The spine has a normal curvature that allows weight to be supported in an upright posture. An exaggeration of this curvature is known as kyphosis, and the most serious type is Scheuermann’s disease. Most common in the upper back (the thoracic spine), it is generally thought to be caused by abnormal growth of the vertebra in which the front part stops growing before the back part does. This growth abnormality causes wedge-shaped vertebral bones, which cause a forward-bending posture. Kyphosis may also be caused by vertebral compression fractures (due to osteoporosis) or degenerative bone conditions, such as arthritis.
In Scheuermann’s disease, boys are affected more often than are girls, and the first signs usually appear in adolescence. The upper back gradually appears more rounded, and there may be accompanying back pain that worsens during the day and is relieved with rest. Pain, if present, is typically felt at the most curved point of the spine and can be aggravated by activity or prolonged periods of sitting or standing. Diagnosis is usually made following a physical examination and X-rays of the spine to measure the “kyphotic angle.” (A kyphotic angle greater than 50 degrees is considered diagnostic.)