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Person sitting and showing the progression from good posture to bad posture

How Kyphosis Affects People With Cystic Fibrosis

Cystic fibrosis (CF) is an inherited condition that affects the lungs and digestive system. But CF can affect the bones and joints as well. People with CF are at an increased risk of developing weak and brittle bones (osteoporosis), reduced bone mineral density (osteopenia), and decreased bone mineralization (osteomalacia).1

Research shows that people with CF are at a greater risk of posture problems and issues in the musculoskeletal system, made up of:1,2

  • Bones
  • Muscles
  • Joints
  • Ligaments
  • Soft tissue

People with CF also report more back and spine pain. These changes to the posture and spine, combined with weakened bones, can result in kyphosis.1,2

What is kyphosis?

Kyphosis, also called thoracic kyphosis, is a type of spinal deformity. It occurs when there is a forward curve in the upper spine. Kyphosis affects the upper backbones and results in a “humpback” appearance.3

In clinical terms, kyphosis is a spine that curves 50 degrees or more. This measurement is done using an X-ray. A person is either born with kyphosis (congenital condition) or it can develop over time. Kyphosis can range from mild to severe. It can progress slowly or quickly. There are several types of kyphosis.3

How does CF influence kyphosis?

People with CF are living longer lives, thanks to modern medicine and newer treatment methods. But this means that other health conditions can take shape as the disease progresses.2

A 2017 study found that people with CF are more affected by postural issues and kyphosis than people who do not have CF. According to research, scoliosis is also more common in people with CF when compared to people without CF.2

The CFTR gene mutation causes CF and has been found in the cells of bones and muscles. Researchers are working to determine whether that mutation is also the cause of kyphosis and other posture complications. Another theory is that the persistent coughing and breathing problems that people with CF have could cause kyphosis.1,2

While the research is ongoing, experts believe there might be a combination of reasons behind kyphosis. These reasons include:2

  • Vitamin D deficiency
  • Use of inhaled corticosteroids, a common treatment for people with CF
  • The overall strain on the back and spine muscles as CF progresses
  • Weakened bones, which are caused by decreased bone mineral density and decreased bone mineralization

How kyphosis affects people with CF

Kyphosis in people with CF can lead to musculoskeletal issues, particularly in the:1,2

  • Shoulders
  • Rib cage
  • Upper back
  • Lower back

Muscle pain and posture weakness can also occur. This pain can worsen as a person ages. In turn, chronic and persistent pain can lead to mental health issues such as:1,2

  • Worsening mood
  • Decreased motivation
  • Low energy levels
  • Reduced quality of life

Kyphosis treatment options for people with CF

The earlier your kyphosis is diagnosed, the sooner you can get treatment. Keep an eye on your posture and any back pain so that you catch any changes as soon as they start to develop. Common treatments for thoracic kyphosis in people with CF are:3,4

  • Pain-relieving medicines, such as ibuprofen
  • Vitamin D and calcium supplements to improve bone mass
  • Exercises to strengthen the core (abdominal) muscles and maintain flexibility
  • Maintaining a healthy weight

Therapies vary depending on how severe the kyphosis is. Researchers are still collecting data on the link between CF and kyphosis. As more information is collected, there is hope that more treatment options will be available. Talk with your doctor about any concerns you have and what treatment may be right for you.2,4

Why good posture is important

Good posture is important for keeping the body in healthy alignment. This applies to everyone. Good posture can prevent injury and pain in daily life. Posture impacts your entire body, including your:4

  • Muscles
  • Joints
  • Ligaments
  • Spine
  • Skeleton

The best way to treat posture problems is to prevent them from happening in the first place. Practice good posture “hygiene.” This includes:1

  • Using an ergonomic chair that provides ample back support
  • Moving and stretching throughout the day
  • Making sure your back and neck are in a neutral position when standing

Talking to a physical therapist can be a great place to start when you want to improve your posture. Physical therapists specialize in balance, mobility, and pain management. They will be able to recommend some movement exercises and positions that support good posture.4

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