What is dowager’s hump?
A dowager’s hump, also known as a buffalo hump or buffalo bump, is an abnormal curvature of the thoracic vertebrae in the upper back, causing a hump or bump to form. The medical term for this condition is hyperkyphosis. A dowager’s hump gives the appearance of poor posture and rounded shoulders.
What causes dowager’s hump?
There are a few potential causes of dowager’s hump:
– Aging – As we age, the front part of the vertebrae loses height putting extra strain on the posterior ligaments. Over time, this causes the vertebrae in the upper spine to compress and wedge together abnormally, creating a hump.
– Osteoporosis – Thinning of the bones due to low bone mineral density causes the vertebrae to weaken and compress. Older women are especially at risk as estrogen levels drop during menopause.
– Spinal injuries – Past fractures or trauma to the spine can lead to hyperkyphosis if the normal curvature of the thoracic spine becomes exaggerated.
– Other medical conditions – Endocrine disorders like Cushing’s disease, genetic disorders like Scheuermann’s kyphosis, arthritis, or disc degeneration can contribute to dowager’s hump.
Who gets dowager’s hump?
Dowager’s hump is common in older women over 60, but it can occur in men and younger adults too. The prevalence increases with age. Up to 40% of older women develop some degree of hyperkyphosis.
Can a dowager’s hump be reversed?
Some mild to moderate cases of dowager’s hump can be improved with treatment, but severe cases are harder to completely reverse. Here are some ways dowager’s hump can potentially be treated:
Exercises
Certain exercises can help improve posture and realign the spine to reduce the protruding hump:
– Back extensions – Laying on the stomach and lifting the head, shoulders and chest off the floor strengthens the back extensor muscles.
– Rows – Using resistance bands or weights to perform upright rows works the back and shoulder muscles.
– Chest openers – Stretches like the doorway chest stretch open the chest and strengthen upper back muscles.
– Yoga and Pilates – Poses like Cobra and Cat-Cow stretch the back and build core strength.
Physical Therapy
A physical therapist can design an exercise program to improve posture and flexibility. They may use:
– Stretching and myofascial release techniques
– Postural exercises and re-training
– Joint mobilization
– Massage
– Cervical traction
– Strengthening exercises
– Bracing or taping
Chiropractic Care
Chiropractors use spinal manipulation and mobilization techniques to improve spinal alignment and reduce nerve irritation. They can also provide nutritional advice, posture retraining, and exercise recommendations.
Surgery
For severe dowager’s hump not responding to conservative treatment, surgery may be an option, such as:
– Spinal fusion – Fusing together two or more vertebrae to stabilize the spine.
– Spinal osteotomy – Removing a wedge of bone to realign and straighten the spine.
– Vertebroplasty – Injecting a special cement into fractured vertebrae to strengthen them.
Surgery aims to halt progression but does not fully reverse the hump, and there are risks to consider.
Posture Support Devices
Special braces, supports, and taping techniques may be used to improve posture alignment on a temporary basis. These include:
– Posture braces
– Posture correction shirts
– Clavicle braces
– Kinesiology tape
Medications
If osteoporosis is contributing, medications to strengthen bones like bisphosphonates or improve bone building like teriparatide may help slow dowager’s hump progression.
Tips for preventing dowager’s hump
While aging is the top cause, certain lifestyle measures can help prevent or slow dowager’s hump:
– Maintain proper posture and spinal alignment when sitting, standing, and sleeping. Avoid slouching.
– Stay active with weight-bearing and muscle-strengthening exercises. Activities like walking, swimming, yoga and Pilates are great options.
– Do stretches and exercises to keep the spine flexible and agile. Target the upper back, chest and shoulders.
– Wear supportive, well-fitted bras to prevent strain on the upper back.
– Avoid high heel shoes which shift the center of gravity forward.
– Use ergonomic furniture and sleep on a supportive mattress. Lumbar support pillows can help.
– Manage chronic conditions like osteoporosis through medication, diet and exercise. Get bone density testing.
– Stop smoking and limit alcohol intake which are risk factors for osteoporosis and spinal degeneration.
– Maintain a healthy weight to avoid extra stress on the spine.
– Get enough vitamin D and calcium for bone health. Supplement if deficient.
Conclusion
Mild cases of dowager’s hump may be partially reversible through posture exercises, physical therapy, chiropractic treatment, and bracing devices. But severe cases are harder to improve without surgery, which has its own set of risks and limitations. The best approach is prevention through lifelong healthy lifestyle habits to maintain optimal spinal strength and flexibility. Proper posture and building strong back muscles are key to help avoid dowager’s hump.