Scoliosis: An Introduction
When the body is looked at from behind, a normal spine appears straight without much alteration from one side to the other.Scoliosis is a condition that is often associated with a lateral, or side-to-side, curvature of the spine.The disorder shouldn’t be confused with poor posture, even though it oftentimes gives the appearance that the person is leaning to one side. Defined by both lateral curvature and rotation of the vertebra, this complicated deformity often causes a symptomatic “rib hump” in the mid or thoracic spine. This is produced by the vertebrae in the region of the major curve rotating toward the concavity and pushing their attached ribs posterior thus causing the distinctive rib hump seen in thoracic scoliosis. The pulmonary and cardiac functions can be interfered with if the thoracic curve and rib rotation is more than 70 degrees. Often later in life in untreated severe idiopathic infantile and juvenile scoliosis patients, this degree of curve and consequential cardiac and pulmonary changes can be life threatening.
Anatomy
If you were to view the trunk from a side view, the spine would disclose four normal curves: the cervical, thoracic, lumbar, and sacral. The thoracic, in the chest region, has a natural round curve, “reversed C,” called a kyphosis, while in the lower spine there is a normal “C” curve, known as swayback or lordosis. Increased kyphosis in the thoracic area is called hyperkyphosis, while increased swayback is termed, hyperlordosis. Scoliosis changes regularly accompany changes from normal on a side view. Postural exercises can eliminate some round back deformities that are simply due to bad posture. A small percentage of people with kyphosis have more rigid deformities than the postural type, which are associated with vertebral deformity. This type of deformity, called Scheuermann’s kyphosis, is much more difficult to treat than postural kyphosis, and it’s cause is unknown.
Even a layman can help to identify a child or adult with scoliosis merely by looking at the person in a standing position, preferably with no shirt and in boxers, and observing the following:
- One shoulder may be higher than the other.
- One scapula (shoulder blade) may be more elevated or more prominent than the other.
- With the arms hanging relaxed at the sides, there may be more area between the arm and the body on one side.
- One hip may look to be higher or more pronounced than the other.
- The head is not in plumb with the pelvis.
- One side of the back appears higher than the other when the individual is observed from the rear and asked to bend forward until the the spine is horizontal.
The child or adult should be sent to a healthcare professional, such as a chiropractor, for further assessment once scoliosis is suspected. your chiropractor would be happy to help.
The most common type of scoliosis is, by far, Idiopathic, and even though there are a variety of causes and many varieties, Idiopathic Scoliosis accounts for approximately 85% of all cases. “Idiopathic” means “no known cause” and is observed with equal occurrence in boys and girls in the mild or low curve magnitudes. This condition can be sub-classified into infantile, juvenile and adolescent types, based upon the age of onset. Idiopathic Scoliosis may be due to genetic or hereditary influences as it frequently runs in families. However girls, for unknown reasons are five to eight times more likely than boys to have their curves develop in size and require treatment. The most frequent time for the development of Idiopathic Scoliosis is during adolescence when children are completing the last major growth spurt. Unfortunately, at this age young people are hesitant to allow their body to be seen by parents and other adults, so it is wise to have this age group viewed on a regular basis.
If a scoliotic curve is found in the growing adolescent, it is crucial that the curves be monitored for advancement by periodic examination and sometimes standing X-rays. In ninety percent of instances, the scoliosis is mild and does not require active treatment, however increases in spinal deformity necessitate evaluation to ascertain if a brace or other treatment is necessary. In a small number of people, surgical treatment may be required.~Surgery may be needed for a small number of people.
Brace treatment (orthosis) is recommended for newly-found symptoms of moderate scoliosis or abnormal kyphosis, as well as when an increase in scoliosis or kyphosis is identified in both juvenile and adolescent children. There are quite a few styles of braces, all designed to prevent curves from increasing through the process of acting as a buttress for the spine during active skeletal growth. Braces generally won’t make the spine entirely straight, and cannot always keep a curve from increasing. However, bracing is successful in stopping curve progression in a very large percentage of skeletally-immature adolescents.
There is no simple solution for scoliosis. The majority of cases, even though frequently monitored, are not actively treated. The usual medical treatment for moderate cases is a brace, whereas severe afflictions in a few instances are treated surgically. You may want to see your local chiropractor first.
In addition to bracing, many other therapies have been used successfully like specialized exercise, electric stimulation of spinal muscles, nutritional programs, and chiropractic treatments. It looks as if the most effective results have been supported with a multi-faceted approach to the management of this abnormality.
There are chiropractors, that have expertise managing scoliosis cases.
