The normal curve that forms the dorsal region of the spine is called dorsal kyphosis. When this curvature is more pronounced than we should call it hyperkinesis. If we have this form we can predispose to pain and other problems in the back. Hyperkinesis is especially important in childhood and adolescence because it is a period where we can act on it and on many occasions, corrects the problem.
How do we know if we have hyperkinesis?
If we see that our child walks as if he has a hump, is “shoulder-loading” or complains with a certain frequency of pain in the middle part of the back, it is important that it is valued by a doctor.
With a simple examination in the consultation our pediatrician or primary care doctor can assess if an x-ray is necessary and / or refer to the specialist. In this case the most recommended specialist is the rehabilitation physician.
A lateral x-ray of the back will give us the diagnosis. It allows us to measure the angles that form the curvatures of the back and distinguish the normal ones from the potentially pathological ones. In addition there are other data that gives us the radiography as we will see later when talking about Scheuermann’s disease. The first time we asked for an X-ray, we usually asked for a poster-anterior view to complete the study and, among other things, to rule out an associated scoliosis.
Scheuermann’s disease is a type of hyperciphosis with specific characteristics that occurs during growth. Although it is called disease, do not be scared, in principle we are talking about a deformity with other problems added that are going to cause back pain mainly. During growth the vertebral bodies of several dorsal vertebrae coalesce and cause a more pronounced curve. This is seen very well in the example radiography.
The usual thing is to see a child at the beginning of his adolescence, with the postures commented on, that hurts his back with activities during the day and that improves at night rising many times without pain. There is usually no trauma with which we associate the onset of pain. During the exploration we see a rigid hyperkinesis that is not corrected by knocking the patient or extending the back.
We do not know the cause of Scheuermann’s disease. It seems that there is a genetic component, although the possibility of mechanical causes is also discussed. It is more common in males and the tall people are at greater risk of evolving to more serious curves.
The diagnosis is made by exploring the patient in the consultation and with an x-ray of the spine. On a lateral radiograph with the patient standing the diagnosis is confirmed when we see a hyperkinesis, wedging of the vertebral bodies and signs of lesions in the discs and vertebral plates.
How do we treat hyperkinesis?
If the patient is of growing age we are in time to correct the deformity and clearly improve the patient’s symptoms. It is important at this stage to follow suitably to decide the treatment according to the evolution.
– When the curve is slightly increased and there are no signs of pain or complications a program of strengthening of the dorsal extensor muscles may be sufficient along with an education of the activities to be avoided.
– If the hyperkinesis is painful and / or the curvature is very pronounced, it is possible to opt for the treatment with a corset. This type of treatment can be very effective; However, it is necessary to continue with close monitoring by the specialist in order not to overcorrect the curve.
– Exceptionally in very severe cases surgery may be necessary. In these cases, there are usually associated diseases that make the situation worse.
In adulthood we will not be able to change the shape of the curve but we can improve the pain in many ways. The best of them is the muscular enhancement developing the best possible dorsal musculature. In addition, specific girdles can be used; infiltrations or even surgical treatments can be performed. We will talk about all these options in future posts.
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