This is the most common cause of thoracic spine pain in adolescents and is characterised by an excessive curvature of the upper back due to multiple vertebral growth plate irregularities.

Management is targeted at preventing progression of the postural deformity and involves a combination of joint mobilisation, stretching, and strengthening exercises for the muscles which support the Lumbar and thoracic spine. In more severe cases a brace may be prescribed to halt the progression of the disease or in extreme cases surgical intervention may be warranted when the curvature of the mid back has become so severe symptoms of spinal cord irritation are present.