Mid & Upper Back

What It Is

The spine has a number of normal curves when you look at it from the side. These curves help with balance and with standing upright (American Academy of Orthopaedic Surgeons, n.d.). They also assist with movement of your neck. The neck and lower back normally have a gentle inward curve, known as a lordosis. The upper back (known as the thoracic spine) normally has a gentle outward, rounded curve, known as a kyphosis (American Academy of Orthopaedic Surgeons, n.d.).

When you look at it from the back, the spine is normally fairly straight. A sideways curve of the spine is called a scoliosis. A scoliosis is different to a kyphosis, so don't get these two confused. So just to recap, a cervical kyphosis is a forward bend in the neck, and a scoliosis is a sideways curve of the spine. It is possible to have both.

Cervical Kyphosis Anatomy

The cervical spine has a natural inward curvature. Cervical kyphosis is when this normal inward curve is lost or reversed, so the neck curves forwards instead (Han et al., 2011). The ability of the spine to stay in position depends on many parts working together. The vertebral bodies (the main blocks of bone in the spine) need to be strong enough to support the head and maintain the normal shape of the spine.

Ligaments, facet joints (the small joints at the back of the spine) and soft tissues in the back and neck also have to be strong, and the back muscles have to be capable of resisting the effects of gravity, which works to pull the head forward. If any of these areas are damaged, the curve of the neck can change.

There are discs located in-between the vertebrae. Cervical kyphosis is linked to faster wear and tear of these discs (Han et al., 2011), and disc bulges can often be seen on scans.

What Causes Cervical Kyphosis?

Cervical kyphosis has several possible causes, including age-related wear and tear of the spine, injury, inflammatory conditions and previous neck surgery, which is one of the most common causes (Han et al., 2011). Across the spine as a whole, kyphosis is often caused by bad posture or by a problem with the structure of the spine (NHS, 2025).

Posture still matters for your neck. Have you ever caught yourself walking looking down at the ground? Or perhaps you are a regular laptop, tablet or smartphone user? Do you do a hobby that keeps your head bent forward, like reading or knitting? Keeping your neck in the same position for a long time is a common cause of neck pain (NHS, 2023), so these habits are worth looking at.

What Are the Implications of a Cervical Kyphosis?

Cervical kyphosis can cause neck pain, and it is linked to faster degeneration (wear and tear) of the discs in the neck (Han et al., 2011). Worn discs can bulge backwards, which may be called a disc bulge, disc herniation or disc prolapse (known to most people as a slipped disc).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Cervical Kyphosis

Physiotherapy can help improve posture and relieve pain and stiffness (NHS, 2025). I can help ease pain and stiffness with hands-on treatment, stretching and strengthening, though exercises will not improve the curve in your spine or stop it getting worse (NHS, 2025). See the My Approach tab for how I work.

1. Pain Relief

The NHS (2025) lists paracetamol or anti-inflammatory medicine as treatments to help ease pain caused by kyphosis, and advises checking with a family doctor, nurse practitioner or pharmacist which type of pain relief is most suitable for you. (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Ice and Heat

Heat or cold packs can help ease neck pain. The NHS suggests either a pack of frozen peas wrapped in a tea towel for 5 minutes, 3 times a day, or a hot water bottle wrapped in a tea towel for 20 minutes, 2 to 3 times a day (NHS, 2023). Never put ice directly on your skin.

Watch Your Neck Position!

Try not to keep your neck bent forwards in the same position for a long time, for example when sitting at a desk. Sit upright, gently roll your shoulders back and bring your neck back (NHS, 2023). This can help reduce neck pain and stiffness.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Scans: a specialist may arrange an X-ray or MRI scan to look at your spine in more detail (NHS, 2025).
Surgery: an operation to correct the curve is an established option for cervical kyphosis that is causing symptoms or getting worse (Han et al., 2011).

How I can help (see the My Approach tab)

Hands-on treatment for tight neck, chest and upper-back muscles
Strengthening for the neck and upper back
Posture and desk habits

Tips

You should be able to exercise if you have kyphosis. Keeping fit and strengthening your core muscles (the muscles around your tummy and lower back) can help (NHS, 2025). Pilates and other strengthening exercises can be useful in this regard.
For postural kyphosis (the most common type, linked to slouching), exercises that strengthen the tummy and back muscles can help improve posture (American Academy of Orthopaedic Surgeons, n.d.).
Speak to a healthcare professional before starting to exercise if you're new to exercise or haven't exercised for some time (NHS, 2025).
Depending on your case of kyphosis, you might not need any treatment for the condition (NHS, 2025).

Treatment

My Approach

Cervical kyphosis is a change in the shape of your neck, and massage and exercise won't change that shape. What I can help with is what comes with it: neck pain, stiffness, tight or tired muscles, and the extra work your neck, shoulders and upper back do to hold your head up. My aim is to ease those symptoms and build the strength and habits that keep you comfortable.

I start by assessing your posture, how your neck and upper back move, which muscles are tight and which are weak, and the sensation, reflexes and strength in your arms, because worn discs can press on a nerve. If you've had an X-ray or MRI, please bring the reports. If you've recently had neck surgery, I need your surgical team's okay before hands-on treatment.

Hands-On Treatment

Warmth first, then massage, myofascial and trigger point work for the tight muscles at the front: the chest, the front of the shoulders and the side of the neck
Work on the chest muscles only with your informed consent and a signed consent form, and you can say no at any time
Assisted stretches where you push gently against my hand and then relax further
Gentle mobilisation of stiff joints in the neck, upper back and ribs, never quick thrusts
Brisk, stimulating work and cool applications for the overstretched, sore muscles between your shoulder blades, rather than stretching them

Exercise and Strength

The deep neck flexor nod: a small "yes" nod that tucks the chin
Strengthening between the shoulder blades, starting with just gravity and adding light weights, then gym-based work if you enjoy it
A doorway chest stretch at three arm heights, each held at least 30 seconds
Core strength, and breathing into your belly rather than your upper chest

Everyday Habits

Breaking up long spells looking down at a screen, book or knitting
Setting up your desk, screen and chair so a good position is the easy option

If you notice new weakness, numbness or pins and needles in your arms, or clumsy hands, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Visits are usually once or twice a week at first, then weekly, with a reassessment at about six weeks, then spaced out as you manage more on your own. Most people notice less pain and stiffness within a few weeks; the curve itself doesn't change, so keeping up your home exercises is what holds the gains.

What I Focus On

Assessment

Neck & Chest Release

Upper-Back Mobility

Neck & Shoulder Blade Strength

Posture Habits

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Kyphosis (roundback) of the spine. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/kyphosis-roundback-of-the-spine/ (Accessed: 7 October 2026).
NHS (2025) Kyphosis. Available at: https://www.nhs.uk/conditions/kyphosis/ (Accessed: 7 October 2026).
Han, K., Lu, C., Li, J. et al. (2011) 'Surgical treatment of cervical kyphosis', European Spine Journal, 20(4), pp. 523–536. doi: 10.1007/s00586-010-1602-8
NHS (2023) Neck pain. Available at: https://www.nhs.uk/conditions/neck-pain/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCervical Kyphosis

What It Is

Cervical Kyphosis Anatomy

What Causes Cervical Kyphosis?

What Are the Implications of a Cervical Kyphosis?

Self-Care & Treatment

How to Treat Cervical Kyphosis

1. Pain Relief

2. Ice and Heat

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise and Strength

Everyday Habits

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCervical Kyphosis

What It Is

Cervical Kyphosis Anatomy

What Causes Cervical Kyphosis?

What Are the Implications of a Cervical Kyphosis?

Self-Care & Treatment

How to Treat Cervical Kyphosis

1. Pain Relief

2. Ice and Heat

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise and Strength

Everyday Habits

Typical Course

References

Related Conditions

Cervicothoracic Joint (CT) Dysfunction

Hyperkyphosis

Intercostal Muscle Strain

Levator Scapulae Syndrome

Book a session