Correcting the Thoracic Kyphosis – Systematic Review Published

It’s a postural phenomenon once driven by age, now arguably driven also by technology. The head drops forward, and the thoracic kyphosis increases beyond normal physiological parameters. Other postural adjustments take place in order to keep the head upright – with the lumbar and cervical curves often implicated. The results can range from low back pain, increased load on the cervical spine, decreased rib excursion, tidal volume and much more. We know the presentation. We know the associated symptoms. But what do we do to restore proper posture and put right the altered thoracic curve?

While the answers to this may be many and varied, a paper published in the newly minted Journal of Contemporary Chiropractic has taken aim at this issue, putting the Chiropractic Biophysics© Technique under the microscope and looking at whether or not it can correct the thoracic hyperkyphosis. Authors Paul Oakley and Deed Harrison undertook the review, find seven peer-reviewed papers fitting the bill –  4 case reports, 2 case series and a randomized clinical trial. All used the Chiropractic Biophysics© technique and all reported reduction of the thoracic hyperkyphosis.

The authors of the paper explained that thoracic hyperkyphosis (THK) is, “A spinal subluxation or deformity featuring the exaggeration of the normal physiologic thoracic kyphosis. Often referred to as age-related hyperkyphosis in adults, it is a structural deformity subluxation that occurs when the physiologic kyphosis surpasses some threshold, becoming pathologic.”

They explained that the location of a thoracic hyperkyphosis changes the internal dimensions where vital organs are held, thus it is associated with many ill health effects and including early mortality. If we needed more evidence that this postural concern is more than cosmetic, this paper’s reference list alone provides 27 reasons why. They also point out that it is relatively common, affecting 20-40% of men and women, and that nonsurgical approaches are suggested in order to delay progression and reduce deformity.

The Chiropractic Biophysics Technique protocol explained in the source documents involved “mirror image thoracic extension traction and exercises, as well as some type of spinal adjustment (mirror image for THK) and/or classic spinal manipulative therapy [1].” Further details on all of the above can be found in the original paper (referenced below).

Interestingly, despite thoracic hyperkyphosis being defined as an age-related issue, the mean age in the data returned through the systematic review was a mere 38.2. Of the 17 participants, 9 were male and 8 were female (indicating a relatively even prevalence between the sexes). The mean initial (pre-intervention) thoracic kyphosis was measured at 61.4 degrees, and the mean post-intervention change was 12.2 degrees (improvement). Keeping in mind thoracic hyperkyphosis isn’t usually diagnosed until the curvature reaches 50 degrees, this is a significant improvement [2].

Admittedly, it is a small sample even with all seven papers considered. Still, with the thoracic hyperkyphosis becoming an increasingly visible problem (both with an aging population and concerns over tech-driven forward-head posture [3]), it could be a significant one. Indeed, the authors of the paper remarked:

“If future CBP [chiropractic biophysics] intervention trials are consistent with the initial CBP patient outcomes for this disorder, the CBP treatment approach may prove to be an effective treatment that may logically lead to reduced mortality rates and improvements in quality of life measures in these patients.”

There is surely more research to be done, but this review has served to flag the growing evidence base indicating that chiropractic care may have a positive impact on this issue which places a significant burden on the health of the individual as well as the burden of disease in society.

It’s a line of enquiry we shall surely see more from as time goes by. In the mean time we know one thing – all indications point to Chiropractic care, specifically CBP ©, being a potentially viable option for the treatment of this condition.

References:

[1] Oakley P and Harrison D (2018), “Reducing thoracic hyperkyphosis subluxation deformity: a systematic review of chiropractic biophysics © methods employed in its structural improvements,” Journal of Contemporary Chiropractic, https://journal.parker.edu/index.php/jcc/article/view/32 retrieved 12 December 2018

[2] Staff Writer, “Kyphosis” The Spine Hospital, https://www.columbiaspine.org/condition/kyphosis/ retrieved 12 December 2018

[3] Staff writer, “Forward Head Posture: its effects on the young and aging,” Australian Spinal Research Foundation,  https://spinalresearch.com.au/forward-head-posture-effects-young-aging/ retrieved 12 December 2018

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