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Dowager's Hump --- Causes and Cures

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December 18, 2015

By SUSAN CALLAHAN, Associate Editor and Featured Columnist



Dowager’s hump is that rounding at the  top of the spine that seems mostly to afflict men and women after age 50. Dowager’s hump, technically known as “kyphosis” or “gibbous deformity”, affects up to 50% of all women, according to a 2007 study from David Geffen School of Medicine at the University of California. The name is a misnomer as it implies that only women suffer from this condition, while studies have found that men have dowager's hump almost as often as women.

How Much Curvature Are We talking About?

Almost everyone has a little bit of curvature in the spine, so how much curvature must be present before it is classified as kyphosis? Many studies define a curvature of greater than 45 degrees as kyphosis.

To get a sense of how curved this is, if you are standing up facing a wall in front of you, you can’t see your toes, right? If you bend your head down enough you can see your toes and if you bend it way down you can see your whole foot.

Well, the little old ladies and men who walk around with a spinal curve so severe that they literally face the ground as they walk are at a 90 degree angle.  Halfway there is 45 degrees.

Why Should You Care About Kyphosis

Other than looking curved and older, why should you care about a dowager’s hump? You should care because a dowager’s hump puts you at increased risk for falls, according to a 2007 study led by Dr. D.M. Kado of the David Geffen School of Medicine, Los Angeles.

In this study of 1,883 older adults, men were more likely to be “hyperkyphotic” than women , meaning they had severe curvature. About 36% of those with hyperkyphosis suffered falls.

You should also care about dowager’s jump because it limits your mobility and increases your risk for fractures.

Finally, having kyphosis also increases your risk for dying. For every added degree of curvature, you increase your mortality risk by 14%, a 2009 study from University of California, Los Angeles found.

Kyphosis Is Not Usually Caused by Spinal Fractures










if you have a dowager’s hump, you may believe as many do, that the hump is caused by tiny fractures along your spine. Surprisingly, studies have found that this is not true. Even among those with the most severe curvature, only a little over a third (36% to 38%) have spinal fractures, according to a 1996 study from the Robert Jones & Agnes Hunt Orthopaedic and District Hospital NHS Trust in the UK .

Other studies, such as a 1999 study from the University of California at Los Angeles, have found only a 20% prevalence of spinal fractures among women older than 65.

If spinal fractures are not usually the culprit, then what is?

You’re a Forward-looking Being--And That’s a Problem

Back muscles, in general, are among the most neglected muscles of our body. We just don’t notice them until they hurt. Then, we only give them enough attention to make them stop hurting. In contrast, the fronts of our bodies get a lot of attention because we see it. If our eyes were located on the back of our heads, we’d all have pretty backs with beautiful straight spines.

But because we are “forward-looking” animals,  most of us are keenly aware when our bellies start to spread.

But what we don’t know is that with every added inch of abdominal fat, something else equally disastrous is happening --- the belly fat is making us tilt forward.

As a result, our spines have to endure a daily pressure pushing it forward , curving it toward the front.  If we did nothing but get older and fatter, our spines would curve.

Added to this, we also make the curvature worse with poor posture and carrying heavy bags, all of which, again, curve our upper shoulders forward.

More Rarely, Disc Disease or Genetics Cause Kyphosis

In rarer cases, degenerative disc disease can cause dowager’s hump, a 2011 study from the University of California at San Francisco.

Two genetic sources of kyphosis are “Scheuermann’s kyphosis”, where kyphosis is caused by abnormally shaped vertebrae and genetic deformities that occur when you are in the womb (congenital kyphosis).

We’ve found the following corrective habits to help you fix your dowager’s hump:

Cure Poor Posture to Correct Dowager’s Hump

We are a nation of slumpers. Slumping is one of the main causes of kyphosis, studies show. By slouching, we mean slumping down in a chair or leaning back in chairs.  To cure your posture, you first have to find what good posture feels like. Many of us can go for years without feeling our spines perfectly aligned.

A properly aligned spine lines up our ears with our shoulders and our eyes do not tilt toward the floor or toward the ceiling. As the classic sergeant drill says, “shoulders back, eyes forward, stand up straight”.

In yoga, you would call this pose your “Mountain Pose”, where your feet are balanced about shoulder width apart, your shoulders are back, your head and neck are lined up so that you look straight ahead.

When you are trying to stand tall in a Mountain Pose, you should imagine that there is a string out of the top of your head pulling you upward, straightening your spine.

You may feel tense when you  start to practice good posture because, frankly, most of us spend 16 hours a day in poor postural positions --- sitting down, slumped down, leaning on something.

If we spend just 5 minutes a day in proper alignment, it’s 5 minutes well spent.

Mind Your Bone Density

Low bone density makes it easier for your spine to curve. Protect your bone density by doing weight-bearing exercises (climb the stairs, walk 45 minutes a day preferably outside, do yoga).

You should also make sure you are getting at least of calcium and 700 IU of Vitamin D (choose D-3 because your body more easily absorbs it). You should also be careful to avoid getting too thin as you age --- not a problem for most of us until age 70.

Fly Like a Bird to Correct Dowager’s

If you strengthen the muscles responsible for maintaining a straight spine, you can begin to correct dowager’s hump. The major muscles of your upper back are the posterior deltoids, the rhomboid and the middle trapezius.

Lie on your stomach on the floor with your arms out at your side. Now, raise your arms up and down as though you are trying to flap them like a bird. This action will work the muscles of your upper back especially.  Most of us rarely target these muscles so it will be easy to tire yourself out. Over time, aim for doing 3 sets of 10 bird flaps. Skip a day in between the bird flapping workouts to give your muscles time to recover.

When these get too easy, you can consider adding weights. I use a simple bottle of water I hold a bottle of water in each hand. Then bend over at the waist at about the similar to the pose you use when you  are catching your breath. In this bent over posture, spread your arms out like a bird (or plane) while holding  the bottles of water.




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