Kyphosis: list of symptoms, types of disease, treatment methods

Kyphosis of the thoracic spine of the 1st degree is the initial phase of the formation of curvature of the spinal arch. Its angle of curvature is 30-40 degrees. Precedes more serious violations. It can be called functional, since all pathological processes are reversible without the use of surgical manipulations. Soft thoracolumbar corsets, manual therapy sessions, and painkillers are used if necessary.

Symptoms provoked by kyphosis in the thoracic spine of the 1st degree:

• deterioration of posture, slight stoop;
• fatigue when staying in one position for a long time;
• discomfort in the dorsal region during intense physical activity;
• difficulty breathing.

In the image (from left to right): normal; kyphosis; progressive kyphosis

Kyphosis

Spinal kyphosis is a curvature in the upper parts of the spinal column, which is accompanied by a violation of its normal location and can cause the development of a number of pathological symptoms from the musculoskeletal system.
Pathological kyphosis, as a rule, develops in the thoracic region and in the vast majority of clinical cases is the result of a vertebral fracture. When nerve roots are pinched, patients begin to complain of intense pain in the chest area, numbness in the legs, and dysfunction of the pelvic organs. With complex types of deformation, problems with the heart and lungs arise.

Consequences of kyphosis 1 and 2 degrees

In cases of significant progression of kyphosis, there is a risk of developing concomitant pathologies:

• breathing problems;
• instability of the functioning of the cardiovascular system;
• pathologies of the gastrointestinal tract.

Often people with kyphosis may complain of pain in the back and between the shoulder blades.

Dangerous complications of kyphosis are:

• paresis;
• urinary incontinence;
• damage to internal organs and systems;
• intervertebral hernia;
• secondary meningitis;
• disability, loss of ability to move;
• myocardial infarction.

Causes

Kyphotic disorders of the thoracic spine in children and adults have several causes, in particular:

• violation of the formation of the spine at the stage of intrauterine development of the fetus;
• vertebral injuries;
• performing surgical interventions in the thoracic spine;
• weakness of the back corset muscles, which occurs due to lack of physical activity or pathology of muscle tissue;
• osteoporotic changes in bones;
• the effect of radiation therapy;
• vertebral compression fractures in elderly people;
• pulmonary tuberculosis;
• tumors and metastases in the area of ​​the spinal column and spinal cord.

Regardless of the reasons for the development of the pathological condition, kyphosis of the thoracic spine negatively affects the entire body and significantly worsens the quality of life of the sick person. That is why the disease needs competent correction, which will improve the clinical picture of the curvature and prevent the progression of the disease.

Prevention

The main method of preventing the development of kyphosis is maintaining correct posture.

To prevent kyphosis, the following methods are necessary::

• maintaining correct posture;
• sleep on a flat surface, preferably on an orthopedic mattress;
• sufficient physical activity;
• compliance with the principles of ergonomics when working, including a comfortable chair, matching the height of the table and chair to a person’s height;
• regular breaks during sedentary work;
• prohibition on carrying heavy objects;
• a balanced diet enriched with vitamins and microelements, a sufficient amount of fluid to drink daily.

Symptoms of kyphosis

In practice, kyphosis in humans is manifested by the presence of a number of symptoms characteristic of the disease, including:

• poor posture, visible curvature of the spine with the formation of a so-called hump in the chest area;
• painful sensations in the spine of varying intensity, which can change their character when changing body position;
• morning stiffness of movements, the need to “disperse” after a night’s rest;
• impaired sensitivity in the lower extremities and abdominal area;
• disorders of the pelvic organs;
• deterioration of the heart and respiratory system;
• feeling of discomfort in the back area, which is permanent;
• inability to perform physical work.

The severity of the symptoms of kyphosis depends on the variant of the disease, the reasons for its development, the neglect of the pathological process and the individual characteristics of the sick person’s body. If such violations are left without medical attention, then over time they will begin to develop consequences and ultimately lead the patient to disability. You can learn more about kyphosis, its diagnosis and treatment from a qualified specialist.

Diagnostics

An orthopedist can diagnose kyphosis

,
neurologist
,
surgeon
. First, a survey is conducted to identify the causes and symptoms of the disease. Next, the patient is examined visually and by palpation to identify curvatures in the spine. Afterwards, diagnostics are prescribed using medical equipment:

• X-ray
  of the spine in different projections, which will reveal the overall picture and calculate the angle of concavity;
• computed tomography
  , it is prescribed to detect the disease at an early stage.

Types of kyphosis

Symptoms, their severity and the severity of the pathological condition largely depend on the type of kyphotic postural disorders. Among the main types of kyphosis, doctors distinguish:

• a congenital variant of the disease, which is the result of a violation of the formation of the spine at the stage of intrauterine development of the fetus;
• genotypic kyphosis, as a consequence of chromosomal abnormalities;
• functional kyphotic disorder - the consequences of incorrect posture and lack of development of the muscular corset of the back, which arose due to a lack of physical activity, violation of the rules of sitting at a desk, desk, etc.;
• post-traumatic disorders arising from vertebral fractures and their incorrect treatment;
• postoperative kyphosis, the development of which is directly related to unsuccessful surgical interventions in the spine and spinal cord;
• degenerative kyphosis is the result of degenerative-destructive changes in the bone tissue of the vertebrae, which cause its thinning, softening and the development of compression fractures;
• paralytic kyphosis against the background of diseases of the central nervous system, which manifest themselves as paralysis and paresis.

The severity of kyphosis symptoms also depends on the degree of deformation or angle of curvature of the vertebrae. Kyphosis is considered physiological when the angle of curvature does not exceed 20 degrees. The first degree of the disease is deformation at the level of 21-55 degrees, the second - 56-90 degrees, the third - 91 degrees or more.

Treatment of kyphosis 1 and 2 degrees

To treat kyphosis, usually based on diagnosis, the doctor prescribes a course based on individual indicators using methods:

• manual therapy;
• therapeutic exercises;
• physiotherapy;
• symptomatic treatment;
• surgical treatment;
• wearing corrective corsets;
• Spa treatment.

Drugs

The use of drugs for kyphosis cannot help eliminate the curvature of the spine. However, they are often used to relieve pain, inflammation, improve the flow of nerve impulses through fibers, and reduce muscle spasms.

For this purpose, your doctor may prescribe the following medications::

Surgery

In some cases, surgical treatment may be prescribed for kyphosis if the following indications exist::

• there is no effect of conservative therapy;
• there is severe pain that cannot be relieved with medications;
• rapid progression of pathologies;
• development of complications of kyphosis, leading to disturbances in the blood supply to organs and tissues, and the functioning of internal organs.

There are several types of surgeries prescribed for kyphosis.:

1. Spondylodesis , carried out to align the vertebrae and secure them with rods or plates. This leads to loss of back mobility, but the ability to move remains;
2. Implants inserted in place of damaged vertebrae. Allows you to eliminate pain and other undesirable symptoms;
3. Kyphoplasty , one of the most modern treatment methods, used for kyphosis of 1-2 degrees. It involves the insertion of special capsules for fixation of pathological vertebrae.

Exercise therapy, massage

The greatest benefit for kyphosis comes from therapeutic exercises , which help strengthen the back muscles, correct posture, and normalize blood circulation. When performing exercises recommended by a doctor, it is important to monitor the condition of the body and not exceed the load. Massage, as well as manual therapy, usually bring benefits only in the initial stages of the disease and will help correct posture, normalize muscle tone, realign the vertebrae and intervertebral discs, and help normalize blood circulation.

Video: “How to correct thoracic kyphosis?”

Treatment at home or with folk remedies

At home, with kyphosis, you can use a number of methods that increase the tone of the tissues of the spinal column and its frame:

• propolis ointment is made by grinding and adding to a nourishing cream, which is then applied in a thin layer and thoroughly rubbed into the skin twice a day for 3 weeks;
• bear and lamb fat , mixed in equal proportions, previously melted in a ceramic bowl, poured into a convenient container and allowed to harden. Twice a day they need to be melted and applied to the sore area of ​​the back, after which it is wrapped in a blanket for one hour.

Which doctor should I contact?

Kyphotic changes in the spine are treated by orthopedic traumatologists, as well as neurologists if the patient has neurological disorders caused by pinched nerve roots. It is important to understand that the success of therapeutic measures directly depends on the timeliness of contacting specialists. This allows you to start treatment of the disease on time, prevent its progression and the development of complications.

You need to take the choice of a doctor responsibly and entrust your health exclusively to specialists with extensive experience and a sufficient level of competence in the treatment of various pathologies of the spine associated with its curvature and poor posture.

The most important

Grade 1 kyphosis is easy to treat, but difficult to detect. Stage 2 disease manifests itself with more pronounced symptoms, so you should consult a doctor when the first symptoms appear, then the problem can be solved without surgery. Pathology of 3 – 4 degrees can be cured only by surgical methods. To avoid the development of the disease, it is necessary to eliminate provoking factors: injuries, muscle weakness, infectious diseases, etc. To do this, you need to monitor your posture, exercise, eat right, take vitamins, minerals, and treat spinal diseases in a timely manner. For heavy work or professional sports, it is recommended to wear a support corset.

IV degree

It is characterized by a curvature of the spine that is 71 degrees or more. Patients suffering from the most severe form of kyphosis should completely exclude independent movement, unless this has already happened due to progressive disease. Such a serious curvature of the spine poses the highest threat to all vital systems of the body: circulatory, respiratory, musculoskeletal and nervous. The only treatment option in this case is surgery. However, there are also cases when it may be contraindicated.

Manifestations

Externally, kyphosis manifests itself with the following symptoms:

• At first, a slight stoop appears; over time, in the absence of treatment, a hump forms or the back in the thoracic region takes on an arched shape.
• The shoulders protrude slightly forward and lean down.
• The shoulder blades are retracted.
• The chest narrows.
• The stomach protrudes slightly, the back and abdominal muscles weaken.

Kyphosis initially manifests itself as stooping

Patients complain of aching pain in the upper back and limited mobility of the spine. These symptoms indicate excessive tension in the muscles around the affected area, compression of internal organs and gradual destruction of the intervertebral discs. The pain can radiate from the back to the neck and lower back.

When the spinal nerves are compressed, sharp pain appears and the sensitivity of those areas for which the affected nerves are responsible is impaired. In advanced cases, a compensatory reaction is observed, which is manifested by increased lordosis in the cervical and lumbar segments. Then the curvature becomes more pronounced, and the patient gets tired faster even with minimal physical activity.

With kyphosis, the chest narrows and lung capacity decreases. Then shortness of breath occurs, colds become more frequent, which are complicated by inflammation of the bronchi and lungs. A displaced spine disrupts the functioning of the heart, causing the heart rate to increase and blood pressure to rise. Due to the pathology, disorders of the functionality of the gastrointestinal tract occur, which is manifested by decreased appetite, belching, stool disorders, etc.

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Scoliosis, kyphosis, stoop, Scheuermann's disease.

There are many types of postural disorders. But the most common posture disorders, which can be found in approximately every fifth person, are scoliosis, that is, curvature of the spine, and kyphosis, a stooped posture.

Non-specialists often confuse these two concepts. Meanwhile, scoliosis and kyphosis are not the same thing .

Scoliosis is a curvature of the spine to the right or left relative to its axis. The most common types of scoliosis are the thoracic and lumbar spine. Scoliosis is an asymmetry of the body, not only the curvature of the spine, but also protruding shoulder blade or ribs on one side (right or left).

Kyphosis is a stooped position, excessive curvature of the spine in the thoracic region. With kyphosis, the relative symmetry of the body is preserved.

Although in fairness it must be said that sometimes kyphosis (stoop) is aggravated by scoliosis. This combination is called kyphoscoliosis. But in general, kyphosis and scoliosis are different conditions and should be considered separately.

Note from Dr. Evdokimenko. Since even a healthy spine has a slight kyphosis in the thoracic region, it would be more correct to call stooping hyperkyphosis. But since the term “kyphosis” has already been established in relation to stoop, you and I will also use this not entirely correct definition.

Below I will tell you in detail about kyphosis, which is often a consequence of Scheuermann's disease. And if you need more detailed information about scoliosis, you can get it on the website of therapeutic exercise specialist Lana Paley:

Types of scoliosis and causes of scoliosis: what causes curvature of the spine to the right or left relative to its axis. Scoliosis of the thoracic and lumbar spine.

Consequences of scoliosis for health, complications of scoliosis: dysfunction of internal organs in scoliosis. Myths about the health consequences of scoliosis.

Treatment of scoliosis: special gymnastics, manual therapy, wearing corrective corsets, breathing exercises using the Katharina Schroth method.

Scheuermann's disease: kyphosis, stoop, juvenile osteochondrosis

The roots of most problems associated with the spine go back to our youth, and with age they only get worse and become more noticeable. This can be most clearly demonstrated using the example of Scheuermann's disease.

Scheuermann's disease (juvenile osteochondrosis, kyphosis, stoop) is a very common disease, the second most common of all chronic back diseases. Scheuermann's disease affects 5% of the population in a severe form, and almost every fifth person on the planet suffers from a mild form!

And at the same time, Scheuermann's disease has been little studied. When I began studying Scheuermann's disease 15 years ago, I was confronted with a distinct lack of literature on the disease, which seemed rather strange given its prevalence. And until now, medical reference books rarely devote more than three to five pages to this disease.

On the Internet, the situation is even more deplorable - some information about Scheuermann’s disease is popping up, but this information is very contradictory, and most often just idiotic! People who write about Scheuermann's disease often do not understand at all the principles of its appearance and development! And they even confuse hyperkyphosis (Scheuermann's disease) with scoliosis!

Even more strange is that the mechanism of development of Scheuermann's disease is practically not understood by most doctors, and even those specialists who know about it most often have little idea of ​​how to treat this disease. I believe that we need to fill this gap. Below I will discuss in detail the causes, development, symptoms and treatment of Scheuermann's disease.

Causes of stoop, kyphosis and Scheuermann's disease

Stooping can occur for a number of reasons: due to severe rickets suffered in childhood, due to serious chronic diseases that weaken the child’s body; due to congenital weakness of the back muscles; due to reflex tension of the pectoral muscles; due to a prolonged bent position of the body (at a machine, at a desk, etc.).

But most often, stooping first appears in adolescence, during the period of active growth, that is, at 11-15 years. And the most likely to “get” stoop and Scheuermann’s disease are teenagers who have grown more than others during their growth period. That is, people who have “stretched out” to a tall height suffer from Scheuermann’s disease somewhat more often than people of short and average height.

In addition, those most susceptible to teenage stoop are slender and “thin-boned” teenagers who do not have a strong muscle corset and have not inherited wide, strong bones.

Naturally, children and adolescents who lead an inactive lifestyle and prefer sitting at books or a computer to physical activity are also at risk. And also children and teenagers who are emotionally “squeezed” and prone to sadness; teenagers who are often bullied at home or at school; teenagers who are burdened with too many responsibilities from an early age.

Observation of Dr. Evdokimenko. Children, teenagers and young people of both sexes, living in prosperous families, but “under the supervision” of overly domineering or overly controlling parents, slouch especially often. Such parents, without realizing it, put constant pressure on the child’s psyche with their demands, claims or high expectations. “Be like this... Achieve this... You must become... You must study straight A's... In our family everyone has a higher education (all professors, academics, geniuses - underline what is necessary)... My child is simply obliged...”

In general, continuous “must, must, be, achieve, etc.” Not every person, and especially not a child, is able to live painlessly under such pressure and meet the excessive expectations of their parents. And if the child also initially has increased responsibility and is not able to “kick”, then he constantly lives in colossal stress.

In response to tension and negative emotions, the child reflexively, due to an innate behavioral instinct, takes a so-called passive-defensive pose. A passive-defensive posture is characterized by dropped shoulders, a lowered head, and a hunched back. With frequent repetition, such a pose can become (and often becomes) habitual, firmly anchored in the stereotype of posture.

“Posture expresses the state of the soul,” Russian Army General Gustav Mannerheim liked to repeat. Many psycho-emotional diseases and neuroses are directly related to poor posture. “If you want to have a hunched over sick child, scold and punish him more often, more often force the child to do what he does not like. If you want to raise a child healthy and beautiful, praise him more often and cherish him, like the rarest and most beautiful flower,” says psychologist Pavel Paley.

Development of stoop, kyphosis and Scheuermann's disease

The reasons why Scheuermann's disease manifests itself during the growth period are obvious. At this time, the teenager’s skeleton begins to grow especially quickly. The spine also rapidly stretches, “lengthens.” However, the back muscles do not have time to grow and strengthen at the same speed as the spine grows in length.

As a result, the back muscles appear to be stretched along the elongated spine. Due to the fact that the muscles are stretched along the spine, they are more difficult to contract and perform their supporting function (the function of holding the spine) worse.

That is, the back muscles, being stretched and weakened, do not maintain good posture. The muscles of the thoracic spine (the muscles of the middle of the back) and the interscapular muscles are particularly stretched and weakened.

As a result, it is difficult for a child to stand and sit straight for a long time - the muscles of the thoracic back of such a child quickly get tired, and he begins to slouch.

Due to stooping, the muscles of the thoracic spine are stretched even more; we can say that they partially atrophy. In the most severe cases, the muscles of the thoracic back almost do not support the back at all. And left without muscle support, the vertebrae of the thoracic spine (when carrying heavy objects, jumping, standing, long walking and even long sitting) are subject to increased pressure and flattened in front, which leads to even greater stooping.

As you understand, due to stooping, the static balance of the body is disrupted. But since our body tries to prevent imbalance under any circumstances, it compensates for stooping (that is, an increase in thoracic kyphosis) by counter-strengthening the lumbar curve (lordosis) and contracting the lumbar muscles.

Sometimes this “compensatory” contraction of the lumbar muscles causes a teenager to feel a feeling of heaviness in the lower back at the slightest vertical load - walking, running, standing. In addition, over time, spasm of the psoas muscles can impair the flow of blood from the lower extremities and cause poor circulation in the legs.

The course of the disease in a number of patients can be complicated by displacements of the intervertebral joints in different parts of the spine, which sometimes leads to a noticeable deterioration in well-being (but such displacements, fortunately, do not occur in every patient).

And finally, in the worst case, deformation of the thoracic spine leads to hunchback, “compression” of the chest occurs and a decrease in the respiratory capacity of the chest (lung volume), which contributes to the development of frequent bronchopulmonary diseases.

But, I repeat, it is extremely rare to reach such a deplorable state - only in one patient out of ten. So let's now go back a little and see what happens to the vertebrae of an ordinary patient.

As you know, the condition of bones (their density) depends on the activity of the blood supply, and in the spine, the role of a kind of pump for pumping blood is performed by the back muscles. Due to the fact that with Scheuermann's disease, the “pumping” of blood by the muscles of the middle of the back sharply decreases, the blood supply to the vertebrae deteriorates and they become less durable and are easily “pressed”.

It is with Scheuermann's disease that Schmorl's hernias form (which we talked about in the chapter on disc herniation), sometimes single, and sometimes multiple. In addition, as you already know, with advanced Scheuermann's disease, the vertebrae flatten in the front and take on a typical wedge-shaped shape, making the disease easily recognizable on an X-ray taken from the side.

Now let's digress a little and try to solve the riddle. One of the medical names for Scheuermann's disease is adolescent spinal osteochondrosis .

It’s strange what the respected professors had in mind when they chose the term “osteochondrosis,” which implies a change in the cartilage tissue of the intervertebral discs, if, perhaps, the only thing that is not damaged in the spine during Scheuermann’s disease is the intervertebral discs! They remain so strong that they “manage” to push through the vertebra, that is, they turn out to be stronger than bone!

As you can see, the use of the term “osteochondrosis” is completely unlawful in this case. However, this is far from the first and not the last case in medicine when names are used that incorrectly reflect the essence of the disease.

Symptoms of Scheuermann's disease

The first, earliest symptom of Scheuermann's disease is a feeling of heaviness and fatigue in the back. Moreover, often a child’s complaints about fatigue are perceived by parents as a sign of laziness and are ignored. But it is actually difficult for a child to stand or sit straight for a long time; he wants to lie down to relieve tired back muscles.

As the disease progresses, minor back pain called “fatigue pain” often appears. These pains rarely become intense, so seeking medical attention is usually delayed.

At first, the “fatigue pain” disappears after a short rest. However, over time, rest ceases to bring noticeable relief and the feeling of “heaviness” bothers the child even after sleep. Subsequently, a characteristic external feature becomes noticeable: stooping, which becomes more and more aggravated.

Note from Dr. Evdokimenko. The presence of stoop (kyphosis) is checked against the wall. You need to stand with your back to the wall, press your heels, buttocks, shoulders and the back of your head against the wall. A child with correct posture will fulfill such a request easily, as if it were something natural. A stooped child suffering from Scheuermann's disease will have to make a noticeable effort to press the back of his head and shoulders against the wall, without lifting his heels and buttocks from the wall. In addition, when externally examining a stooped child, we are immediately struck by his drooping shoulders and protruding or somewhat saggy belly.

Gradually, limited mobility in the thoracic spine and shortening of the lumbar muscles are added to the first symptoms. If, due to shortening and spasm of the lumbar muscles, the passage of blood to the lower extremities worsens, then after exercise or when the weather changes, the teenager’s legs begin to “twist”. My legs “twist” especially badly at night.

Sometimes painful spasms of the muscles of the lumbar region and displacement of the vertebrae of the thoracic spine occur, which can lead to attacks of noticeable pain in these areas of the back.

The peak of the disease occurs between sixteen and twenty years of age, after which, oddly enough, the condition of many sufferers improves somewhat: after all, the formation of the skeleton by this age is basically completed, and the body adapts to incorrect posture.

The relatively prosperous period lasts 10-15 years, but from about the age of thirty-five, if no measures are taken, the state of health slowly deteriorates again. After all, at this age, the natural reserve of strength dries up, and most thirty- to thirty-five-year-old people do not engage in maintaining good physical shape.

Without proper treatment, changes in well-being - sometimes improvement, sometimes worsening - accompany the patient throughout his life, but one thing remains unchanged - stooping and a feeling of constant fatigue in the back and legs.

In old age, circulatory problems in the lower extremities may occur, which is manifested by decreased sensitivity of the legs and difficulty walking; feet are constantly cold - blood has difficulty passing to the tips of the toes. The skin of the legs becomes dry, rough, and sometimes trophic ulcers form on the legs. But, fortunately, this does not come to this very often, only in extremely advanced cases.

Examination for kyphosis and Scheuermann's disease

In typical cases, the clinical picture of Scheuermann's disease is so characteristic that clarifying the diagnosis does not present any difficulties - an X-ray of the thoracic spine is sufficient. On an x-ray, a competent doctor can easily recognize Schmorl’s hernias and wedge-shaped deformities of the vertebrae of the thoracic spine.

Other examinations are carried out when there is any doubt, for example, when Scheuermann's disease is accompanied by atypically severe pain. Magnetic resonance imaging and blood tests may then be required to rule out other concomitant spinal pathologies.

By the way, it will be useful for parents of boys to know that the detection of a wedge-shaped deformation of 2-3 vertebrae on an x-ray of the spine or the presence of several Schmorl’s hernias can serve as a basis for exemption from military service.

Combating stoop, treating kyphosis and Scheuermann's disease

The classical treatment of Scheuermann's disease according to medical textbooks looks rather strange, given the development of the disease. For example, it is customary to prescribe chondroprotectors to such patients - drugs for the treatment of cartilage tissue. The logic of such prescriptions is completely inexplicable, because cartilage is practically not damaged in Scheuermann’s disease!

Physiotherapy is often prescribed - usually to relieve pain or improve circulation - which, of course, is an important, but secondary goal.

Gymnastics, which is recommended by most textbooks and “wanders” from book to book, is monstrously illiterate! - after all, it mainly consists of stretching exercises. And this is doubly surprising, because with Scheuermann’s disease the muscles are already overstretched and weakened in the middle back.

But what strikes me most is the advice of many authors to constantly wear a corset to correct their posture. Of course, as long as the patient wears a corset, the appearance of improvement is created. But the muscles under the corset become unaccustomed to the load - and some time after the corset is removed, the posture worsens even more. All this is quite sad, considering that such treatment of the disease is practiced by most government medical institutions.

But the situation is much worse when treating Scheuermann's disease in many commercial medical centers. Even after making the correct diagnosis (which does not always happen!), doctors at paid centers strive to prescribe the most “commercially reasonable” treatment to the patient - a large number of procedures are performed, and the “best, newest” medications are prescribed. All this, of course, makes the right impression on the patient, but does not contribute to his recovery at all.

Meanwhile, coping with the manifestations of Scheuermann's disease (or significantly reducing them) is actually not that difficult. You just need to think through each step and act consistently, but at the same time understand that it is impossible to eliminate such a deficiency at once and, unfortunately, there are no magical instant treatment methods.

And yet, with sufficient determination, acting competently, taking into account the causes of the disease, it is almost always possible to achieve significant positive results.

So where to start? If we are talking about a child, you need to choose the right furniture for him to do homework and play (or work) on the computer. The “angle rule” will help you avoid making a mistake in choosing a chair or computer chair: for a sitting person, the lower leg and thigh should form a right angle. Both adults and children would benefit from a work chair with a special convex back that prevents the back from slouching. Another rule: regardless of the type of chair (chair), your feet should rest on the floor and not dangle or be tucked under the chair (chair).

In general, given that at school a child is forced to sit for a long time (at a desk), try to arrange so that at home the child takes a break from a sitting position more often. You can even allow him to prepare his homework while lying down or reclining.

We spend about a third of our lives sleeping. Therefore, it is very important to choose the right mattress for your bed or sofa. The mattress should be quite dense and even (a mattress that is too soft, and even more so a sagging mattress is absolutely not suitable for a child suffering from Scheuermann's disease).

However, remember that recommendations requiring sleeping on boards or a wooden board are already outdated. Of course, if normal treatment is not carried out, there is nothing else left to do but come up with such executions, but they will not solve the problem. What can really help is properly selected therapeutic exercises.

Therapeutic gymnastics is the main, most important and most necessary method of treatment: it ensures 80% of success in the treatment of Scheuermann's disease.

First of all, as you understand, you need to strengthen the muscles of the middle back (thoracic spine).

To a much lesser extent, with Scheuermann's disease, the muscles of the neck and lower back are strengthened. But you must definitely pay attention to the gluteal muscles, which are almost always weakened in such patients. It has been noticed: the stronger the gluteal muscles, the easier it is for a person to maintain correct posture.

Strengthening exercises, which are given in Chapter 21, must be done for Scheuermann's disease for at least 40 minutes, strictly every other day or at least 3 times a week. There is no need to do such exercises every day - otherwise the muscles will not have time to rest and recover. But doing them less than 3 times a week is practically pointless: then the muscles will not be able to strengthen properly.

In addition to strengthening exercises, 10-15 minutes a day should be devoted to stretching exercises for the lumbar muscles to reduce their spasm and tension.

The minimum result from gymnastics can be expected no earlier than 2-3 months, and to achieve a lasting effect you need to practice for at least six months to a year, after which you can reduce the duration of exercise to 30 minutes (3 times a week).

Of course, this is an average approximate lesson plan. In fact, any treatment (and gymnastics is also a treatment!) must be prescribed and prescribed by a doctor, taking into account the stage of the disease and the patient’s condition. In general, I would like to warn any potential patient against amateur activities, even in the field of gymnastics: you can also harm yourself with gymnastics if you do it incorrectly and inappropriately.

And although I have collected in this book exercises that I consider extremely useful for back diseases and Scheuermann's disease, before you start doing them, consult with your doctor. He may have reasonable objections, especially if there are any contraindications for gymnastics related to the condition of your body.

However, for those who do not have the opportunity to consult a doctor, in conclusion I will say two words about what kind of gymnastics should never be done with Scheuermann’s disease.

I categorically forbid a person who wants to improve his posture from doing exercises aimed at strengthening and “pumping up” the chest muscles. After all, being strongly “pumped up”, the pectoral muscles pull the shoulders forward, which further aggravates the stoop.

At one time, when I was 18 years old, I also noticeably stooped. The stooped position gave the misleading impression that my pectoral muscles were not developed enough, so my sports trainer constantly demanded: “pump up your chest.” That's what I did. As a result, my shoulders pulled further and further forward, I slouched even more, and my chest “sank” - which is why my pectoral muscles visually became smaller and smaller. That is, the more I trained my pectoral muscles, the worse they looked.

Only over time I realized the mistake and began to do the exact opposite: I left the pectoral muscles alone and began to strengthen the interscapular muscles, the muscles of the middle back. After about six months, my posture improved noticeably and my chest expanded. Then it turned out that my pectoral muscles had been quite developed all this time. It’s just that before, against the backdrop of the “sunken” chest, they shrank and seemed smaller than they are.

The most curious thing is that mistakes similar to the one described above by my coach are still made by about half of the coaches or physical education instructors.

The second common mistake of sports teachers is that they often recommend to slouched people various exercises with weights: kettlebells, barbells, etc. But since in Scheuermann’s disease the muscles do not support the back, almost the entire load falls directly on the thoracic vertebrae. The result is increased deformation of the vertebrae, their flattening and multiple Schmorl hernias.

Attention! With Scheuermann-Mau disease, all exercises performed with weights (more than 10 kg) can only be done while lying down.

Back massage for Scheuermann's disease is used to restore blood circulation in the muscles and is especially useful in combination with gymnastics. In this case, massage accelerates the recovery and metabolic processes in the muscles after exercise, and in addition, increases muscle tone and strength. After a massage session, many patients note that they can stand straighter and find it easier to hold their back.

Of course, you need to understand that you cannot achieve results with just a massage, and in addition, with Scheuermann’s disease, it is advisable to do massage regularly, at least 2-3 courses per year for 8-10 sessions. Due to the relative high cost of the procedure, not everyone can afford it. Therefore, it turns out that only gymnastics can be better than gymnastics, and massage is only an optimal addition to it.

Postisometric relaxation (PIR) for Scheuermann's disease is required in cases where there is spasm and shortening of the lumbar muscles. There is no other method that can better stretch and relax the lower back muscles. Therefore, post-isometric relaxation is necessary for almost half of the patients, and some of them require a fairly large number of such procedures - from 6 to 8 sessions, carried out 2 times a year.

Manual therapy for Scheuermann's disease, on the contrary, is used minimally, and only when there are displacements of the intervertebral joints in some specific areas and when the patient is ready to do gymnastics in the future. Otherwise, the patient’s condition may even worsen over time - manual manipulations carried out too actively by such patients, with weakened muscles and ligaments, can cause further “loosening” of the spine.

I remember such a sad example. Once at my appointment there was a young man who had been treated at one of the commercial centers. He went there with complaints of moderate pain in the thoracic spine, and the center’s doctors immediately got down to business: they conducted six sessions of manual therapy, without prescribing either gymnastics or massage. Therefore, although the patient’s condition initially improved briefly, after a month the pain returned and became even stronger. The young man turned to the same center again - and everything happened again. In total, the patient managed to undergo twenty-five (!) manual therapy sessions over six months. The result was sad: the young man’s spine resembled a bunch of hinges: it seemed that he could bend as he liked in any direction, but was absolutely unable to fix and maintain the position: his back got tired and began to hurt almost immediately.

As a result, where timely treatment would have taken three to four months, we had to work for almost another year, and it took enormous effort from the patient himself to finally correct the situation.

In order to avoid similar mistakes, for the past five years I have been conducting a preliminary conversation with patients even before prescribing manual therapy: I must be sure that after performing manual manipulations, the patient will follow the recommendations for therapeutic exercises. Otherwise, responsibility for the failure of treatment lies not only with the patient who refused to work, but also with me.

In most cases, medications are not needed for Scheuermann's disease. Only when the destruction of the vertebrae has gone too far and there is a possibility of further deterioration of the spinal bones, do I still recommend medications to patients to strengthen the skeleton.

These could be either vitamin D supplements or other medications to strengthen bones. However, it must be borne in mind that most of these medications are intended only for patients over 18 years of age. Younger patients can be offered fish oil that they “hate” (it is now available not only in liquid form, but also in capsules: taking them is much easier and more pleasant).

Other treatment methods for kyphosis and Scheuermann's disease , from my point of view, are absolutely not relevant and are a waste of time and money. And in general, as already mentioned, 80% of the key to success in this disease is correctly selected therapeutic exercises, which do not require financial costs or complex special devices. So, no matter how trite it sounds, in this case the patient’s health is the work of the patient himself.

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Article by Dr. Evdokimenko© for the book “Back and Neck Pain”, published in 2001. Edited in 2011

All rights reserved.

How does the treatment process work?

In our center, all therapeutic measures are aimed at eliminating the root cause of kyphosis, eliminating negative symptoms, pain, and also providing assistance in correcting the existing curvature of the spinal column.

At the initial appointment after diagnostic procedures, the doctor selects an individual approach taking into account the degree of curvature and existing symptoms.

The key technique in the comprehensive approach to treating kyphosis in our Center is kinesitherapy - a unique method of treatment with movement on special decompression simulators. This method of treating kyphosis very effectively eliminates the cause of the disease - muscle weakness and incorrect posture, and strengthens the muscle corset.

Plus, kinesi training prevents the abrasion of cartilage, which not only relieves the pain symptom by relaxing the muscles and bringing them to normal, but also prevents.

Elimination of kyphosis is carried out using an individually selected set of exercises for each patient, which is formed on the basis of an examination and according to the results of special tests during myofascial examination to clarify the muscles that need strengthening. Thanks to testing, it leaves a balanced complex of effective treatment for kyphosis. The patient can perform it in our gym on decompression machines under the supervision of an instructor and doctor.

As part of a comprehensive program, kyphosis therapy in our Center is complemented by the use of:

• medical massage that improves blood circulation in the affected area and relieves muscle blocks;
• physiotherapy using special devices to reduce pain and inflammation;
• manual therapy to facilitate restoration of the normal position of the spine;
• osteopathy, which allows for targeted action on the source of problems, eliminates spasms, and alleviates the patient’s general condition;
• reflexology – gives a focal effect in the treatment of the spine, creates conditions for eliminating pain.

After completion of treatment for each patient, a system of supportive preventive exercises, which the patient can perform at home, and if adjustments or questions are necessary, always seek a consultation with a kinesiotherapist and other specialists of our medical Center.

We are ready to restore beautiful posture, the joy of light movements and the health of the spine!

To make an initial appointment, please call or online on the website. Leave your contact information and our administrators will call you back to determine a convenient time to visit the doctor’s office for an initial consultation at the Innovative Medical Center.

The article was reviewed by traumatologist-orthopedist V.Yu. Bogdanov.