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Introduction
The Dowager’s Hump is a type of postural problem that was usually seen in elderly women. The name- ‘Dowager’ is itself associated with the idea of an elderly woman or widow. But nowadays the Dowager’s Hump is seen in young adults and small children as well. This hump is a bump or a lump which forms at the neck’s base where the spinal cord has curved forward. There is a slight curve on the seventh vertebrae of our necks, but an individual with a Dowager’s Hump will have a more pronounced and abnormally curved spinal cord.
Dowager’s Hump in young people is usually a result of bad postures. It can be corrected by performing a number of exercises and postural modifications.
What Causes a Dowager’s Hump?
The development of the Dowager’s Hump is a result of constantly holding the body in a bad posture which affects the spinal cord and results in the pronounced curve on the back. While a bad posture might be the most common cause for a Dowager’s Hump, there can be other reasons too.
Osteoporosis– A person who suffers from osteoporosis is more likely to have a Dowager’s Hump because they have bones that are weaker and less dense than average people. When the bones get weaker, the spinal column is more likely to bend when the person bends and sits in incorrect positions, which results in the formation of the Dowager’s Hump. The Dowager’s Hump caused by osteoporosis is generally seen in the older people. A change in the diet where the intake of vitamin D and calcium is increased and correct postures can help in preventing the hump from occurring at all.
Genetics- Improper development of the vertebral column might be experienced by some people which can result in the formation of an abnormal curve or a hump in the spinal cord. This abnormality of the spinal cord that leads to the formation of Dowager’s Hump is due to genetics and can exist in other family members too.
Fractures in the spine- If a spine gets fractured, broken, damaged, or collapsed, on repairing itself, the spine can grow in the position of a Dowager’s Hump.
Incorrect posture- The most common reason for the formation of the Dowager’s Hump in young people today is improper and poor posture. Sitting and bending in bad postures tend to make the spinal cord bend in a pronounced manner which forms the Dowager’s Hump.
If the Dowager’s Hump is caused due to an injury or spinal defect, the person must seek medical help. After proper medical assessment, the doctors and physical therapists will be able to suggest the right treatment option for you.
One of the main reasons why Dowager’s Hump is more common among young people today is because of the increasing amount of time that we tend to spend on our digital screens. We look down on our phones or sit in front of the computers and laptops, pushing our heads forward that makes the upper spine bend and repeated practice of sitting for hours in such bad postures result in the Dowager’s Hump. The human head on an average weighs around 12 lbs and when the head is placed rightly on top of the spine, the spine will easily take up the weight. But if the head is pushed forward extensively and for long periods, it induces an additional pressure of 10lbs on the neck and back which results in a bend of the spinal cord and a curve is produced on the back.
Symptoms of a Dowager’s Hump
The most common symptoms and indications of Dowager’s Hump are mentioned below:
Chronic pain: When the head is in pushed forward more than it should be, it causes stress on the neck and the back which leads to chronic pain in the neck region that tends to persist.
Increased risks of complications: Patients who suffer from Dowager’s Hump tend to develop conditions like disc herniations, nerve impingements, poor posture, muscle spasms, arthritis, and a lot of other such painful conditions.
Aesthetics: This is the most painful and frustrating symptom of developing a Dowager’s Hump.
The other signs and symptoms that can accompany Dowager’s Hump or Kyphosis are:
- Difficulty in breathing.
- Muscle fatigue.
- Problems in balancing and restriction of lungs’ movements.
- Chronic pain in the shoulder and back.
- Spine curve.
- Loss in height.
- Thoracic Kyphosis or hunched back.
- Loss of appetite.
- Difficulty in sleeping.
- Changes in body postures.
- Successive crush fractures.
- Vertebral compression fractures.
- Falls.
- Hip ache.
- Stiff back.
- Loss of sensation.
- Loss of bladder and bowel control.
- Bulging abdomen.
To understand that you actually have a Dowager’s Hump, you must first notice the signs as Dowager’s Hump has few characteristics like:
Forward posturing: The head is usually displaced from its ideal position and it is pushed forward which is known as hyperkyphosis.
Enlarged protuberance: The most common sign of having a Dowager’s Hump is the enlarged protuberance.
Lack of spinal curve in the cervical region: The changes in your spine due to compensation mechanisms make the spine lose its natural curvation.
Hyperextension of the mid-thoracic region: Due to the head being displaced in a forward position, the compensation mechanism of the mid-thoracic aspect of the spine is hyper-extended.
Kyphosis measurement for a Dowager’s Hump
A normal spine, when viewed from the side, is not a straight line, like it is when viewed from the front or the back. The thoracic or rib cage section of the spine has a normal forward curve known as Kyphosis. This curve has a normal range of 20 to 50 degrees. The combination of this forward curvature with the reverse curvature, known as Lordosis, in the cervical spine and the lumbar spine, works together to help the people to sit and stand upright.
An abnormal or exaggerated curving of the forward curvature in the upper back of the person is known as hyperkyphosis. The abnormal curvature, when greater than 50 degrees, leads to a stooped forward posture or a hump. This hump is known as the Dowager’s Hump.
Problems that a Dowager’s Hump can cause
There are several complications associated with a Dowager’s Hump. Most of these problems occur due to the disease or the condition that is causing the hump to form. The hump can get enlarged gradually which will make it difficult for the person to tilt his head backward. It can even make it very painful to turn the head from side to side. The Dowager’s Hump can even lead to stress frustration and lead to symptoms of depression due to the abnormal appearance that comes with the formation of the hump. Other problems that the Dowager’s Hump can cause are:
Breathing problems: When the Kyphosis gets severe, it can put a lot of pressure on the spinal cord and also the lungs. It restricts the lung movements and thus, the person can experience breathing problems.
Body image issues: When the person develops a Dowager’s Hump, he/she might feel depressed about the rounded back or feel embarrassed for wearing braces to fix the condition. This is more common in young people. For older people, the hump can lead to social isolation because of their poor body image.
Restrictions on the physical functions: The weakened back muscles and difficulty in doing the normal tasks like walking, bending and turning the head on two sides can restrict or disrupt normal life activities. The excessive spinal curve can even make it hard for the individuals to drive a car or lie down or their backs.
Digestive problems: When the Kyphosis is severe, it can compress the digestive tract that leads to problems like acid influx and difficulty in swallowing.
How to treat a Dowager’s Hump?
When an individual is suffering from Dowager’s Hump or Kyphosis, the doctor will conduct a thorough examination of the size of the hump and the condition of the spinal cord. He might also perform neurological examinations to check the individual’s muscle strength and reflexes. There are certain tests that the doctor might recommend after evaluating the signs and symptoms:
MRI: To detect if there is an infection or a tumor in your spine.
X-rays or CT scan: To determine the degree of curvature and the deformities of the vertebrae, an x-ray must be done. CT scan can be recommended for more-detailed images of the spine.
Bone density tests: When the bone density of a person is low, it can make Kyphosis worse. Thus, the doctor will recommend this test to check the bone density of the person.
Nerve tests: When Dowager’s Hump or Kyphosis leads to numbness or muscle weakness, the doctor can recommend the test to determine if the nerve impulses that are traveling between the spinal cord and the extremities are working fine or not.
After going through the above-mentioned tests, the doctor will recommend the various treatments depending upon the severity of your condition which could include:
Pain relievers: Medications to relieve pain that are commonly available at medical store like ibuprofen, acetaminophen, naproxen sodium and more can be prescribed by your doctor. If these fail to relieve the pain because of its severity, then the doctor can suggest stronger pain relievers.
Osteoporosis medications: If the bones are not strong enough, the person can use the bone-strengthening medications as prescribed by the doctor as these can help in preventing additional spinal fractures that could worsen or increase the hump.
There are therapies which can also help the person to manage certain types of Kyphosis. The following therapies can help:
Bracing: When young people or children develop Dowager’s Hump due to some underlying disease like Scheuermann’s disease, the progression can be prevented with the use of braces.
Exercises: Regular exercises to correct the posture like stretching exercises can help the individual to improve the spinal flexibility and also relieve the back pain.
Surgery: When the condition is severe and all the above-mentioned process cannot work, then the doctor can recommend surgery. Spinal infusion is the procedure that one commonly goes through for reducing the degree of spinal curvation. The surgeon inserts pieces of artificial bones between the vertebrae and then fastens them together with metal rods and screws to correct the position and heal the spinal cord.
Healthy diet: Maintaining a good bone density for preventing the development of Dowager’s Hump, the doctor will recommend you to eat healthy food that is rich in vitamin D and calcium. He will also suggest that you avoid tobacco and limit alcohol consumption.
Best Exercises to Treat a Dowager’s Hump
Dowager’s Hump or Kyphosis can be very painful. Regular exercises to relieve the pain and correct the body posture can help the individual to deal with Dowager’s Hump. The best exercises to treat a Dowager’s Hump are:
Abdominal press: People who suffer from Dowager’s Hump can benefit from the exercise by getting relief from the pain as this exercise will strengthen their abdominal muscles. Lie down on your back with your feet flat on the ground and knees bent. Keep the back relaxed in a neutral position and tighten the stomach muscles. Raise one leg up to the level of the knee of the resting leg and press your hand on the raised leg’s knee. Keep the abdominals firm during this exercise; use this tension to resist the pressure of your hand on the knee. Hold the position for three seconds and repeat with the opposite hands and legs.
Bridge: Another exercise for core-strengthening that can help your back and abdominal muscles to strengthen is this exercise. This exercise starts in a neutral position where you lie down on your back and tighten your stomach muscles while lifting your hips from the floor. Keep the feet and shoulders flat on the floor and hold the position for three seconds then relax.
Lunges: This exercise is beneficial for strengthening the hamstring muscles in your legs, muscles in the stomach and buttocks as well. Stand up straight with both feet together and keep your back tensed to prepare for stretch. Take a step forward with one leg and step down with your heel first, then the toe. Bend both the knees at 90-degree angles, while the leading foot should be flat on the floor. Your hind foot’s heel must point at the air and your toes should be on the floor. The hips should tilt down a bit and push off from the floor with your front foot to return to the standing position.
Quadruped: This is a core exercise that is quite similar to you crawling on the floor. Keep the hands on the floor in a position that is directly underneath your shoulders and the back and shoulders must be straight. Face the floor with your head pointing at the floor and reach in front of you with one hand off the floor and placing it a step forward. Step backward in a similar way and hold for three seconds and return to your original position.
Back extension: This exercise is effective for reducing the degree of curvature on the back and relief pain. The exercise can be done on a bench or a short table by lying on your stomach and hooking around the ends of the table to stabilize yourself. Clasp your hands behind the neck with elbows out, in order to keep your waist and upper body hanging off the table. Bend down to form a 90-degree angle with the upper body and the legs. You will be upside down with your head at the floor, followed by bending yourself up to get your entire body in the horizontal position back again.
Aids to treating a Dowager’s Hump
To get back to the normal posture after developing a Dowager’s Hump is a lot of work. There are other ways to treat the hump along with exercises and medical treatment procedures. The aids to treat a Dowager’s Hump are:
Dowager Hump Braces:
The hump braces is a short-term solution to the problem. Neck exercises are the best treatment to heal the spine but dowager hump braces are a good option when you have had a compression fracture. There are different uses of the braces like,
- Braces for minimal Kyphosis: This can be used if you have an acute vertebral fracture and minimal Kyphosis.
- Braces for advanced Kyphosis: People who suffer from acute vertebral fractures and advanced Kyphosis can consider this option as a semi-rigid support.
- Dowager hump brace alternatives: There are other alternatives to these braces that can make you alert when your posture is incorrect. Products like the Lumo Lift beeps or vibrates to remind you that the position is incorrect.
- Dowager hump correction braces: The development of the hump due to bad posturing and slouching can be fixed with these braces. It can take up to three months to get back your normal shape and the product must be used for short-term periods only. The muscles will get weaker if you constantly keep using them for a longer period of time.
Support Bras:
Support bras are available in the market today. You can get a proper support bra if you have large breasts because they tend to cause chronic back pain and neck pain. These bras will help to relieve the pain and provide comfort.
Dowager’s Hump pillow:
The more forward your head gets due to the hump, the more pillow-support is needed. The sleeping position also matters in this case. If you sleep on your back, then only the arch and the neck needs support. Getting a pillow that supports the areas around your head and the neck depending upon your sleeping positions can help in relieving the pain while sleeping.
Neck hump exercises:
Exercises to get rid of the hump include stretching and strengthening exercises. Certain stretching exercises for the neck portion and the spinal cord can help in fixing the condition.
Sternocleidomastoid stretch: When you have a forward head posture, certain muscles get tight and they need to be stretched. Locate the sternocleidomastoid- the mastoid process muscle which can be seen when you turn your head and follow the steps:
- Find the pulse and replace the index finger and third finger with the thumb.
- Keep the thumb on the pulse and push away from the pulse.
- Turn your head some more and you will feel the muscle right on your thumb.
- Grab the side of the muscle with your thumb and massage the area.
- Massage all the way up to your jaw and repeat the process.
- Do the massage for 10 to 12 minutes several times a day to get rid of all the tender spots in these muscles.
Suboccipital Muscle Stretch: The base of the skull is another important part here. They get very tight from the forward head posture. The steps to perform this stretch are:
- Place a small ball at the skull’s base and keep your hands over the ball and gently move the head slightly from side to side.
- A little bit of nod can help some people to loosen up the side muscles.
- Put enough pressure to get the gentle release in the muscles of the base of the neck.
Chin Tuck stretch: Once the muscles feel relaxed, the chin tuck stretch is the best exercise to do. Draw your chin towards the ground and feel a lengthening in the muscles of the base of your skull.
Chest Stretch: This exercise helps in opening up the muscles of your chest that are pulled forward because of the hump. Put the hands by your ears and breathe in to open up the pec minor. While exhaling, bring the upper arms and the forearms down towards the floor, and inhale back up. Repeat the exercise.
Arm Reach stretch exercise: To increase the flexibility of the muscles that pull you forward, arm reach stretching is best. Take the arm behind you and lengthen it. Keep your spine straight all the while and use the support that you need under your head. You can do it with one hand or with both hands together.
Angel in the snow stretch: Press the arms down like you are creating an indention in the snow and continue to slide upwards. Keep the chin tucked and keep sliding up as long as your arms stay in contact with the floor.
Dowager’s Hump Treatment Timeline
As much as it is true that the hump on your back did not develop overnight, equally getting rid of it will take time. The faster you act on the corrections the better it is. It also depends on any underlying factors that might have caused the Dowager’s Hump, like fractures or if you have a low bone density. For young people, who are determined and act faster when they see the signs, the process to heal the hump can be faster. It can also take up to one year or more if you wait longer to make the corrections.
How to Prevent Dowager’s Hump?
A number of things can be done to avoid getting Dowager’s Hump. For example:
Correcting your sitting postures: The most important step is to correct your sitting postures. Alter the surface on which you sit often. Sit straight where the head does not exert pressure on the back and the neck. Sit on the edge of the chair when tired by keeping the knees at a position lower than the hips as this allows you to tilt the pelvis forward too.
Dyna disc: There are things like Dyna disc that are actually covered in cloth that you can place under your pelvis to tilt your pelvis forward. These products provide support of the arch in your back in order to line up the vertebrae of your back. This alignment helps in bringing back the head in an ideal position over your shoulders.
Supports for your back while sitting: Low-cost support for your back is available which you can use while sitting or driving, like, a small scarf, extra mittens during winter and a paper towel roll. Adjust your sitting position and feel comfortable in it while sitting or driving.
Conclusion
With proper sitting postures and taking care of your back, the Dowager’s Hump can be easily avoided. Make sure the curve of your back is not more than 50 degrees. It is a thing to worry about nowadays with the increase in the use of computers and digital screens. Sitting upright for long hours can cause the chronic back pain and exert a lot of pressure on the back and the neck. Proper exercises and healthy diet to avoid low bone density will keep the Dowager’s Hump away.
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