Dowager’s Hump

What is a Dowager’s Hump?

It is a condition characterized by a formation of a hump on the upper back. It is popularly known as kyphosis. In this condition, the upper back is more than 45 degrees forward. It affects both men and women, although it is more common in women, especially those who are already in their post-menopausal age. ^{(1, 2)}

Dowager’s Hump Pictures

 

Image 1: A comparison image between a normal spine and someone who has a kyphotic spine/dowager’s hump, hunchback.
Picture Source: drmikesnyder.com

Picture 2: A dowager’s hump is commonly seen on elderly people.
Photo Source: images.theconversation.com

Photo 3: How the shape of the spine changes with age.
Image Source: www.abundanthealthchiro.com

What are the Symptoms?

• Abnormal curvature of the spine
• Muscle fatigue
• Restricted lung movement causing difficulty in breathing
• An abnormal posture and balance problems
• Chronic back and shoulder pain ⁽³⁾
• Loss of appetite
• Loss in height
• Hunch back
• The abdomen bulges
• Hip pain
• Difficulty in sleeping ⁽²⁾

What can increase your risk for Dowager’s hump?

1. If you constantly do movement that requires bending of the waist
2. Bending when lifting
3. Jogging and running
4. High impact aerobics ^{(3, 4)}

Complications

1. Nerve damage
2. Breathing problems
3. Hip fracture
4. Soft tissue inflammation ^{(2, 4)}

Causes

There are various reasons why a Dowager’s hump is formed. The most common causes are as follows:

• Genetic – If you have a genetic abnormality in your spine, then that puts you at risk to having a dowager’s hump. As a matter of fact, some people are born with dowager’s hump. Hence, it is safe to say that a dowager’s hump is somewhat hereditary.
• Poor posture – A dowager’s hump can be developed out of a poor posture. Overstretching the spinal ligaments can actually put stress on your spinal column. The lifestyle that many people have today increases the risk for poor posture. Spending too much time in the digital screen makes the bones adapt to such position. The human head alone is too much for the spine to bear, much more if you have a poor posture. The spine needs to adapt, which causes pressure to the neck and back.
• Compression fractures – If you sustained injury affecting the spinal column, there is a possibility of pressure on the bones leading to deformity.
• Osteoporosis – As you grow old, your bone loses density which makes them weak and prone to bending and fracture. A lack of vitamin D and thyroid-related disorder also put you at risk for osteoporosis.
• Arthritis – The spine collapses because the disc loses fluid. Eventually, it could lead to the development of dowager’s hump. ^{(4, 5, 6, 7)}

How to get rid of Dowager’s hump (Treatment)

Image 4: A correction brace is worn to correct the patient’s posture and reverse the signs and symptoms of kyphosis.
Picture Source: i.ebayimg.com

There is no single treatment for dowager’s hump. It is a multi-disciplinary approach and the goal is to not only treat kyphosis but also to prevent it from happening in the future. The treatment approach includes the following:

Dowager’s hump Exercises

Exercises designed to correct kyphosis should be done for at least three sessions a week.

• Moderate stretching
• Yoga (with some restrictions)
• Progressive weight lifting exercise
• Rope exercise

Brace

An orthosis or brace is commonly used in children with kyphosis. How long the child wears the brace depends on the assessment of the patient’s condition. The goal is to restore lumbar lordosis.

Dowager’s hump Surgery

Surgical procedures for dowager’s hump include vertebroplasty and kyphoplasty. What they do is they restore the vertebra’s height and reduce or totally eliminate the pain.

• Vertebroplasty – it uses a needle to target the affected area.
• Kyphoplasty – a balloon is inserted through a tube and targets the vertebra. ^{(4, 5, 7, 8, 9)}

Can you prevent dowager’s hump?

1. Strengthen your bones by taking vitamin D and vitamin C.
2. Perform exercises that can strengthen the bones such as flexibility and chest exercises.
3. Improve your balance and coordination.
4. Maintain a good posture.
5. Work on your diet. Make sure you are eating a well-balanced meal. ^{(2, 6, 10)}

The psychological aspect of having a dowager’s hump

Well, aside from the pain and discomfort caused by dowager’s hump, it can also affect your psychological well-being. With about 45 degrees protrusion from your back, other people can easily notice it. Even if you conceal it, it will still bulge and it does not look great. Aside from the protrusion at your back, your head arches forward and your neck looks like a vulture. Nobody wants to have that.

As your physical appearance changes, your self-confidence and self-esteem suffer. You will become conscious of your looks and chances are you tend to shy away, especially in a large crowd. Some people even have to dissociate themselves with others out of fear and shame.

Which is why it is important to address the problem as soon as you notice it. If you are born with it, then it should be addressed while you are young. If it is developed through the years because of bad posture and other causes mentioned above, then you need to see your doctor and ask for help.

A dowager’s hump is something that should not be taken for granted. If it has been there for a long period of time without any interventions or management, then eventually, it could affect your physical and emotional well-being. It could lead to other health problems. It gets worse as time passes by. Hence, it is of utmost importance to exert active measures to correct it.

Ditch any bad posture habits. Take good care of your bones by eating a well-balanced meal, drinking milk, and taking supplements that promote bone health. If you notice that there is something wrong with your back, then you need to have yourself checked. It is easy to treat a disease or any health condition if it is diagnosed the earliest time possible. Any forms of delay can further aggravate the condition. ^{(2, 5, 7, 8, 9)}

References:

1. https://www.belmarrahealth.com/dowager-hump-kyphosis/
2. https://healthosphere.com/dowagers-hump-treatment-symptoms-pictures-causes-prevention/
3. https://www.livestrong.com/article/145107-dowagers-hump-causes/
4. https://www.healthline.com/health/hump-behind-the-shoulders
5. https://www.postureresources.com/dowagers-hump-fat-pad-causes-treatment/
6. https://www.drweil.com/health-wellness/body-mind-spirit/bone-joint/cure-for-a-dowagers-hump/
7. https://www.skyflohealth.com/dowagers-hump/
8. https://www.parentgiving.com/elder-care/dump-the-dowagers-hump/
9. https://www.yogauonline.com/yoga-for-osteoporosis/osteoporosis-vertebral-fractures-and-dowagers-hump-role-hyperkyphosis
10. https://theboneclinic.com.au/dowagers-hump/A