What is Scoliosis?
Scoliosis is a condition that causes the spine to curve in an “S” formation. Typically, this condition arises in adolescents while they are going through puberty. Scoliosis is idiopathic in nature meaning to date there is no consensus on what is the cause of the disorder.
Potential factors that influence development of scoliosis are birth defects that cause abnormal spinal development, fractures to major lower extremity bones or hip dysplasia. Neuromuscular conditions such as cerebral palsy or muscular dystrophy can also be a cause of scoliosis.
In adult cases of scoliosis, it is critical that further investigation be completed to determine the secondary cause of scoliosis. Osteoporosis, degeneration of the vertebrae, malignancy, paralysis and neuromuscular disorders could be the cause.
Many individuals, when assessed by a physician, chiropractor or physiotherapist, may have a slight spinal curvature that deviates from “normal”. Most of us don’t know we have scoliosis or an abnormal curve in our spine. The reality is that there are lots of people who have spinal curves which don’t cause any discomfort, pain or immobility. When your doctor, chiropractor or physiotherapist identifies scoliosis they may order x-rays to determine the amount of curvature of the scoliosis, Typically, a baseline measurement is set to monitor the progression over time as the adolescent matures. This will measure progression as fast growing scoliosis patients may need to be braced to prevent further complications.
Scoliosis Symptoms and Treatment:
One of the most common features of scoliosis is noticing a curve of the spine. This curve tends to become more prominent or noticeable when you bend forward. Upon observation it may be identified that the ribs bulge in appearance. This may cause the shoulder blades to become more prominent. The shoulder blades and shoulder levels may also appear uneven. The waistline may appear uneven; one hip may be higher than the other. As a result, one may experience joint pain in the lower extremities, such as ankle, knee or hip pain. The presence of a short leg can also be seen as a result of the spinal curvature. The leg length discrepancy may or may not be a cause of one’s pain. If the leg length is significant one may try a heel lift or altering their shoe if leg length discrepancy is greater than approximately 2 to 6 cm (1 to 2.5 inches).
It is when curves substantially progress above approximately 20 to 40 degrees that they can become an issue to your health causing impairment to the chest cavity which reduces the ability of the lungs to expand properly. Only curvatures greater than 40 degrees may involve surgical treatment. Curves less than 40 degrees will be treated through conservative management, such as exercise, manual therapy, electrical muscle stimulation, massage, bracing, etc.
In severe cases of scoliosis, the curvature can cause significant pain impairing internal organs. Recent research supports the use of braces in severe scoliosis patients to help prevent progression of the condition. Patients often complain about the cosmetic appearance of the scoliosis however, this alone should not be a reason for surgical intervention. Surgery should only be used when absolutely necessary.
Research to date has no gold standard on treatment for mild to moderate cases of scoliosis. I find it is best to use a combination of manual therapy, personalized and supervised exercises and stretching. A spinal orthopaedic specialist should assess the patient and determine if a brace is required.
1. Signs and symptoms usually occur in adolescents usually between the ages of approximately 9 to 16 years of age.
2. Females typically have a much higher risk of curves worsening.
3. Back pain can occur as a result of scoliosis.
4. As scoliosis worsens the appearance of one’s spine will become more noticeable with changes in spinal alignment.
5. In severe cases, rigid bracing is used to help prevent the worsening of the condition.