Yes, osteoporosis is one of the common reasons of hunchback. People with osteoporosis most experience damage of bones in the upper (thoracic) spine. These bones break causing back pain, loss in height and a stooped or hunched posture, called kyphosis.
What does one mean by “Osteoporosis” and “Kyphosis or hunchback”?
Why do people with osteoporosis get kyphosis?
Are certain women more prone to osteoporosis?
What are the other causes of hunchback? Is hunchback / kyphosis hereditary?
What are the symptoms of osteoporosis and kyphosis?
How is osteoporosis & kyphosis diagnosed?
What is the treatment of osteoporosis and hunchback? Is there a cure?
What are the complications of osteoporosis and hunchback when not treated early?
Is kyphosis a normal part of aging? Can hunchback be prevented in old age?
What is the daily calcium requirement to prevent osteoporosis or hunchback?
What are the sources of food rich in calcium?
What is the role of vitamin D in the prevention of osteoporosis?
What is the effect of pregnancy or breastfeeding on bone density?
Many of us have sometimes witnessed or heard of an elderly woman in the family or someone we know to have fractured a bone like the hip bone after a fall in the washroom or kitchen. If you look around in your family or friend’s circle, you may also realize that some elderly women start bending forwards, with a hunchback or become shorter as they grow old. Have you ever wondered that most of such stories are about elderly aunts or grandmas who are often diagnosed with a condition called “Osteoporosis” which is sometimes accompanied with a condition known as “Kyphosis?”
“Osteo” means bone and “porosis” means “porous”, thus osteoporosis is a disease of the bones in which the bones become prone to easy breakage due to brittleness and weakening. Kyphosis is a progressive deformity of the back bone or the spine that leads to a forward curvature of the upper back. Osteoporosis is one of the most common causes of Kyphosis also known as “hunchback or Dowager’s hump”.
The most common reasons for bone loss in women are:
Normally, the curvature of the neck is forwards and appears like the alphabet “C” from the side. This appearance is called as normal lordosis, and it is important for the movement of the head and supports the weight of the head. Loss of this curvature due to conditions like injuries and poor posture is called military neck or straight neck or cervical kyphosis, as it gives the appearance of a soldier standing straight with chin up, at attention. In case of a significant curvature loss, symptoms like the stiffness of the neck, headache, pain in neck and shoulder may be seen.
Fracture of the neck bones i.e. the vertebra due to osteoporosis is the most common cause of kyphosis or hunchback. Even though it is more common in females, it can also be sometimes seen in men.
The vertebral bones of the spine weaken due to osteoporosis, making them susceptible to fracture. Wedge-shaped fractures are characteristic leading to collapse of the front of the vertebra. As a result, the vertebra loses its height from the front, whereas its height at the back remains mostly unchanged. The uneven loss of bone leads to forward tipping of the spine. This leads to an excessive kyphotic curvature and a posture that stoops forward.
Even though older women generally seem to have osteoporosis, younger women can get it too. Kyphosis is also more common in elderly women as it happens gradually over a long period of time. But the curvature of the upper back may start even at an early age of 40! Hence, girls and women of all ages should be encouraged to take precautions to protect their bones.
The chance of getting osteoporosis is higher in women:
As mentioned earlier, vertebral fractures or fracture of the joints in the spine due to osteoporosis can lead to the collapse of these joints, causing them to bend forward. Some other causes of hunchback are:
While there is no clear evidence that kyphosis is hereditary, a specific type known as Scheuermann’s kyphosis may have a high genetic predisposition as it runs in families.
Osteoporosis often termed as a “silent” disease may not present any clues of bone loss for many years till a fracture occurs that may cause severe pain and disability. Osteoporotic fractures are generally seen in the hip, the spinal joints i.e vertebrae and wrist. Osteoporosis of vertebrae can be risky because it may lead to restriction of day-to-day activities like climbing stairs, bending forward etc. Depending on the location of the fracture, any or all of these symptoms may be seen:
Osteoporosis and kyphosis can be diagnosed on the basis of your medical history, examination and investigations. Bone density test is done to assess the strength of the bones. The central dual-energy x-ray absorptiometry (DEXA Scan) is a special type of x-ray for testing bone density using a small amount of radiation. Investigations like X-Ray, urine and blood tests are also done for supporting the diagnosis.
A bone density test for osteoporosis is usually advised for:
Kyphosis in majority of the cases can be successfully treated. The primary treatment goals are correction of the abnormal curvature of the spine and prevention of the risks arising due to complications at a later stage in life.
While prevention with physical exercises is an important consideration in the management of osteoporosis, doctors may also prescribe medicines or injections in the joints to manage pain, prevent further bone loss or to promote building of new bone mass. Your physician may also advice supplements of calcium, vitamin D, and physical activity. In addition to the treatment of osteoporosis or other underlying cause, some interventions are often advised for management of the hunchback.
Mild hunchback generally may not cause any problems, severe hunchback may have an impinging effect on the organs like lungs or it may compress neighbouring nerves, tissues leading to other medical problems. Treatment often depends on type of kyphosis, age, extent of effects of the hunchback and the overall health of the person.
Some of these interventions include:
Physical therapy and chiropractic treatment that may include activities like physiologic therapeutics, back strengthening exercises, nutrition, and posture correction exercises
Delay in treating osteoporosis can cause serious bone fractures especially in the spine and hip. One in three women is likely to have a fracture caused by osteoporosis in her lifetime.
Persons with osteoporosis can have fractures even after minor falls, or bumps into household items like furniture. Sometimes there maybe “spontaneous fractures”, i.e fractures without any trauma. Falls are the one of the leading cause of injuries in the elderly over 65 years of age.
Kyphosis due to osteoporosis is a progressive change that occurs as a person ages. Activities that are focused towards bone strengthening are the best prevention techniques. Building strong bones during childhood and teenage is important for prevention of osteoporosis. Preventive steps can be taken to delay the natural bone loss as a person ages and to prevent bones from becoming weak and brittle. Some of these measures are:
Indian Council of Medical Research (ICMR) recommends the following:
Even though many people believe that milk or dairy products are the only sources of calcium, other non-dairy yet great dietary sources of calcium include:
Merely eating foods with calcium is not enough, it also needs to be absorbed well. Vitamin D helps in the absorption of calcium from the food that one eats by functioning synergistically with magnesium and vitamin K2 to aid the absorption of calcium. Thus a deficiency of vitamin D, may also lead to a deficiency of calcium deficiency, or abnormal shuttling of calcium into other parts of the body besides the bones. As a result, there may be a deposition of calcium in soft tissue leading to problems due to calcification. Prolonged deficiency of Vitamin D can lead to osteoporosis too.
When exposed to sunlight, the skin makes vitamin D. Exposure to sunlight for 15-30 minutes to the exposed parts of the body like face, arms, hands, arms at least two to three times a week is usually recommended depending on factors like the geographical location, season, colour and sensitivity of the skin.
Vitamin D can also be obtained from foods like eggs, milk or from vitamin supplements as recommended by your doctors. Further, since sunlight is often inadequate during winter months, supplementation may be required to maintain the nutritional adequacy of the vitamin in consultation with the child specialist.
A baby inside the mother’s womb requires calcium for the bones to grow. This calcium requirement is fulfilled by the mother’s diet or supplements taken. The inadequacy of calcium in diet or its replacement leads to supplementation from the mother’s bones. Similarly, during lactation, the baby’s requirement for calcium is fulfilled by the mother’s milk. As a result, there can be a temporary loss of some bone density during pregnancy. This loss usually gets restored after childbirth or cessation of breastfeeding if adequate calcium is consumed.
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