How to get rid of a ‘dowager’s hump’

Otherwise known (more appropriately) as kyphosis, the condition describes any rounding of the upper back. Here’s how to combat it

You might not be aware of the medical term kyphosis, but chances are you will have heard of a ‘dowager’s hump’, or its modern day equivalent: tech neck. Used to describe any sort of rounding of the upper back, this outdated name stemmed from the fact that a pronounced hump in the spine at the base of the neck was often noted in women of a certain age and stature. However, gender and age are in no way uniquely responsible for this condition: poor posture is a major contributing factor. 
The United Chiropractic Association, which has over 600 members across the UK, says that poor posture is as big a health risk as obesity. They urge people to have their posture checked by a registered chiropractor and to take steps to safeguard their posture and health.
Here, two experts explain how our tech-laden lifestyle choices are putting us all at increased risk of developing spinal issues and how we can stop our slide into slouch. 
“Dowager’s hump, neck hump, and hunchback all refer to the visible alteration of the spine at the base of the neck,” says Michael Fatica, a consultant osteopath. “It is the poor alignment of the cervical spine – our neck – and its connection to the thoracic spine where our rib cage starts. The hump is most visible on the surface, at the level of the junction between the neck and the upper back, where a necklace might rest, for example.” 
Tim Allardyce, an osteopath and physiotherapist, Allardyce says, “some degree of spinal curvature is perfectly normal. What we are concerned about, as professionals, and what’s happening when you have a pronounced hump in that part of your spine, is too much ‘hyper kyphotic’ curvature. The most accurate way of describing a dowager’s hump is ‘hyper kyphosis of the upper thoracic spine’.”
The term dowager’s hump is falling out of use, as it has negative and misogynistic connotations. It harks back to a time when a titled widow, mourning her husband, would be bent over in grief and might be admonished and told to stand up straight.  
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Hyper kyphosis can be congenital, developmental, nutritional or post-traumatic. But, Fatica says, “these types of kyphosis will, as a general rule, normally affect the mid thoracic spine and are less likely to cause the pronounced hump at the base of the neck.”
Hyper kyphosis of the upper thoracic spine, resulting in the tell-tale dowager’s hump, can be caused either by disease or lifestyle. “Osteoporosis is one cause,” explains Allardyce. “When your bones aren’t as strong, the vertebrae can actually compress and sink into themselves. This typically occurs at the front of each vertebrate, creating a wedge shape. This causes a pronounced forward flexion of the spine, creating the classic humped effect.” 
Degenerative changes – slow, progressive loss of the normal structure and function of the spine – are usually as a result of the normal ageing process, but can also be due to arthritis, infection or tumours.  
The most common cause of dowager’s hump, however, is bad posture. Modern life – and in particular, the omnipresence of technology – mean that the majority of us spend hours slouched over computers, or at desk-based jobs. This is leading us to have problems with the neck and upper thoracic spine – a state of spinal misalignment with shoulders rounded and head protruding, otherwise known as ‘tech neck’.
A lot of this stems from the way we use technology. “Our use of smartphones, from an ever younger age, is causing significant disruption in the development of normal cervical alignment,” says Fatica. “And the alteration in alignment is occurring slightly higher – not as much in the upper back, but more the lower neck.”
Weak muscles in the upper back and neck, combined with tight muscles in the chest and shoulders, combine to exacerbate the issue.
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We are all increasingly at risk, claim both our experts. “When we are born we are pretty much all kyphosis from head to bottom,” says Fatica. “As we grow, we develop normal curves in the spine as a result of activities like laying on our tummies, crawling and walking. 
“However, in the last 10-15 years, this process has been interrupted in an unprecedented way as a direct result of technology, so it stands to reason that Gen Alpha – those born from 2010 onwards – will be most exposed to the posture-disadvantages associated with this modern age.”
‘Tech neck’ speaks to contemporary society far more than ‘dowager’s hump’ and will no doubt replace the latter.
Increased mechanical strain on the neck and shoulder musculature impacts the body and you may develop: 
Symptoms may include:
Both experts agree that changing the way we interact with technology can help us prevent hyperkyphosis of the upper thoracic spine.  Check out the following tips:
Avoid prolonged periods looking down at your phone, limit to short intervals and hold it up at eye level so your neck is not bent forward. 
… with your neck bent forwards. Sit up straight at 90 degrees, with a firm cushion placed between your lower back and the bed.
This is among the biggest culprits behind the condition.
The screen of your computer should be at eye level. If you have to work on a laptop, have a separate keyboard so that you can type at desk level but view the screen at eye-level. 
… so that your back and neck are supported. If you are a gamer, set your tech up so that you are not craning forward or slouching. 
Consider moving all your communication apps onto your desktop computer instead of your phone, so that you can communicate while looking straight ahead rather than craning forward and downwards.
Ensure your diet is varied and contains protein, calcium, carbohydrates and healthy fats.
Aim for 15-20 minutes. Walk purposefully with your chin up, looking straight ahead – do not be tempted to walk and scroll or talk on your phone, you are aiming to correct your posture
Particularly load-bearing exercises in the gym to strengthen core and Pilates – particularly reformer Pilates.
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Exercises from Michael Fatica
1. Both arms start outstretched in front of you.
2. With your arms you will make an L shape, as your right arm goes out horizontally to your right side at shoulder height, your left arm arcs up to brush your ear with the hand stretched out above your head making the letter L. 
3. Then repeat with the left arm moving horizontally and the right arm vertically.
1. As if drawing back a bow string, start with your arm outstretched in front of you, draw the band back, with your elbow high so your knuckles draw back level with your face.
2. Then slowly return to the starting position.
1. Start with the arm outstretched, slowly draw the arm holding the band back to your waist, pulling from your back muscles. 
2. Pause then slowly return to the starting position.
1. Starting with your arms in front, as if holding a ball at waist height, open your arms out to the side to make a W shape with your elbows bent. 
2. As you do this, squeeze your shoulder blades together.
3. Then return to the start position.
1. To stretch out the chest muscles, stand by a door frame, put one hand on each side of the frame, take a step forward and lean in until you feel the stretch across your chest. Hold for 20 seconds. Repeat three times daily.
1. Facing forwards with a small towel held across the back of your neck, pull forwards on the ends of the towel to hold your neck steady then draw the head backwards keeping your head facing forwards.
“If you are experiencing any pain, or have noticed a change in your alignment, it’s important to seek professional advice and a proper diagnosis,” advises Allardyce. “Look for a clinic specialising in osteopathy and physiotherapy, or see your GP and ask for a referral. They will suggest a range of manual therapy and rehabilitation options aimed at improving mobility. You will be advised to continue some exercises at home.”
“If you want to evaluate the impact of this objectively, the only way to do it properly is to get load bearing images (X-rays) of the cervical spine. MRI’s are no good as you’re lying down and things  change in that position,” adds Fatica.
If the case is mild, you can reverse neck alignment to some extent. “However, if it’s disease related, such as a result of osteoporosis, it’s more difficult,” warns Allardyce. “The best course of action is to start good behaviours early, incorporating exercises to correct poor posture into your daily regime.”  
“A buffalo hump is a term used for the build-up of fatty tissue in this area, rather than being caused by extreme curvature of the spine,” says Fatica. It is often a symptom of Cushing’s Disease where the body produces excess cortisol.”