Khoo Bee Khim
CNA – If you’re reading this on your mobile device, consider it a reminder to raise your head and straighten your back. That’s because, other than back and neck aches, you could be setting yourself up for a dowager’s hump – a rounded protrusion on your upper back – down the road.
“The medical term is kyphosis of the spine and it typically affects the middle and upper portions of the spine (or what is known as the thoracic spine),” said deputy head of Orthopaedic Department and Head of Service (Spine Surgery) at Tan Tock Seng Hospital Adjunct Associate Professor Dr Jacob Oh.
“Generally speaking, all adults will have some degree of kyphosis in this area but an excessive curvature is abnormal and gives the appearance of a hump from the side profile,” he said.
COMMON AMONG OFFICE WORKERS
While there’s no evidence that a “text neck” causes permanent structural kyphosis, poor posture and the excessive curvature that Dr Oh mentioned are probably linked.
“Poor postural habits with a head-forward tilt, which are associated with mobile device use and desk work, will aggravate the kyphosis in our upper back and cause a more prominent dowager’s hump,” said a senior physiotherapist with Core Concepts Xu Weijie. “This is because prolonged poor posture weakens our back muscles and spinal ligaments.”
In fact, dowager’s humps are common in more than 80 per cent of the office population that Xu sees, although they are usually incidental findings rather than the main complaints.
“This is due to the above reasons where this population deals with long hours of desk work and mobile device usage,” he said.
Weight gain from too much snacking and inactivity at work can also worsen the kyphosis, especially if you have considerable heft in your mid-section. “Our centre of gravity moves forward at the abdomen area, which causes the cervical and thoracic spine to compensate by rounding more to balance out the forward shift of the abdomen,” said Xu.
OTHER CAUSES
Age is another factor for kyphosis, which is why you may notice the back humps in your elderly parents or grandparents.
“As we grow older, the intervertebral disc in our spine degenerates and leads to more kyphosis,” said Dr Oh, who added that most patients are above the age of 70 and female.
“Women are more commonly affected as this condition is associated with osteoporosis.”
He added, “Another big group of patients, who present with this problem, are those who sustained a compression fracture, usually seen in elderly women due to osteoporosis. In osteoporosis, the bones become brittle, break easily and heal in a ‘wedge’ shape, which can manifest as kyphosis or bent spine.”
SOLUTIONS: WHAT WORKS, WHAT DOESN’T
The fortunate thing is, most patients are asymptomatic, said Dr Oh. “Apart from the cosmetic appearance, kyphosis seldom causes health issues and can be left alone.”
But if your situation is severe, that is, you have pain or the inability to stand upright, it warrants medical investigation, he said, which can involve “X-rays or a CT scan to make sure that there isn’t any neurological involvement”. In the case of an osteoporosis-related compression fracture, there is a need to assess that the fracture has fully healed, he said.
“If the pain is chronic and disabling, surgery can be performed to provide additional support and recreate the natural alignment of the spine,” said Dr Oh.
As for the neck support devices that you might have seen on the Internet, Xu isn’t opposed to using them in the short term if they do provide relief in the neck and upper back for you.
“However, the active approach of doing exercises and stretches is more important as it provides longer-term changes to improve posture and muscle strength to support our neck and upper back spine,” he said.
Here’s a look at Xu’s three stretching exercises that can also strengthen your upper back muscles and help you “hold a better upright posture for longer periods of time”, he said.
The exercises can reduce the imbalances in your muscles created by prolonged poor posture and help to reduce the overall prominence of the dowager’s hump with time, he said.
Lateral stretch
– Stand with your feet shoulder-width apart. Place right hand on your hip and raise left hand up
– Lean your up-stretched left arm to the side. Increase the stretch by pushing your hips in. Hold for 15-30 seconds and repeat on the other side. Do this every one to two hours.
Pectoral stretch
– Sit down on the edge of a chair. Place your hands behind you and interlock the fingers.
– Breathe in and push your shoulders back until you feel a stretch in your chest. Hold this position for 15-30 seconds, then breathe out and relax. Do this every one to two hours.
Postural correction stretch
– Start in a seated position, back straight and head looking forward.
– Bend your elbows at 90 degrees and face palms upwards. Keep your elbows close to your body, then point and pull your thumbs outwards until palms are slightly wider than shoulder-width apart.
– Pull your shoulders backwards, squeezing your shoulder blades together at the back. You should feel the muscles between the shoulder blades working and a stretch at the chest muscles in front. Hold for 15-30 seconds. Do this every one to two hours.
