What's This Hump On My Back?
Dr. Jeff Williams, Chiropractor Amarillo, breaks it down
It is very common for us to have new patients come in for neck pain or low back pain. We always start by taking a good history and performing a very thorough orthopedic and neurologic exam. It is typically after I have completed everything, explained everything to the patient, and am about to start working on them when they stop me for one last question. That one last question is, "Can you tell me what this hump on my back is?"
That is about the time they start running their hand and fingers over the area where you neck turns into your upper back. The usual answer when I ask if it hurts is, "No, but I see it in the mirror and I'm afraid I'm going to end up looking like my grandma someday." What they are referring to is technically termed 'kyphosis' or sometimes it is termed 'hyperkyphosis'.
Mild kyphosis may be something that is less than desirable cosmeticaly but causes no issues or should be a source of any real concern.
More serious kyphosis, according to the Mayo Clinic, can be caused by the following:
- Fractures. Broken or crushed vertebrae (compression fractures) can result in curvature of the spine. Mild compression fractures often don't produce noticeable signs or symptoms.
- Osteoporosis. This bone-thinning disorder can cause spinal curvature, especially if weakened vertebrae result in compression fractures. Osteoporosis is most common in older women and people who have taken corticosteroids for long periods of time.
- Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
- Scheuermann's disease. Also called Scheuermann's kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than girls.
- Birth defects. Spinal bones that don't develop properly before birth can cause kyphosis.
- Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Ehlers-Danlos syndrome and Marfan syndrome.
- Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.
These more sinister causes are, of course much less common. Most small little humps at the neck and body junction is actually anatomically very normal and literally everyone has one. It is so common that it has an anatomical name. It's called the vertebral prominens. Prominens is a fancy way of saying 'prominent'. Or obvious. Your seventh cervical vertebra or first thoracic vertebra is your vertebral prominens and it naturally just sticks out a little bit further as the curve in your neck reverses course and goes into your upper back area. Whether it is your seventh cervical or first thoracic vertebra varies from person to person but the point is, it is normal.
However, there are things we can do that causes our vertebral prominens to become more and more prominent. The most notable being consistently poor posture turning into what is called upper cross syndrome. (Google it)
Let me be clear, there really is no 'bad posture' per se. As long as a person switches postures consistently and regularly, there is no posture that is really going to get anyone into big trouble according to more recent research. Truly bad posture is any posture that is held consistently for extended periods of time.
For example, if a person is accustomed to sitting most of the day every day in one position, that is bad posture. If a person has a habit of sitting kind of slumped forward with their head stuck out kind of like a chicken and that goes on consistently for some time daily, that would be considered bad posture. The most concerning thing we see as chiropractors right now would be teenagers and young adults looking down at their electronics all day long. A person simply cannot adopt that posture with any regularity and not suffer the eventual consequences. It's a slow burn but it will catch up.
If a person is switching positions all day long every 5-10 mintues, that is not necessarily considered bad posture. Although, no healthcare professional I'm aware of is a proponent of sitting all day every day regardless of the changes in positioning. So keep that in mind as well.
When patients spend a considerable amount of time sitting, slumped over, with their head jutted forward, this develops into what is commonly called Upper Cross Syndrome. According to Healthline.com "Upper crossed syndrome (UCS) occurs when the muscles in the neck, shoulders, and chest become deformed, usually as a result of poor posture. The muscles that are typically the most affected are the upper trapezius and the levator scapula, which are the back muscles of the shoulders and neck. First, they become extremely strained and overactive. Then, the muscles in the front of the chest, called the major and minor pectoralis, become tight and shortened." - https://www.healthline.com/health/upper-crossed-syndrome
Patients most at risk of developing UCS are those that read a lot, watch TV, biking, driving, or using electronics often.
Some of the more common symptoms are:
- neck pain
- weakness in the front of the neck
- strain in the back of the neck
- pain in the upper back and shoulders
- tightness and pain in the chest
- jaw pain
- lower back pain
- trouble with sitting to read or watch TV
- trouble driving for long periods
- restricted movement in the neck and shoulders
- pain and reduced movement in the ribs
- pain, numbness, and tingling in the upper arms
How many people does that describe?
As you may have guessed by now, UCS can accentuate the vertebral prominens and most definitely make it more prominent, if you will.
As I said, there is no truly bad posture. It is more about the consistent and long lasting postures that get patients into trouble. For these reasons, patients need to be certain they are changing positions regularly and consistently to the greates extent possible. Stretching, working on ranges of motion, and getting up and walking around regularly. It is also helpful to keep in mind the perfect ergonomic positioning when sitting is having the ear hole above the tips of the shoulders, the shoulders directly above the hips, and the feet separated flat on the floor. Sliding or gliding your head directly backward when stretching and sitting for long periods is always a great idea.
Some of the causes of hyperkyphosis cannot be controlled and everyone on the planet is born with a vertebral prominens. . But those are rare instances. More times than not, any little hump is only a cosmetic concern. If, for some reason, the 'hump' is a little more than you like or want, start with more frequent changes in your normal posture. Further down the road, you can engage in UCS exercises easily found on the internet. Beyond that, there are very rare instances where one may have a benign, harmless fatty tumor called a lipoma. A dermatologist can typically easily remove a lipoma if that's the case.
As always, if you need to be evaluated or examined, simply call us here at Creek Stone Integrated Care in Amarillo, TX at 806-355-3000 and set up an appointment for us to take a look.
Dr. Jeff Williams, DC, FIANM is a Fellowship-trained Neuromusculoskeletal specialist and chiropractor in Amarillo, TX. As an Amarillo chiropractor, Dr. Williams treats chronic pain, disc pain, low back pain, neck pain, whiplash injuries, and more. Dr. Williams is also the host of The Chiropractic Forward Podcast (https://www.chiropracticforward.com). Through the podcast, Dr. Williams teaches fellow chiropractors and advocates weekly for evidence-based, patient-centered practice through current and relevant research. If you have any questions for Dr. Williams, feel free to email at [email protected] Learn more about Dr. Williams and his practice at https://www.amarillochiropractor.com.
Dr. Williams was voted Best Chiropractor In Amarillo in the Best of Amarillo 2020. Dr. Williams's full-time Amarillo chiropractic practice is Creek Stone Integrated Care at 3501 SW 45th St., Ste. T, Amarillo, TX 79109. If you are searching for a chiropractor near me, Dr. Williams is your Amarillo Chiropractor.