Why do old people have a hump in their back?

February 21, 2013 9:24 AM

Can someone explain why old age or bone loss causes older people to have a hump in their upper back or neck? I think its called dowager’s hump.
posted by john123357 to Health & Fitness (16 answers total)

Kyphosis
posted by Avenger at 9:27 AM on February 21, 2013

The term you want is kyphosis.
posted by gaspode at 9:29 AM on February 21, 2013

Response by poster: so what causes kyphosis in older people?
posted by john123357 at 9:30 AM on February 21, 2013

It's not well understood why. This article from 2010 says:

The natural history of hyperkyphosis is not firmly established. Hyperkyphosis may develop from either muscle weakness and degenerative disc disease, leading to vertebral fractures and worsening hyperkyphosis, or from initial vertebral fractures that precipitate its development.

It is also possible that different individuals may develop the same magnitude of hyperkyphosis from different processes, some from vertebral fractures and others from muscle weakness, degenerative disc disease, or other genetically determined processes. Regardless, there are significant negative consequences of hyperkyphosis, and early intervention and treatment of hyperkyphosis could have important clinical and public health benefits

posted by brainmouse at 9:31 AM on February 21, 2013

Osteoporosis is a significant part of the answer. Weakened bones often deform under the stress of daily life. If you have a museum of anatomy or natural science nearby, you might be able to examine the bones of people with osteoporosis. They look very different in texture and even shape, and it's not hard to imagine that kind of living tissue deforming under pressure.
posted by Nomyte at 9:34 AM on February 21, 2013

Some more:

This article (which only has the abstract publicly available) says:

The causes and consequences of hyperkyphosis are not well understood. Some physicians think that fractures cause hyperkyphosis and that management strategies should focus solely on diagnosis and treatment for osteoporosis. Recent studies, however, demonstrate that many older adults who are most affected by hyperkyphosis do not have vertebral fractures.

This one doesn't get at a cause, but does describe one method that helps prevent/slow it:

Kyphosis increases with age in healthy women, with the greatest difference observed between women 50 and 59 years of age. The progression of kyphosis was greater in women who did not perform extension exercises compared to those who performed extension exercises three times per week for 1 year. The difference in change in CD and TA between the two groups was highly significant (CD p = .0001, TA p = .0001).

posted by brainmouse at 9:35 AM on February 21, 2013

I would have thought the answer was osteoporosis. People get compression fractures in their vertebrae.
posted by kestrel251 at 9:38 AM on February 21, 2013

Response by poster: why would gradual bone loss in your spine cause a hump though?
posted by john123357 at 9:41 AM on February 21, 2013

Because then the vertebrae all kind of smush down on each other. Google some images of the spine and think about the anatomy. Also, intervertebral discs degenerating and suchlike adds to it.
posted by gaspode at 9:44 AM on February 21, 2013 [1 favorite]

Response by poster: so does bone loss in the spine just mean each vertebrae gets thinner?
posted by john123357 at 9:46 AM on February 21, 2013

Heads are heavy. People slouch when they're tired.

Combine slouching with smushed-down-ness from bone loss, and the spine curves into a hump and stays like that. Especially if you've lived a whole life with a lot of bending over/hunching/slouching.
posted by EmpressCallipygos at 9:54 AM on February 21, 2013

Response by poster: can it be reversed with physical therapy if its mild to moderate?
posted by john123357 at 9:58 AM on February 21, 2013

I don't know whether it can be reversed. I had a boyfriend once who had wedge shaped vertebrae and the only reason his back was not humped was that he had strong back muscles. So perhaps it's possible to mitigate the way it looks?
posted by plonkee at 10:04 AM on February 21, 2013

It can definitely be helped a Lot by physical therapy! The hump itself may not change, but several elderly family and friends have improved posture through PT after years of hunching, and it's helped them tremendously.
posted by ldthomps at 10:50 AM on February 21, 2013

Response by poster: so can anyone tell me if bone loss in the spine just mean each vertebrae gets thinner?
posted by john123357 at 8:59 PM on March 5, 2013

John, could you perhaps elaborate on why you want to know?
posted by EmpressCallipygos at 4:17 AM on March 6, 2013