Scheuermann’s disease describes a medical condition that impacts the shape of vertebrae in the spine. This condition often affects children and adolescents, resulting in a characteristic rounding of the upper back.

Scheuermann’s disease, also known as Scheuermann’s kyphosis, refers to a juvenile form of kyphosis. The term kyphosis describes a pronounced increase in the forward curvature of the upper back. Scheuermann’s disease occurs when the small bones in the spine, known as vertebrae, develop into a wedge shape instead of the typical rectangular shape. As such, this causes the spine to develop in a forward angle as it grows.

As the condition affects the spine, people often experience back pain especially during the early teenage years. To treat Scheuermann’s disease, a doctor will typically recommend a combination of nonsurgical methods, such as bracing and physical therapy. In rare cases, a doctor may recommend surgery.

In this article, we discuss Scheuermann’s disease, including possible causes, symptoms, and more.

Scheuermann’s disease is a medical condition that affects the spine. It occurs when the front sections of the vertebrae grow slower than the back sections during childhood.

It typically involves anterior wedging greater than or equal to 5 degrees in 3 or more adjacent vertebral bodies in the spine. This causes the vertebrae to have a wedge shape rather than a rectangular one, resulting in a forward curvature of the upper back.

The spine has a natural “S” curve, which provides support for the body’s weight and helps to absorb impact. Normal curvature of the spine ranges between 20–40 degrees. Doctors consider anything outside of this range as hyperkyphosis. As a reference, Scheuermann’s disease causes a curvature that often falls between 45–75 degrees.

Other terms for Scheuermann’s disease include:

  • Scheuermann’s kyphosis
  • juvenile kyphosis
  • juvenile discogenic disease

Evidence suggests that the condition affects about 0.4 to 10% of people in the United States. It typically impacts teenagers between the ages of 12–17 years and rarely occurs in children under the age of 10 years. Research indicates that the condition affects males and females in equal numbers.

The exact cause of Scheuermann disease is not currently known. However, health experts believe that a number of factors may contribute to the development of the condition and Scheuermann’s disease may run in some families.

Some evidence suggests that Scheuermann’s disease occurs as a result of discordant vertebral endplate mineralization and ossification during growth. This refers to a problem with the processes by which bones harden and form. These bone development issues lead to the alteration of their shape and the resulting excess curvature of the spine.

Additionally, others suggest that damage to the growth area of the vertebrae, problems with the mechanics of the spine, or problems with the muscles may lead to the condition.

Other evidence indicates that the likely cause of Scheuermann’s disease is a complex interaction between genetics and environmental factors. In other words, an external factor may trigger the development of wedge-shaped vertebrae in an individual with a genetic predisposition for Scheuermann’s disease.

The name of the condition derives from Danish surgeon Holger Scheuerman, who documented the first known cases of the condition. He proposed that it may result from avascular necrosis. This term refers to lack of blood supply to the bone, which may interrupt the shape and growth of bone during development.

He also found it often occurred in agricultural workers who hunched over every day to do their work. This led to the theory that poor posture may cause the condition. Additional evidence did not fully support the theory but does suggest that proper posture may help improve the condition.

While research into the prevalence of Scheuermann’s disease by sex is mixed, some research suggests that the condition occurs roughly twice as frequently in males.

There are two main symptoms of Scheuermann’s disease. They include a noticeable forward curvature of the spine, and subacute thoracic pain.

The curve is present in the upper back and usually becomes apparent during a time when the bones are growing very quickly. This is why it is not uncommon for a person to receive a diagnosis between the ages of 10–15 years. However, for some, the condition may worsen in adulthood.

Additionally, a person might also experience middle-back pain. The pain is rarely disabling and has no identifying event. However, a person may notice that pain worsens with movement and activity and improves with rest.

A person may also experience:

  • fatigue
  • rigidity to the spine, noticed particularly when bending or moving
  • decreased lung and heart capacity due to decreased chest space that makes breathing more difficult

Roughly a third of people with Scheuermann’s disease also develop scoliosis. This condition typically develops around the same time and describes a spinal problem where the spine curves from side to side.

The onset of excessive kyphosis is generally slow. The progressive appearance of back rounding is typically what leads a person to seek medical help. People are more likely to see a physician as the curvature becomes more noticeable.

An individual may first suspect a problem due to a slouching appearance or presence of unusual or unexplained pain in the back.

A practitioner will typically review the individual’s personal and family medical history. Family history may reveal if a parent or other relative has had the condition. Additionally, a doctor will perform a physical examination of the spine. They may have the person move or bend to observe how their spine responds.

To fully diagnose the condition, a doctor will need to examine a lateral X-ray of the spine, which they will order. To confirm a Scheuermann’s disease diagnose doctor needs to observe spinal curvature greater than 40–45 degrees and wedging greater than or equal to 5 degrees in three or more adjacent vertebral bodies.

Treatment for Scheuermann’s disease can vary depending on a variety of factors. When choosing treatment options, a doctor will consider factors such as:

  • age
  • gender
  • severity of the curve
  • flexibility of the curve

For some, nonsurgical treatment may help. Some possible options include:

  • bracing or casting, which adds support to the spine and may help guide development
  • taking NSAIDs for pain
  • stretching and physical therapy
  • making lifestyle modifications such as correcting posture

If more conservative treatment methods do not work or the curve is severe, a doctor may recommend surgical intervention. Surgery typically involves a spinal fusion to correct the abnormal vertebrae.

The prognosis is typically good for the majority of people living with Scheuermann’s disease, improving with conservative treatment options. Pain will typically improve following spine growth.

It’s important to note that a person with Scheuermann’s disease has a higher risk of developing chronic back pain and possibly experiencing a lower-health-related quality of life.

Scheuermann’s disease describes an excessive curvature of the upper back that typically affects teenagers. The exact cause is unknown, but it occurs due to vertebrae in the spine developing a wedge shape rather than a rectangular one.

Diagnosis typically occurs during adolescence, following pain and a noticeable rounding of the upper back. To confirm a diagnosis, a doctor requires images of the spine to identify key characteristics, including wedge-shaped vertebrae and 45-degree angle of the spine.

Treatment can range from conservative interventions to surgical correction. Prognosis is generally good, though some may experience ongoing back pain and possibly other health-related issues later in life.