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
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.
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).