What is dowager’s hump?
A dowager’s hump, also known as a buffalo hump or camel hump, is an abnormal curvature of the thoracic vertebrae in the upper back, causing a hump or bump to form. It gets its name from older women who develop a hunched posture. However, dowager’s hump can affect people of any age. It occurs when the front portion of the vertebrae in the thoracic spine become misaligned and pushed forward, causing them to protrude from the back as a hump or bump.
Is dowager’s hump present at birth?
No, dowager’s hump does not present at birth. Dowager’s hump is an acquired condition that develops over time due to structural changes in the spine. Babies are born with healthy, properly aligned spines that do not have curvature or humps.
Dowager’s hump develops later in life as a result of factors that cause the vertebrae in the upper back to shift forward abnormally. It is not a condition someone is genetically predisposed to having from birth.
What causes dowager’s hump to develop?
There are several factors that can cause dowager’s hump to develop over time:
Osteoporosis
Osteoporosis is a condition characterized by low bone mineral density and deterioration of bone tissue. It causes the bones to become fragile and weak. In the spine, osteoporosis can cause the vertebrae to fracture and collapse, leading them to shift forward into a hunched position over time. This results in the signature hump at the upper back.
Poor posture
Slouching or hunching forward for prolonged periods can gradually cause the vertebrae in the upper thoracic spine to slide forward abnormally. Over time, this creates a permanent hump. Activities like looking down at phones and computers promote bad posture if done excessively without stretching and strengthening exercises to counterbalance the strain on the back.
Degenerative disc disease
Wear and tear on the discs between the vertebrae from aging or injury can cause them to deteriorate, collapse, and lose shock absorption. This allows the vertebrae to slide closer and misalign. The upper vertebrae can protrude forward, forming dowager’s hump.
Congenital deformities
Rare congenital spinal abnormalities like Scheuermann’s kyphosis cause exaggerated curvature of the upper spine that leads to hunching due to vertebral wedging present from birth. But most dowager’s humps are acquired.
At what age does dowager’s hump typically develop?
Dowager’s hump often emerges in middle or older age, generally after 60 years old. However, it can also develop earlier in adulthood due to certain risk factors:
– Women over 40 – Estrogen decline and osteoporosis places older women at greater risk.
– Osteoporosis – Those with osteoporosis often develop dowager’s earlier from weakened vertebrae.
– Degenerative disc disease – Disc degeneration from injury can accelerate spinal changes.
– Poor posture – Long-term poor posture overworks the back and shifts the spine.
– Obesity – Excess weight places extra pressure on the spine that leads to misalignment.
While occasionally seen in younger adults, most dowager’s humps emerge after middle age due to age-related factors like osteoporosis. Proper prevention and treatment can help slow its progression at any age.
Can dowager’s hump be prevented?
Although largely influenced by age and genetics, there are some preventive measures that may help reduce risk of dowager’s hump:
– Maintain proper upright posture and avoid slouching.
– Exercise regularly with a focus on back-strengthening activities.
– Do yoga or pilates to improve flexibility and counteract spinal compression.
– Maintain a healthy weight to avoid extra pressure on the spine.
– Get adequate calcium and vitamin D for bone support.
– Use ergonomic furniture and workspaces.
– Avoid lifting heavy objects improperly.
– Quit smoking to optimize bone density.
– Treat osteoporosis to strengthen vulnerable vertebrae.
While dowager’s hump cannot always be prevented, these healthy lifestyle measures can help reduce risk and slow progression in older adults. Early intervention gives the best chance to avoid permanent hunching.
Can dowager’s hump be corrected?
Mild dowager’s hump can often be improved through:
– Postural training – Retraining proper upright posture and correcting slouching habits.
– Physical therapy – Targeted exercises to strengthen the back and improve flexibility.
– Spinal bracing – Custom braces may be used to help support and straighten the spine.
– Injections – Steroid injections can help reduce pain and inflammation in vertebrae.
However, severe dowager’s hump with structural changes in the spine cannot be fully reversed without surgery. Surgical options may include:
– Spinal fusion – Fusing together vertebrae for stabilization.
– Spinal osteotomy – Surgically repositioning and realigning vertebrae.
– Thoracoplasty – Removal of rib segments to reshape the humped upper back.
These invasive surgical procedures have extensive recovery times and are reserved for severe, debilitating cases that do not respond sufficiently to nonsurgical treatments.
Conclusion
In summary, dowager’s hump does not present at birth. It develops from age-related spinal changes like osteoporosis and disc degeneration that cause the vertebrae to misalign and protrude forward. Prevention aims to support bone density and maintain proper posture. Mild cases may improve with physical therapy and bracing. Severe cases may require surgery to realign the distorted spine. While largely influenced by aging and genetics, early intervention provides the best opportunity to correct dowager’s hump before permanent deformity sets in.