middle back that hurts, other regions of the spine may be affected.

Your chiropractor will determine areas of restricted joint motion, disc injury, muscle spasm, and ligament injury. One way the chiropractor does that is through motion and static palpation, diagnostic techniques unique to chiropractic. Motion and static palpation is an examination by means of touch. The chiropractor will feel for tenderness, tightness, and how well each spinal joint moves.

The chiropractor will also analyze how you walk and look at your overall posture and spinal alignment. Those details will help your chiropractor understand your body mechanics and how well your spine is working and moving.

You'll also go through your past medical history with the chiropractor. Your chiropractor will have x-rays of your spine taken, or an MRI if it is indicated, to evaluate possible fracture and degenerative changes.

After the examination, the chiropractor will be better able to create an effective treatment plan for your back pain.

Possible Chiropractic Approaches for Treating Kyphosis
The exact treatment plan depends on your diagnosis. Your chiropractor may use a type of spinal manipulation, or spinal adjustment, to improve joint motion and soft tissue health. Some spinal manipulation techniques are:

• Specific spinal manipulation: The chiropractor identifies the joints that are restricted or show abnormal motion, also called subluxations, and returns motion to the joint with a gentle thrusting technique. This gentle thrusting rapidly stretches soft tissue and stimulates the nervous system to return normal motion to the spine.
  
• Flexion-distraction technique: This is a gentle, non-thrusting type of manipulation that is indicated in kyphosis associated with degenerative disc disease as well as motion restrictions in the thoracic spine. This treatment is still hands-on, utilizing a specialized table to assist the chiropractor, but uses a slow pumping action on the disc instead of direct force.
  
• Instrument-assisted manipulation: This is another non-thrusting technique. Using a hand-held instrument, the chiropractor can apply force without thrusting into the spine. This is especially appropriate in older patients with degenerative joint syndrome.

The chiropractor may also use manual therapy to treat injured soft tissues such as ligaments and muscles. Some examples are:

• Trigger point therapy: The chiropractor identifies specific hypertonic (tight), painful points on a muscle. He or she puts direct pressure (using the fingers) on these points to relieve the tension.
  
• Manual joint stretching and resistance techniques: Muscle energy therapy, an osteopathic technique, is an example of a resistance manual joint therapy.
  
• Instrument-assisted soft tissue therapy: The chiropractor may use Graston technique, an instrument-assisted therapy to treat the injured soft tissue. Your chiropractor will perform gentle repeated strokes of the instrument over the area of muscle injury.

In addition to spinal manipulation and manual techniques, the chiropractor may use various therapy modalities to help reduce inflammation caused by kyphosis.

Some examples are:

• Interferential electrical stimulation: This uses a low frequency electrical current to stimulate your muscles in order to reduce inflammation.
  
• Ultrasound: By increasing blood circulation, ultrasound helps reduce muscle spasms, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and heating.

To reinforce the improved joint mechanics (return of normal spinal motion), your chiropractor will prescribe therapeutic exercises.

Chiropractors are "whole person" doctors who view problems with posture and middle back pain as unique to each patient. Therefore, they don't focus on just your middle back pain. Chiropractic care includes nutrition, stress management, and lifestyle goals (because all of those can add to your kyphosis-related pain, so you need to address them if you really want to relieve your pain).

Chiropractors emphasize prevention as the key to long-term health—another example of chiropractors looking at the whole person, not just the painful problem. Keeping the back healthy is vital to the chiropractic approach to care.

How Chiropractic Helps Patients with Kyphosis
A chiropractor will help you return to your normal activities quickly so that you can enjoy your daily life without pain. He or she will work to address the underlying mechanical (how the spine moves), postural, or disc-related causes of your kyphosis.