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As we age, it is common to notice Posture Changes: Shoulders rounded, head tilted forward, back begins to curve.
You may associate this with older adults and wonder: Would this happen to me? Can I stop it?
This is sometimes called a “hunchback” or “roundback”, but the medical term for a curved back is kyphosis.
When the curve is beyond what is considered normal (more than 40 degrees), we call it hyperkyphosis.
In more severe cases, this may reduce pain. mobility and physical function, or lower quality of life.
Here’s how it happens, and how to reduce your risk.
What causes back arching?
A healthy spine has an elongated shape, so it is completely normal to have a curve in the upper spine.
But when that curve becomes exaggerated and fixed (meaning you can’t stand straight even if you try), it could be a sign of a problem.
A common cause of a crooked back is poor posture. This type, called postural kyphosis, usually develops over time due to muscle imbalance, especially in young people who spend hours:
- bent over a desk
- leaning on a chair, or
- Looking down at the phone.
Fortunately, this type of arched back can often be reversed with the right exercises, stretches, and posture awareness.
Older adults often develop a curved back, known as age-related kyphosis or hyperkyphosis.
This is usually caused by wear and tear to the spine, including vertebral compression fractures, which are small cracks in the bones (vertebrae) of the spine.
What are these cracks often caused by? osteoporosisA condition that makes the bones more fragile with age.
In these cases, it’s not just poor posture — it’s a structural change in the spine.
How can you tell the difference?
Symptoms of age-related hyperkyphosis include:
- Your back bends even when you try to stand straight
- back pain or hardness
- Loss of height (anything more than 3-4 centimeters compared to your maximum adult height can be considered outside of “normal” aging).
Other causes of a crooked back include:
- Scheuermann’s kyphosis (which often develops during adolescence when the bones in the spine grow unevenly, causing a forward curvature of the upper back)
- Congenital kyphosis (a rare condition present from birth, caused by improper formation of the spinal bones. This can result in a more severe, fixed curve that worsens as the child grows)
- scoliosis (where the spine curves sideways into a C- or S-shape when viewed from the back), and
- Lordosis (excessive inward curvature of the lower back when viewed from the side).
In addition to these structural conditions, ArthritisAnd in rare cases, spinal cord injury or infection may also play a role.
Should I see a doctor about my twisted back?
Yes, especially if you’ve noticed a curve developing, ongoing back pain, or loss of height over time.
These may be signs of vertebral fractures, which may occur in the absence of obvious injury, and are often painless.
While one in five adults suffers a vertebral fracture, two-thirds of these fractures are not diagnosed and treated.
In Australia, the Royal Australian College of General Practitioners and Healthy Bones Australia recommend spine X-rays for the following:
- people with kyphosis
- Decrease in height equal to or greater than 3 centimeters, or
- Unexplained back pain.
What can I do to reduce my risk?
If you’re young or middle-aged, the habits you form today matter.
The best way to prevent a crooked back is to keep your bones strong, muscles active, and posture under control. That means:
- doing regular resistance training, especially targeting the upper back muscles
- Being physically active, aiming for at least 150 minutes per week
- Getting enough protein, calcium and vitamin D to support bone and muscle health
- Avoid smoking and limit alcohol to reduce risk factors that impair bone density and overall health.
Pay attention to your posture while sitting and standing. Keep your head above your shoulders and shoulders above your hips. This reduces the stress on your spine.
What exercises help prevent and manage a crooked back?
Focus on exercises that strengthen the muscles that support upright posture, especially the upper back and core, while improving mobility in the chest and shoulders.
In general, you want to prioritize extension-based movements. These include straightening or lifting the spine and pulling the shoulders back.
Repeated forward bending (or twisting) activities may make the condition worse, especially in people with osteoporosis or spinal fractures.
Good exercises include:
- Back extension (gently lift your chest off the floor while lying face down)
- Resistance exercises that target the muscles between your shoulder blades
- Weight-bearing activities (such as brisk walking, jogging, climbing stairs, or dancing) to keep bones strong and support overall fitness.
- Stretch your chest and hip flexors to open up your posture and relieve stiffness.
Flexibility and balance training (such as yoga and Pilates) can be beneficial, especially for postural awareness, balance, and mobility. But research increasingly supports muscle strengthening as a cornerstone of prevention and management.
Muscle-strengthening exercises, such as weight lifting or resistance training, reduce spinal curvature while increasing muscle and bone mass.
If you suspect that you have kyphosis or already have osteoporosis or vertebral fractures, consult a health professional before starting an exercise program. Some activities may have to be avoided.
Can a twisted back be reversed?
If it is due to bad posture and muscle weakness, then yes, it is possible.
But if it causes bone changes, especially vertebral fractures, it is unlikely to be completely reversed. However, treatment can reduce pain, improve function, and slow further progression.
Protecting your posture isn’t just about looks. It’s about staying strong, mobile and independent as you age.
Jakub Mesinovic is Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University
David Scott is an Associate Professor (Research) and NHMRC Emerging Leadership Fellow, Deakin University
This article was originally published by The Conversation and is republished under a Creative Commons license. read the original article