The Health Biz

Scoliosis: An Introduction

When the body is looked at from behind, a normal spine is straight without much alteration from one side to the other. Therefore, if the spine is seen to have a lateral, or side-to-side, curvature, the patient might have a condition called scoliosis.This condition often gives the appearance of the person leaning to one side though it should not be confused with bad posture. Scoliosis is a troublesome deformity that is characterized by both lateral curvature and rotation of the vertebra frequently causing 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 connected ribs posterior hence causing the symptomatic rib hump seen in thoracic scoliosis. The pulmonary and cardiac functions can be interfered with if the thoracic curve and rib rotation exceeds 70 degrees. Oftentimes later in life in untreated severe idiopathic infantile and juvenile scoliosis patients, this degree of curve and subsequent cardiac and pulmonary changes can be life threatening.

Anatomy

If a person were to observe the trunk from a side view, the spine would disclose four normal curves: the cervical, thoracic, lumbar, and sacral. In the lower spine there is a healthy “C-shaped” curve called swayback or lordosis, while the thoracic curve in the chest vicinity has a “reverse C” called a kyphosis. Hyperlordosis is the term used to describe increased swayback, while increased kyphosis in the thoracic spine is called hyperkyphosis. Scoliosis changes generally accompany changes from normal on a side view. Postural exercises can eliminate some round back deformities that are simply due to poor posture. A small number of individuals with kyphosis have more rigid deformities than the postural type, which are coincidental with vertebral deformity. This kind of deformity, called Scheuermann’s kyphosis, is much harder to treat than postural kyphosis, and it’s cause is unknown.

Even a nonprofessional can help to identify a child or adult with scoliosis simply by viewing the person in a standing position, preferably bare-chested and in boxers, and observing the following:

• One shoulder may be higher than the other.

• One scapula (shoulder blade) may be raised or more conspicuous than the other.

• With the arms hanging freely at the sides, there may be more room between the arm and the body on one side.

• One hip may look to be more elevated or more prominent than the other.

• The head is not centered over the pelvis.

• One side of the back appears more elevated 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 evaluation once scoliosis is suspected. your chiropractor would be happy to help.

There are a variety of origins and many kinds of scoliosis, but the most common, by far, is Idiopathic Scoliosis, which accounts for approximately 85 % of all cases. “Idiopathic” means “no known cause” and is seen with equal occurrence in boys and girls in the mild or low curve magnitudes. Depending on the age of onset, this affliction can be sub-classified into infantile, juvenile and adolescent types. Idiopathic Scoliosis often runs in families and may be linked to genetic or hereditary influences. For reasons yet to be found, girls are five to eight times more likely than boys to have their curves develop in size and require treatment. As the term “Idiopathic Scoliosis” suggests, this type of scoliosis more often than not occurs when children are finishing their last major growth spurt. Unfortunately, at this age young people are disinclined to allow their body to be viewed by parents and other adults, so it is smart to have this age group viewed on a regular basis.

It is crucial that if a scoliotic curve is observed in a growing adolescent, the curves be monitored for any development by a periodic examination and sometimes standing x-rays. In ninety percent of conditions, the scoliosis is mild and does not require active treatment, however increases in spinal deformity demand evaluation to ascertain if a brace or other management is required. In a small number of patients, surgical treatment may be needed.~Surgery may be required for a small number of individuals.

Brace support (orthosis) is recommended for both juvenile and adolescent children when an increase in their scoliosis or kyphosis is observed, or when new symptoms of moderate scoliosis or abnormal kyphosis are found. There are quite a few kinds of braces, all made to prevent curves from increasing through acting as a buttress for the spine during active skeletal growth. Braces will not usually make the spine completely straight, and cannot always keep a curve from increasing. Nevertheless, bracing is effectual in halting curve progression in a very large number of skeletally-immature adolescents.

Scoliosis has no simple answer. The majority of cases, even though frequently monitored, are not actively treated. The common medical treatment for moderate cases is a brace, whereas severe cases in some cases are treated surgically. You may want to see your local chiropractor first.

Besides bracing, many other modalities have been used successfully including specialized exercise, electric stimulation of spinal muscles, nutritional programs, and chiropractic treatments. It looks as if the best results have been supported with a multi-faceted approach to the management of this affliction.

There are chiropractors, that have expertise managing scoliosis conditions.

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