Posture Changes in Older Adults

Medically Reviewed by Michael W. Smith, MD on March 26, 2021
4 min read

“With age comes wisdom,” writer Oscar Wilde observed. But he died at 46, too young to know firsthand what actually comes with age -- like fundamental changes to your posture.

Live long enough, and you’ll find you can’t stand up as straight as you once did. Your spine may even form a permanent curve, like the top of a question mark.

While spines should have some natural curve, a major curve in the thoracic spine (the part between your neck and low back) is called hyperkyphosis. Doctors usually just call it kyphosis, and lay folks simply describe it as a hunched back.

Minor posture changes may be a normal part of aging. Still, you should keep your doctors in the loop if you notice posture changes in your own body. You may be able to make lifestyle changes or take medications to prevent further posture changes or keep symptoms at bay.

Often with kyphosis, you’ll have no symptoms or just mild discomfort. But you should be aware of some possible problems, including:

Theresa Marko, DPT, a New York City-based clinical specialist in orthopedic physical therapy, often treats patients who have age-related posture changes. She says they can have pain just about anywhere, from their necks to their ankles.

“When the mechanics of your joints change [due to kyphosis], it can cause dysfunction in any of the [interdependent] joints. It’s like a kinetic chain,” she says.

Aging affects three main “systems” responsible for your posture: The column of bones (vertebrae) in your spine; the disks that act as cushions between your vertebrae; and your muscles. Here’s what can happen to these systems as the years go by.

Bone loss. Osteoporosis and its milder form, osteopenia, cause vertebrae to lose calcium, become less dense, and shrink a little. Weakened bones can add to posture problems, though a healthy lifestyle can help.

Disk shrinkage. Over the years, your spinal disks’ rubbery exterior and squishy interior start to dry out. As a result, the bones in your spine creep closer together, which affects the way you move.

Muscle loss. Your muscles help support your spine and keep your torso upright, but you tend to lose muscle mass as you age. This process can be slowed with continued exercise.

These aren’t the only reasons for posture changes, just the most common ones. Others include:

  • Post-traumatic kyphosis, which may happen after a vertebral fracture
  • Post-surgical kyphosis, which can occur when spinal surgery doesn’t heal as planned
  • Paralytic disorders, conditions that make you partly or fully paralyzed

Kyphosis may not have to be a sure thing as you age. Keeping your back, chest, and core muscles strong can help prevent posture problems. Consider strengthening exercises that focus on your shoulders and your core.

You should think about your posture as you go about your daily activities, like sitting up straight when you watch TV, and taking breaks from activities that promote poor posture, like sitting at your computer.

Postural kyphosis can be reversed, and you may want to see how far a commitment to not slouching will take you before you try other options. Beyond that, your doctor may recommend certain exercises, physical therapy, and/or a firm bed.

The other posture problems, especially those associated with “old age,” tend to stick around. At least lifestyle choices and, in some cases, treatments can improve symptoms and help keep problems from getting worse.

Lifestyle choices. The lifestyle choices that improve age-related posture problems can benefit anyone, with or without orthopedic issues.

Medications. Two types of medications you may need are bone-building drugs and pain relievers -- but usually not the heavy hitters. Start with acetaminophen or a nonsteroidal anti-inflammatory drug like ibuprofen before asking your doctor for a prescription painkiller. If you have osteoporosis, your doctor may recommend drugs that help build bones back up or ones that help keep your bones dense.

Physical therapy. Think of it as a reliable, drug-free option to improve poor posture and the discomfort that goes with it. “A physical therapist can give you postural advice and exercises to help you come out of that slouched position. We may also manually work on muscles in the front of your body, since they could be constricting you and pulling you down into that ‘C shape,” Marko says.

Once you start to improve, you can learn moves you can do on your own “to maintain your improved range of motion, alignment, and strength,” she says.