Curved back or dowager’s hump

What is known as a dowager’s hump can be the consequence of advanced osteoporosis. This generally occurs due to spinal collapses. The increased tilted posture is associated with a noticeable decrease in the patient’s body size.

Curved back or dowager’s hump

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Crooked back: Osteoporosis can lead to kyphotic misalignment

Primarily post-menopausal and elderly women may be affected by a rounded back caused by osteoporosis. An abnormal and significantly crooked thoracic spine (hyperkyphosis) is for that reason referred to as a “dowager’s hump” or “widow’s hump”.

Not only is a curved back very painful, but the misalignment shifts the body’s centre of gravity forwards. Pathological kyphosis (in this case the increased tilt of the thoracic spine forwards) changes the body’s static equilibrium and increases the tendency to sway. This can lead to a higher risk of falling.

In addition, it may result in reduced lung function, which may make breathing more difficult.

Causes of an osteoporosis-related curved back

The reduced bone density caused by osteoporosis can lead to a widow’s hump, especially in women who have undergone menopause-related hormonal changes.

Find out more about the causes of osteoporosis

In osteoporosis, the bones lose density and stability. Osteoporotic fractures are particularly common in the spine. As a result, the vertebrae can slump down. This is known as an osteoporotic vertebral compression fracture, which can lead to a widow’s hump.

 

Symptoms and signs of a curved back

Symptoms of a rounded back are the visibly increased curvature of the thoracic spine (hyperkyphosis) and chronic back pain. This is primarily due to the changes in static equilibrium that affect the entire spinal column over the long term. The increased kyphosis can lead to shortening, hardening and stiffness of the muscles and tendons. If back pain comes on suddenly, one of the things the doctor will consider is an acute vertebral fracture. An X-ray will help get an accurate diagnosis.  

Images of the progression of a curved back (kyphosis)

Images of the progression of a hunched back (kyphosis)

Can a curved back caused by osteoporosis be prevented?

Everyone can do something to try to prevent osteoporosis and therefore also a widow’s hump: Movement, muscle training and a diet containing calcium in a patient’s early years are important factors.

Therapy for a curved back

A curved back caused by osteoporosis is treated in accordance with the S3 guideline on osteoporosis prophylaxis, diagnostics and therapy.1

Patients often want to know how they can get rid of a widow’s hump through training. If osteoporosis is so advanced that a widow’s hump has started, the deformation of the spinal column can generally no longer be fully corrected.

However, slight improvement can be achieved with suitable training in some cases. Tailored exercises can contribute to ensuring that the hump does not worsen. In addition, orthoses which support the spinal column (see below) help maintain upright posture during the day.

Exercise for osteoporosis to strengthen the muscles   

Which doctor treats a curved back?

Your first point of contact should be your GP. They will refer you to an orthopaedist, the consultant who treats osteoporosis.

Products by medi: Straight back despite osteoporosis with Spinomed back orthoses

The Spinomed back orthoses which straighten the spinal column are medical aids which counteract widow’s hump and can help achieve a straight back: As a component of osteoporosis therapy developed by doctors in accordance with the guidelines, they activate the back muscles and can reduce the kyphosis angle (hump angle). Thanks to the innovative belt system, the biofeedback principle constantly prompts the wearer to maintain an upright posture.2,3

 

Sources:

1 Prophylaxe, Diagnostik und Therapie der Osteoporose bei postmenopausalen Frauen und bei Männern. Leitlinie des Dachverbands der Deutschsprachigen Wissenschaftlichen Osteologischen Gesellschaften e.V. 2017. Online veröffentlicht unter: https://www.awmf.org/uploads/tx_szleitlinien/183-001l_S3_Osteoporose-Prophylaxe-Diagnostik-Therapie_2019-02.pdf (Letzter Zugriff 08.11.2021).

2 Pfeifer M et al. Die Wirkungen einer neu entwickelten Rückenorthese auf Körperhaltung, Rumpfmuskelkraft und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2004;83(3):177-186.

3 Pfeifer M et al. Die Wirkungen von zwei neu entwickelten Rückenorthesen auf Rumpfmuskelkraft, Körperhaltung und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2011;90(5):805-815.
 

Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.

Your medical retailer will fit them individually for you.