What exactly is dowager’s hump?

The word dowager used to mean an elderly woman whose late husband left her well-off. I guess in olden times they were the only women who lived long enough to develop a hump when the spine curves forward, called a kyphosis, usually due to brittle bones when vertebrae fracture and collapse into a wedge shape.

What causes it?

Osteoporosis (brittle bones) may lead to collapsed vertebrae which automatically make the spine curve forward into a hump. Shoulders become rounded, the leg muscles tight with pain and you get stiffness in the back and shoulders. Extreme fatigue and headaches or migraines are common. Walking becomes difficult and height is lost. The head must be raised to see.

Other possible causes include:

Osteoarthritis in your spine can prevent your spine from staying upright.

Spinal infections, fractures, tumours and calcification of spinal ligaments can change the shape of your spine.

A rare congenital problem when the spine doesn’t form properly before birth.

Scheuermann’s kyphosis, again rare, shows up in teenagers, when their vertebrae develop into a wedge shape instead of a rectangle.

What’s the treatment?

Physiotherapy is the mainstay of treatment plus these options –

Taping: therapeutic tape can be applied from the top of your shoulder joint diagonally across your back to the spine on both sides to support the spine.

Bracing: in children, teenagers and young adults, a brace can be worn for about two hours per day. As bones are still growing they can be moulded to reduce spine curvature and halt the progression of kyphosis.

Spinal fusion surgery: for severe kyphosis surgery may be considered.