Kyphosis

Quick answer: Kyphosis is the natural outward curve of the upper back. When the curve becomes excessive and the upper back rounds forward, it’s called hyperkyphosis, or hunchback posture.

Also called: thoracic kyphosis, roundback; used loosely for hunchback.

Is kyphosis normal?

Yes. Every healthy spine has an outward curve in the upper back, balanced by inward curves in the neck and lower back. It becomes a concern when the curve is exaggerated, stiff, or getting worse.

What are the types of excessive kyphosis?

• Postural kyphosis: from habits such as long hours hunched forward. According to the American Academy of Orthopaedic Surgeons, it’s usually flexible and improves when you stand tall.
• Scheuermann’s kyphosis: a structural form that develops in adolescence, when some vertebrae grow wedge-shaped.
• Age-related kyphosis: often a mix of posture, muscle strength and, sometimes, bone loss from osteoporosis.
• Congenital kyphosis: present from birth because of how the spine formed.

How many degrees of kyphosis is normal?

The American Academy of Orthopaedic Surgeons puts a normal thoracic curve at 20 to 45 degrees. A curve greater than 50 degrees is considered abnormal, and surgery is generally only discussed past 70 to 75 degrees or with severe pain. Published thresholds vary slightly between sources, with some clinicians using 40 degrees as the cut-off.

The practical point: a rounded upper back is not automatically a problem. Some curve is supposed to be there, and most people who worry about theirs are well inside the normal range.

What is the difference between kyphosis and lordosis?

They are the two directions a spine curves, and a healthy spine has both. Kyphosis curves outward, lordosis curves inward, and they alternate down the spine to keep your head balanced over your hips.

Feature	Kyphosis	Lordosis
Direction of curve	Outward — the back of the body is convex	Inward — the front of the body is convex
Where it belongs normally	Upper back (thoracic) and sacrum	Neck (cervical) and lower back (lumbar)
What it looks like when excessive	Rounded, stooped upper back. Called hyperkyphosis, roundback or hunchback	Exaggerated arch in the lower back, often with the pelvis tipped forward. Called hyperlordosis or sway back
What it looks like when reduced	Flat upper back (hypokyphosis or flatback)	Flattened lower back, or in the neck a straightened or reversed curve — military neck or cervical kyphosis
Read more	Hyperkyphosis · Hunchback posture	Hyperlordosis · Sway back

Because they alternate, they also influence each other. An exaggerated curve in one region often comes with a compensating change in another, which is why assessing one part of the spine in isolation tends to miss what is actually happening.

Which page do you actually need?

“Kyphosis” covers a lot of ground, and the useful page depends on what you are looking at:

• A visibly rounded upper back, and you want to know what to do about it → hunchback posture
• A bump where the neck meets the upper back → neck hump
• The clinical term and the measurements → hyperkyphosis
• Your neck has lost its curve on a scan → cervical kyphosis or military neck
• A sideways curve as well as a forward one → kyphoscoliosis
• Your head sits ahead of your shoulders → forward head posture

Sources

• Kyphosis (Roundback) of the Spine. OrthoInfo, American Academy of Orthopaedic Surgeons.

Related terms

• Hyperkyphosis
• Hunchback
• Neck hump
• Cervical kyphosis
• Lordosis

Learn more and take the next step

For self-checks, causes and exercises, read our full guide to hunchback posture. For a bump at the base of the neck, see neck hump.

If you’d like someone to look at what’s driving your posture, a free 30-minute consultation starts with a postural assessment, in one of our clinics or through virtual posture therapy.

This entry is general education, not medical advice. If you have pain, numbness, weakness, or a change in your posture that appeared quickly, see a physician first.