Why does our back curve with age and what can we do to prevent it?

As we age, it's common to notice changes in posture: shoulders round, head leans forward, and back begins to curve. You may associate this with older people and wonder: Will this happen to me? Can I prevent it?

Although colloquially referred to as a " hump ," the medical term for a curved back is kyphosis. When the curvature exceeds what is considered normal (more than 40 degrees), we speak of hyperkyphosis. In particularly severe cases, it can cause pain, reduced mobility and physical function, or a lower quality of life.

A healthy spine has an elongated S shape, so a curve at the top is completely normal.

However, when this curvature becomes exaggerated and fixed, preventing the back from staying straight, it may be a warning of a problem.

A common cause of this change in the shape of the back is poor posture. In fact, postural kyphosis is relatively common due to muscular imbalances, especially in young people who spend many hours hunched over in a chair, at a desk, or looking down at their phones. Fortunately, this type of back curvature can usually be reversed with proper exercises, stretching, and postural awareness.

In older people, kyphosis or hyperkyphosis often appears as a result of wear and tear on the spine, especially when, as a result of osteoporosis—a disease that causes bones to become more fragile with age—the vertebrae of the spine crack and fracture. In these cases, the cause is not due to poor posture, but to a structural change in the spine.

With age-related hyperkyphosis, the back curves even when the person tries to stay upright. At the same time, a person often loses height, even more than 3-4 centimeters. It is also often accompanied by back pain and stiffness.

When the bones of the spine grow unevenly during adolescence, a pronounced forward curve forms in the upper back. This is known as Scheuermann's kyphosis.

There is also a rare congenital kyphosis, present from birth and caused by improper formation of the spinal bones. It can lead to a more severe, fixed curvature that worsens as the child grows.

If the spine curves sideways in a C shape (or S shape when viewed from behind), we call it scoliosis. An excessive inward curve in the lower back, when viewed from the side, is known as lordosis.

In addition to these structural conditions, arthritis and, in rare cases, certain spinal injuries or infections can also contribute to hunching.

If you've noticed your spine developing a more pronounced curve, you're experiencing ongoing back pain, or you've recently lost height, you may be experiencing signs of a vertebral fracture. In that case, it's a good idea to make an appointment with a healthcare professional.

Although one in five older adults suffers a vertebral fracture, up to two-thirds of these injuries go undiagnosed and untreated. Therefore, health professionals recommend a spinal X-ray for people with unexplained back pain, identified kyphosis, or who have experienced height loss of 3 centimeters or more.

Place your head in line with your shoulders and your shoulders over your hips.

The best way to prevent back curvature is to maintain strong bones, active muscles, and proper posture. This involves:

- Do resistance exercise regularly , especially for your upper back muscles.

- Stay physically active at least 150 minutes a week.

- Consume enough protein, calcium, and vitamin D to ensure healthy bones and muscles.

- Avoid smoking and limit alcohol consumption to reduce risk factors that worsen bone density and overall well-being.

- On the other hand, it's important to pay attention to your posture when sitting and standing. Keeping your head aligned between your shoulders and your shoulders over your hips drastically reduces tension on your spine.

- It is best to practice exercises that strengthen the muscles that support an upright posture , especially the upper back and trunk, while improving the mobility of the chest and shoulders.

In general, it is advisable to prioritize extension movements, that is, those that consist of straightening or lifting the spine and pulling the shoulders back.

Repeated forward bending movements can worsen the condition, especially in people with osteoporosis or vertebral fractures.

Some recommended exercises are:

- Back extensions , gently lifting your chest off the floor while lying face down.

- Resistance exercises targeting the muscles between the shoulder blades.

- Brisk walking, jogging, climbing stairs , or dancing with light weights helps keep bones strong and promotes overall fitness.

- Stretching your chest and hip flexors opens your posture and relieves tension.

Flexibility and balance training, such as yoga or Pilates, can also be beneficial, especially for postural awareness and mobility. However, research increasingly points to muscle strengthening (weight lifting or resistance training) as a cornerstone of spinal curvature prevention and treatment.

All that said, if you suspect you have kyphosis or already have osteoporosis or a vertebral fracture, consult a healthcare professional before starting an exercise program. You may need to avoid some activities.

On the other hand, keep in mind that the curvature can be reversed if it was caused by poor posture and muscle weakness. However, if it's due to bone changes, especially vertebral fractures, it's unlikely to disappear completely, although treatment can reduce pain and slow its progression.

Protecting your posture isn't just about appearances—it's about keeping you strong, mobile, and independent as you age.

Article published in The Conversation .