Scheuermann’s kyphosis (Scheuermann’s disease) is a rounded upper back that develops during the teenage growth years. The front of several vertebrae grows more slowly than the back, so they become wedge-shaped. Unlike postural rounding, the curve stays when you stand tall or lie flat. Most people are managed with exercise and monitoring. Bracing is used for some teenagers who are still growing, and surgery is reserved for a small number with severe curves or ongoing pain.
It is usually noticed between about 10 and 15 years of age, often by a parent, coach or school check, and is more common in boys. Some adults first learn they have it from an X-ray taken for back pain. Many people have little or no pain. Others have an ache at the top of the curve after long sitting, standing or sport.
Doctors confirm it on a side-view X-ray. The usual criteria are three or more neighboring vertebrae, each wedged by about 5 degrees or more, with an upper back curve beyond the typical range of about 20 to 45 degrees.
Key takeaways
- What it is: a rigid rounded upper back from wedge-shaped vertebrae that formed during growth.
- How it differs from postural rounding: the curve does not straighten when standing tall or lying flat.
- Who gets it: usually noticed in the early teenage years, more often in boys; sometimes first found in adulthood.
- Treatment for most: exercise and regular monitoring of the curve.
- Bracing and surgery: bracing for some teenagers who are still growing; surgery for a small number with severe curves or ongoing pain despite other care.
Where are you right now?
- Just diagnosed, as a teenager or a parent: read “Postural rounding or Scheuermann’s?” and “Month by month”.
- Weeks into exercises and still aching: go to “If it isn’t going to plan”.
- In a brace or after spinal surgery: follow the plan from your orthopedic team. Brace hours and exercises are set for each person.
- An adult getting back to work or sport: the “When can I…” table gives typical ranges. Most sports are usually encouraged.
Postural rounding or Scheuermann’s?
- Postural rounding: flexible. The curve largely disappears when you lie on your back or stand tall against a wall, and the ache eases with movement. The vertebrae are a normal shape. See stiff, rounded upper back.
- Scheuermann’s kyphosis: rigid. The curve stays, and bending forward often shows a sharper angle at its peak. Tight hamstrings and chest muscles are common alongside it.
- Other fixed curves: in older adults, a spinal compression fracture from thin bones can also wedge a vertebra. Inflammatory spine conditions are another, less common cause.
An examination and a side-view X-ray are needed to tell these apart.
Month by month
These stages describe exercise and monitoring, the plan for most people.
- Month 1: assessment and a baseline X-ray. A home program usually starts: upper back extension, shoulder blade and back strength, and stretches for the chest and hamstrings, a few times a week.
- Months 2 to 3: the ache is often less frequent as strength builds. Standing tall takes less effort, though the curve itself changes little.
- Months 3 to 6: the exercises become part of the routine, and sport continues.
- Every 6 to 12 months while growing: a doctor rechecks the curve, sometimes with an X-ray, to see whether it is increasing.
- If a brace is used: it is typically worn for many hours a day until growth is nearly finished, often for 1 to 2 years, with exercises alongside.
- After growth ends: the curve usually changes little. Exercise continues for comfort and function.
Exercise rarely changes the shape of the bones. It changes how well the back around them copes.
Where else this could be coming from
- The neck: a rounded upper back often goes with a forward head position, which can bring neck pain from desk work and forward head posture.
- Muscles along the curve: the muscles between and beside the shoulder blades work hard to hold you upright and can ache by the end of the day. See pain between the shoulder blades.
- Rib joints: a stiff upper back can leave the rib joints irritable, with sharp pain beside the spine on twisting or deep breaths. See rib joint pain in the upper back.
- The shoulders: rounded shoulders tip the shoulder blades forward, which can narrow the space above the shoulder joint and add pain when reaching overhead.
- The lower back: the low back often curves more to balance the upper back, and low back pain is common alongside Scheuermann’s.
Is this normal?
- The exercises have not changed how it looks: common. Exercise builds strength and flexibility around the curve; the shape of the vertebrae usually stays.
- It aches after a long day of class or desk work: common. Changing position every 30 to 45 minutes helps.
- My hamstrings are very tight: common with Scheuermann’s, and part of what the stretches address.
- I am self-conscious about how it looks: common, especially in the teenage years. It is worth raising with the team, as it can be part of treatment decisions.
If it isn’t going to plan
It is week eight. You have done the exercises most days, and the ache at the top of your back still builds by the end of a school or work day, worst after an hour at a desk. In a shop window, the curve looks the same. The thought in your head is that if the exercises have not straightened it, there is no point carrying on.
The belief that fails here is that exercise will straighten the curve. Once the vertebrae are wedge-shaped, exercise does not reshape them. What it changes is the strength of the back and shoulder blade muscles, the flexibility of the chest and hamstrings, and how long you can sit or stand before the ache arrives. That is usually where the pain comes from, and those gains take 8 to 12 weeks or more.
If the ache is not easing after about 3 months of steady exercise, or the curve seems to be increasing, see your doctor or a physical therapist. Questions worth asking:
- How large is my curve, and is it changing?
- Am I still growing, and does that change the plan?
- Is a brace worth discussing for me?
- Which exercises target where my pain comes from?
- When should the curve be measured again?
When can I…
| Activity | Typical range |
|---|---|
| Sleep on that side | No restriction; a pillow that keeps the neck level often helps |
| Drive | No restriction for licensed drivers |
| Reach overhead | Usually no restriction; it may feel stiff at the top of the curve |
| Lift | Usually no restriction; heavy lifting built up gradually with good technique |
| Desk work | Continues, with a change of position every 30 to 45 minutes |
| Manual work or sport | Most sports are encouraged; while a brace is worn, the orthopedic team advises on sport |
If you have had surgery, your surgeon’s protocol comes first.
Call your local emergency number or go to the emergency department if
- Leg or bladder signs: new weakness, numbness or heaviness in the legs, unsteady walking, or loss of bladder or bowel control.
- Major injury: severe back pain after a significant fall or car accident.
See a doctor today if
- Pain with fever: back pain with fever or feeling unwell.
- Sudden severe pain: sharp pain at one point on the spine after a minor fall.
Get it checked soon if
- Changing curve: the rounding seems to be increasing, especially during a growth spurt.
- Night pain: pain that wakes you at night or is there all the time.
- Morning stiffness: stiffness lasting more than 30 minutes each morning that eases with activity.
- Breathing: shortness of breath with exercise that seems out of proportion.
More on this area: upper and mid back conditions.
Scheuermann’s kyphosis is usually managed with exercise and monitoring, and most people stay active throughout.
Written by Louise Yow, Neck & Shoulder Physio.