Scoliosis

Scoliosis and Pregnancy – You Should Know [QUICK OVERVIEW] 0

According to most medical researchers conducted on women with scoliosis, the effect on their pregnancy conditions seems to be relatively insignificant.

The risks of pregnancy increase the spinal cord curvature were also significant in the lower order.

Exception cases were observed wherein women were apparently going through their 3rd or 4th childbearing.

Only among them, the curvature was found to increase by 50 and 100.

The included criteria were:

  • Treatment of scoliosis through nonsurgical methods.
  • Women with scoliosis who had undergone more than 3 pregnancies.
  • Women with scoliosis who were in their 1st or 2nd pregnancy.

Clinical Studies on patients with scoliosis and pregnancy

The clinical studies which were conducted on a group of expecting mothers revealed certain interesting facts like

The changes in the posture, which took place during the growth of pregnancy, were found to be in a natural manner. They helped them in taking a straight position.

Most of the weight was concentrated in the abdominal region. The weight then spread along its width area.

When women who were into their 12th week of pregnancy were subject to scanning, it was found that

  • The expanding uterus moved out of the pelvis region and grew towards sideways, superior and forward directions.
  • The position of lumbar lordosis was observed to remain more or less undisturbed.

The only observed fact was that Normal delivery may not be possible in some advanced scoliosis cases, where cesarean delivery was recommended.

In some cesarean delivery cases, the women were also made to undergo surgical methods to cure their scoliosis problem.

Clinical Studies on patients who had a pregnancy after scoliosis therapy

In another case, the patients who became pregnant after undergoing therapy for scoliosis were subject to clinical analysis.

For this purpose, a group of 20 female patients was selected. Around 35 – 40% of them had developed back pain during their pregnancy period.

70% of the tested patients reported back pain even after childbirth.

They had to undergo physical therapy again.

This was conducted to solve the problem of lower back pain.

Types of scoliosis and their effects on pregnancy

Among the various scoliosis types, only the kyphosis scoliosis seemed to have major negative effects on women’s health during pregnancy.

Even in such cases, their ability to conceive normally and deliver the baby normally through the vaginal canal seemed to have no major side effects.

This was after they were given proper medication to overcome their health problems.

Conclusion

The studies conducted in all the cases mentioned above (only) have revealed that scoliosis may not have any significant negative impact on pregnancy and childbirth, except for a few rare cases.

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Degenerative Scoliosis – Causes, Consequences [SOLUTIONS GUIDE] 0

What is degenerative scoliosis?


Degenerative scoliosis is a condition where the human spinal-cord undergoes a complete deformation in its shape.

It may start off with the stiffening and straightening process, ultimately leading to bending on one side.

The starting point of this condition is usually the degeneration of joints in the spinal cord.


What are the probable causes of this condition?

According to orthopedic specialists, this condition could be caused due to many reasons.

Though they point out some of the most common causes that might have been developing since childhood, they are unsure about the exact reasons that cause this abnormal condition.

However

Some of the most common causes, as pointed out by them, include

Bone-abnormality at the time of birth:

This is known as the congenital-form. In this case, the spine’s deformation happens either due to rotation or twisting of the spinal-cord roots. As the child starts growing, it results in the formation of multiple-dimensional curvature in the spinal cord.

  • Observation: In most cases, abnormal structured growth is usually not observed during early childhood. This happens mainly because of the relative softness of the child’s spinal cord. But as the child grows into teens and the spinal-cord starts getting harder, the abnormal shape is explicitly observed. Experts opine that this condition’s advancement is promoted by the Hemi-vertebra. The person’s top portion of the spinal cord and its lower portion is not in the standard vertical alignment.

Aging: This is yet another common cause in people over the age of 60. Here also, the causes are multiple in nature. Some of them are found to be

Wear & tear: This usually happens when the person is taking part in risky and traumatizing physical-activity filled games, actions, etc.

This could also happen due to excessive driving without proper caring of the spinal cord.

  • Observation: It may not be explicitly visible during adulthood, spanning from 25-55 or even much later. But as the muscle strength goes on weakening with age, this phenomenon becomes acuter. It is said that it gets worsened when the muscles surrounding the person’s spinal cord become weak. Then the curvature also gets more intense in nature.
  • Shallow-water-diving. No one knows the actual link between this sport and the development of scoliosis accurately. However, medical records show that people who practice this sort of sports or activities tend to develop severe scoliosis over a period, which becomes acute as they grow beyond their 60s.

Spinal-canal narrowing: This is said to be another major reason for the intense condition of this problem.

Digestion problems developed in the later ages of 60+ could also lead to spinal disorders. Accumulation of this problem slowly turns to scoliosis over time.

Some of the most common bowel disorders in old age could be listed as

  • Constipation-problem: Though most of the medical world opines that constipation results from scoliosis, the reverse phenomenon is observed in many cases at old age. Instances of chronic constipation have often turned into scoliosis problems. Hence it is suggested that seniors suffering from constipation need to care for it.
  • Injury to the spinal cord: An internal injury to the spinal cord often leads to weakening the lower and central portion over time. If left untreated, this could slowly turn into scoliosis. Experts suggest that prevention is better than trying to rectify the issue.

When does degenerative scoliosis occur?

There is a particular age or time during which one can expect the occurrence of scoliosis.

It could start right at the childhood age and surface when the person is in his teens, middle age, or old age.

What are the various forms?

Some of the commonly occurring forms of scoliosis are categorized into

Neuromuscular scoliosis: This is an asymmetrical shape developed by the spinal-cord due to unusual patterns found in the myoneural-lines.

  • Characteristics: The Pelvic-region becomes oblique in nature. Trunk-region collapses.
  • Treatment: According to experts, surgery is said to be the most effective way as it has crossed the stages of therapy and Bracing.

dextroconvex scoliosis: This is defined as scoliosis related to muscle-spasm in the chest area. From there, it slowly extends into the back and the arm region. Over time it reaches the lower back region.

  • Characteristics: The spine starts taking a curvature in the shape of “S”. This often results in shoulder pain.
  • Treatment: Therapy is suggested as one of the most effective ways to treat this type of scoliosis. Even though surgery is also an available option, it is avoided due to the risk of causing further injuries. Therapy takes more time, but at least saves the patient from possible permanent damages.

Levoconvex scoliosis: The curvature of the spinal cord to its left side is called as Levoconvex scoliosis. It is considered to be more dangerous since it affects the heart region.

  • Characteristics: This often results in impairing shoulder-alignment, with one tending to lower than the other. This often occurs due to the curving of T1-T12 bones of the spinal cord.
  • Treatment: The most effective treatment for this type of scoliosis is said to be putting the Braces. This helps to shape the curving spinal back into its normal shape.

Kyphosis scoliosis: It is called the frontward twisting of the spinal cord. It normally starts developing within the embryo when the spinal cord’s frontal-part fails to develop or segment in the right manner.

  • Characteristics: It is based on the two types of failures, namely Type-1related to the formation and type-2 related to segmentation. Type-1 is associated with the spinal cord’s Thoracolumbar region (The junction area between the lumbar and Thoracic-region). This type of scoliosis gets worse with time. Type-2 results when Normal disc formation is obstructed. This can often be observed when the person starts walking.
  • Treatment: Physical-therapy is highly recommended for this type of scoliosis. In the post-therapeutic-period, experts suggest exercises that aim to activate muscles around the region where Kyphosis is formed. This is supposed to be one of the most effective long-term treatment methods compared to surgical methods.

Rotatory scoliosis: This occurs when the spinal-cord experiences a rotational motion as well as has a curvature.

  • Characteristics: Leg and body movement becomes difficult. Participating in sports and related activities become an almost impossible task.
  • Treatment: Fluid-Isometrics is said to be one of the most effective treatments.

Cobb angle scoliosis: This is normally formed by the two lines (Parallel to Superior and Inferior end-Vertebra, respectively) intersection, resulting in a deep U-shaped curve at the spinal cord center.

This syndrome is named after the ortho expert Dr. Cobb who worked extensively on the causes, symptoms, and possible treatments related to this problem related to the crooked back.

  • Characteristics: The spinal cord gets into the shape of a crane’s neck. It is often followed by severe pain in the central portion of the spine, extending to the upper and lower portions.
  • Treatment: Side-Shift-Therapy is one of the most effective treatment methods advised for this type of scoliosis.

Functional scoliosis: This type of scoliosis is temporary in nature compared to the structural-scoliosis, which is permanent. This may be caused by inflammation (Appendicitis), causing spasms in the muscle.

  • Characteristics: These types of scoliosis can occur at any time. Since it is dependant on the functional condition of the spinal cord at that time, there will be no need to treat the spinal cord itself.
  • Treatment: Maximum treatment procedures are concerned with correcting the functional condition, which led to the development of such scoliosis. For example, the one caused by inflammation is healed when Appendicitis is treated.

Is scoliosis a disability?

According to the Blue-Book-Listing 1.04 aimed at benefits associated with Social-Security-disability, people with scoliosis problems are eligible.

Certain associated-symptoms are required to be explicitly exhibited and certified by a registered orthopedic-specialist. They are

  • Proving that Scoliosis condition prevents the person from performing his/her regular functions and s/he is unable to work.
  • Limitation of motion accompanied by pain, motor-loss, etc.
  • Inability to sit/rest in a particular posture for more than 2-3 hours, chronic disk-pain, etc.
  • Medical-Vocational-Allowance considerations.

Scoliosis FAQ

How do I determine whether I have Scoliosis?

Most of the time, you may feel consistent back-ache, which refuses to go away.

You may also experience shoulder pain of the same intensity. It may be caused by a lack of exercise, excessive fatty or acidity-causing food and beverages (especially alcohol), etc.

If you are experiencing any such sort of pains, wait for a couple of days and try out simple medications to get rid of your acidity or related problems.

If the pain still persists:

Take a look at your standing posture, in front of a life-size mirror, or you can even expose your back portion to one of your family members (friends) and ask them to tell you any abnormal deviation of the spinal cord from its normal position.

The best way is to consult your physician and ask him to complete your spinal cord analysis.

He will be able to point out your problem accurately.

What are the treatment options which I have?

Physical-Therapy is the most preferred method because it involves non-invasive methods of treatments.

Moreover, the methods naturally try to bring the spinal-cord back to its normal position.

The effects are said to be long-lasting and without any significant negative-side-effects on your spinal-cord and your health.

Bracing is another method where your spinal-cord is set at the right angle with the help of an external device. You will have to wear this device most of the time during the day, or perhaps even during the night. The structure of the brace depends on the type of scoliosis and its intensity. However, it may not be possible to treat all types of scoliosis in this method. For example, Kyphosis is one such type.

Surgery is said to be the last suggested method. Even orthopedic experts have the same opinion. This is primarily due to the reasons that

  • Surgery involves restructuring /removal of certain key parts of your spinal cord. This may give relief in the initial stages. At later stages and in a longer duration, this may prove to be a disadvantage.
  • Surgery may result in permanent injury to critically functional parts of your spinal cord, making them permanently non-functional.
  • Surgery may make you carry the pain for a longer time in your life.
  • However, there are many cases where surgery is considered the only option because all the other available options have been evaluated /tried out and ineffective.

Who decides about my treatment method?

Obviously, it will be your physician/Orthopedic expert who is treating you for a long time.

What is the basic difference between congenital-scoliosis and idiopathic-scoliosis?

The former gets formed in the early/advanced stages pre-natal period. Some of them are said to be formed even within the embryo itself. The latter is said to form during childhood, teenage, adulthood, or old ages.

Sclerosis of the Spine – Complications involved [EXPLANATION GUIDE] 0


What is sclerosis of the spine?

It is a condition where the interior space between the spinal cord disks starts compressing over a while.

Most of the time, these symptoms are observed in the lower back portion.

When this condition occurs, the result is often consistent pain and hindered normal activities.

The patient is unable to sit or move comfortably for a longer period.

This also results in the tissue hardening of the spinal cord region. Sclerosis is said to be only the first stage.

This will be followed by many other complex disorders like

  • Multiple Sclerosis
  • Systematic Sclerosis
  • Amyotrophic Lateral Sclerosis
  • Liver cirrhosis and many more.

What are the possible causes?

Several causes have been attributed to the development and worsening of this condition.

  • Wearing out/inflammation of the myelin sheath surrounding the neurons: This is said to severely affect the interneuron communication adversely. Axons lose results, which starts spreading its effects to the complete spinal cord, especially the lower region.
  • Neurons start wearing out: This often leads to the formation of tumors like structure in the various regions of the brain, spinal cord, and the skull. This ultimately leads to bone hardening and an abnormal increase in bone density. This might lead to spine curvature when the conditions go to the critical state.
  • Vertebral bones start wearing out: Each of these vertebras has an endplate present at its top and bottom. As the plates start wearing out, results in consistently decreasing blood supply to these regions.

What are the possible consequences?

  • In the initial stages of the Sclerosis, one will observe changes in movement coordination. The smooth flow, which is supposed to be a mark of movement, is no longer there. At times, the person may feel that he is literally being prevented from moving by some internal force.
  • The next stage is the development of numbness along the complete spinal cord, which often extends to the region’s arms and legs. Even simple movements cause a severe sense of fatigue.
  • Kind of itchy feelings start developing within the spinal region and extend to all the connected muscles and bones.
  • The next stage is the weakening of muscles. As the neurons become weaker and the blood supply becomes erratic, the muscles lose their strength and stamina.
  • The person starts losing his physical balance while walking.
  • The next stage is the development of breathing complexities.
  • The next stage is the weakening of limbs to such an extent that they start shaking involuntarily. In the beginning, it may be sporadic. But as time progresses, it becomes severe in intensity.
  • The person starts losing body weight dramatically. This is largely attributed to the thinning of muscle mass and loss of bone weight.

The ultimate result would be the affecting of brain cells and neurons. The person is unable to retain memory for a long time.

This could be due to the systematic degeneration of the brain cells.

This onset is often accompanied by a severe state of mental depression.

According to experts, this critical condition is highly irreversible.

That means once the person reaches this stage, it may not be possible to reverse the trend, no matter how sophisticated the treatment or the medication at this stage may be.

What is the best method of treating sclerosis?

Experts opine that early detection and treatment are among the best methods for curing this “disease.” There are numerous methods by which this can be diagnosed.

Advanced scanning and radiology methods are available through which it could be detected.

What are the possible methods of treatment?

Though surgical methods are available, experts often strongly recommend that the person be subject to a therapeutic treatment.

Only when the patient’s condition has progressed to such an extent, where the therapeutic and other methods fail, surgery would be advised as a last resort.

Can You Die from Scoliosis? – Science Say [MYTHS VS FACTS] 1

If you were to ask the question, can you die from scoliosis and expect a prompt answer, it is “No” and “yes.”

The first answer is no because scoliosis alone cannot kill a patient, while the answer “yes” is because when it becomes severe, it can lead to other complications resulting in death.

However, it is not like a sudden-death situation.

According to a study conducted at the major American cities from 2007 till today, scoliosis related deaths were about 1.7 – 1.8 for every 1000 cases.

You will be able to judge the answer to the question can scoliosis kill you, based on these facts alone.

Scoliosis intensity becomes severe only when it is left untreated for a long time.

Even in such cases, the diagnosis will reveal the intensity. Kyphosis and Cobb angle scoliosis are said to be the most complex ones observed in medical history so far.

There are various methods of cure available for this problem today.

If it is in the initial stages, patients are given braces.

Wearing them over a longer period can result in spinal corrections.

The next available option is Therapy.

One of the most well-known therapy methods is said to be the Schroth method.

Bodywork method, message type therapy, mobilization type therapy, and manipulation type therapy are the other notable therapy types.

The last and least advised method is the surgical method.

This is said to be the final resort when the spinal deformity has gone beyond the control of Bracing and/or Therapeutic methods. There are many advantages as well as disadvantages of using this method.

Advantages

  • It works where the other methods have relatively failed.
  • The structural changes brought about are swift and permanent.

Disadvantages

  • Involved risks, including permanent damage, numbness, and other side effects, are more.
  • Involves physical changes to the spinal cord structure, increasing the chances of affecting other body parts’ functionality more.

 

Non-surgical Methods – Completely Curing Scoliosis [EXPERTS SAY] 0

Traditional methods of getting rid of scoliosis involved surgery.

Though it is undoubtedly one of the most effective and reliable methods, surgery’s side effects make it risky.

The other risk involved in the age-factor.

When performed in children and adolescents, this method was found to give 70%-80% success-rates.

On the other hand, performing surgery on people belonging to the adult and old-age showed only 60%-70%.

Even in such cases, the chances of risks involved in the post-surgical period were quite high.

Keeping all these aspects in view, the orthopedists/experts suggest that the patient undergo physical Therapy for scoliosis.

This non-invasive-method is said to be safer and beneficial in many ways. Some of the benefits include

Lessened risks of injuries: The Therapist uses various exercising and massaging techniques to change the spinal cord –shape, without actually causing them any sort of internal injuries.

In some cases, the usages of therapeutic-machines are recommended to perform the stretching exercises.

They may take more time and effort on the orthopedist part to make it work, but it surely and practically works.

The spinal cord can be conditioned over some time slowly: Once the specialist can diagnose the problem accurately, he will be able to prescribe the right method of Therapy.

When performed according to the right procedure and steps, Therapy can produce non-reversible results.

That means the cure is more or less permanent compared to the results obtained through surgical methods.

Therapy can be perfumed based on specific cases: Though the machines and equipment used may be the same, the treatment methods vary for each type of scoliosis.

This takes some time for the therapist to analyze the individual deformation-type in detail.

Then he decides the type of Therapy and the time for which the Therapy has to be performed. This makes it easy for planning the therapeutic-schedule accurately.

Therapeutic-methods are much cost-effective compared to the surgical methods involved.


How to get rid of scoliosis through different types of Therapy

There are various types of therapeutic methods through which one can get rid of scoliosis for good.

Some of the use Pilates for scoliosis, while the others depend on stretches for scoliosis.

All these methods depend on the therapist’s efficiency and the machine & methods deployed during the process.

Some of the most prominent among them are

Physical-therapy-method: The basic types of physiotherapy-method involve the process of bone and structure-realignment and/or corrections/manipulations. Though both of them sound similar, clinically speaking, they are different. The process of alignment involves

Reducing the muscle-spasms that are exerted onto the spinal cord. This is done by constant decompression forces on each part of the back-muscle, extending to the spinal cord. When done repeatedly over specific-time-frame, the results could be quite appreciable in nature. Dextroconvex-type-of-scoliosis is one such case where Therapy works practically well.

Therapy works in three-planes to solve the 3-dimensional-problem posed by scoliosis.

  • The Saggital-Plane: This method involves spinal-de-rotation, Spinal-deflex, and spinal-correction. It involves elongation of the spine all along in the Saggital-plane. This Therapy is said to be highly effective in reestablishing the symmetrical-alignment of the spinal-cord back to normal. The other advantage of this method is the restoring of muscular-balance on both the concave and convex sides of the spinal cord’s muscles. Experts suggest that the concave-side-muscles have to be shortened (During scoliosis development, this part of muscles normally tends to elongate beyond their normal dimensions, especially in the longitudinal direction). Now, the other part involves elongating the convex-part of the muscles. (Normally, muscles in this part tend to get compressed during the progressive development of scoliosis over time). Once these two tasks are successfully performed, the patient’s muscular-structure surrounding the spinal-cord is restored.
  • The Frontal-Plane: Methods of Therapy applied in this plane are normally in concerto with the Saggital-plane. They are mainly focused on restoring the structural elements that balance the coordination between the frontal-organs like the heart, lungs, and others with that of the back of the spinal cord. Once this is achieved, the vertical-balancing is achieved.
  • The Transverse-Plane: This is used to establish the stabilizing-factors between the horizontal and vertical planes of the spinal cord. Once this balance is achieved, the relative-progression of scoliosis is bought under control.

Benefits of Physical-Therapy

It involves many physical, mental, and psychological benefits, which work in the long run. It has been found to practically solve many of the complex forms like thoracolumbar scoliosis. Some of the most prominent of them are listed as

  • 3-Dimensional-Auto-Correction: As we have seen in the three planar-method used by this Therapy, it restores the balance in all three dimensions.
  • Coordination-restoration: In most of the scoliosis-cases, the effective coordination between various organs with the spinal cord is eventually lost. This happens because of the increasing damages caused to the neurons and other nerve cells. Physical Therapy aims to restore this balance by soothing the nerves in the first place. Experts deploy certain manipulation and alignment techniques that slowly restore the sensitivity of the nervous system back in order. Of course, this is achieved in parallel with the 3-D corrections. This balanced approach ensures that the neurons regain their sensations back and better coordinate the muscular/neural/spinal movements and functions.
  • Reestablish the body-equilibrium: This is achieved by bringing the body’s C.O.G (Center-Of-Gravity) back to its original position. This helps in making the patient walk normally without wobbling or falling down in the process!
  • Increasing the muscles’ strength/endurance-levels: Gradual applications of alignment and correction methods help bring the natural flow of blood back into the muscles, especially those surrounding the concave and convex regions of the spinal cord. That means supplies of oxygen, vitamins, and minerals are to the muscles and tissues are brought back in order. When the patient starts on a nourishing diet-pan, the muscles get increased endurance-power.
  • Respiration is restored back to normalcy: In some scoliosis cases like the Kyphosis-scoliosis and Cobb-angle-scoliosis, the functionality of lungs comes under immense pressure. The post-therapy period restores the “space” around the lungs back to its original condition.

Post-therapeutic-exercises

Experts say that Therapy is only half the job done. Though the results are said to be more or less permanent in nature, the patient has to perform certain mild scoliosis exercises to keep the spinal-cord in its most efficient functional condition. Some of such exercises are

  • Dynamic-hip-movement: This is normally achieved with the help of a large-ball. This helps in achieving the lateral-movement of the back. It also strengthens the spinal-cord, starting from its base, extending up to the neck region.
  • Stretching the spine and rise to a comfortably-seated-posture: This is quite useful in restoring the abdomen’s structure and functionality in the M-Rectus point.
  • Spine-movement in the lateral-direction: This exercise helps in stretching-out the lateral-chain of muscles in the same direction in which the scoliosis-convexity goes.
  • Step-chair-exercises: This involves resistance-training to the muscles and bones in and around the spinal cord region. This is done with the help of light-weight resistance-springs.

 

Surgical Scoliosis Solutions Cost [EXPENSES EVALUATION] 0

If you are serious about getting surgery for your scoliosis problems, it is better than you have it covered by medical insurance.

According to various studies conducted across the USA, the average cost estimation comes to about $150,000, which is quite huge.

Most of the time, this will be apart from the costs incurred on doctor visits, scanning charges, radiology costs, anesthesiologist consultation costs, hospitalization costs, and more.

Now the question is about the effectiveness of the surgery.

Surgery is advised only in such cases where the deformity’s complexity and intensity have gone beyond the stage of corrections through braces and therapy.

Moreover, surgery is performed for the reduced pain level in the patient.

The other reason to perform surgery is to restore functional level normalcy back in the patient’s body.

According to a survey conducted across the USA in the past 3 – 4 years, most patients with initial and mid-level scoliosis problems were treated in a non-surgical manner itself.

This was primarily due to the reason that the problem had not progressed to such an extent from where their heart, lungs, or other critical organs’ functionalities could be affected.

They all got well from therapy or usage of braces over a while.

The chances of complications arising due to surgery also need to be considered.

In children and adolescents, the chances of complications are quite less, while the adult scoliosis surgery complications seem to be high in %.

This is basically because of the bone hardness, other medical issues, complex procedures involved, and other factors.

The other complications could be blood loss, breaking of rods/post-surgery hooks dislocation, spinal fusion failure, post-surgical back pain, etc.

The overall success rate in adults’ cases is estimated to range from 60 70% today.

This is why most non-critical stage patients prefer non-surgical methods for getting their problems in the long run, which will also save a lot of money for them.

Physiotherapy for Scoliosis – Know Everything [THE GUIDE] 0

Physiotherapy is one of the available treatment options for those who have scoliosis.

While a few years ago, most patients needed to use a brace or maybe even go for surgery, there is now an alternative.

More than that, physiotherapy offers an option that strengthens the back muscles while correcting the spine’s curvature.


What Is Scoliosis?

The human spine consists of 24 spinal bones that are termed vertebrae.

The spinal column is composed of these vertebrae stacked on top of each other, which forms the body’s primary support.

Looking from the side, three curves can be seen.

The cervical spine, or the neck, has a slight inward curve while the thoracic spine has an outward one.

The lumbar spine, or the lower back, and the cervical spine curve inward as well.

Looking from the back, the vertebrae looks like a straight column, so that the head is positioned in the center of the body.

When one has scoliosis, this curvature is different, forming a spine deformity. Instead of the spine’s straight normal curvature, it is instead C-shaped (or one curve), or it may even be S-shaped (or two curves).

Any curving of the spine that is more than 10 degrees is considered scoliosis.

Scoliosis can also be categorized depending on when it starts to develop.

Before three years of age, cases are called infantile scoliosis.

On the other hand, juvenile scoliosis happens between the ages of 4 and 9.

Adolescent scoliosis occurs after ten years, and until growth is completed.

No one develops classic scoliosis during adulthood, but some might have residual effects of childhood scoliosis.

Most infantile scoliosis happens in the low thoracic region and has only one curve but some vertebral rotation.

When the vertebrae rotate:

The ribs that are attached will shift and cause a hump that is very visible on one side.

The hump is very visible when the child bends forward at the waist.

These cases also normally bend to the right, especially after the patient reaches two years of age.

In the case of juvenile scoliosis:

Boys develop this condition earlier than girls.

Because the curving might last until the skeleton matures and because this occurs later for boys compared to girls, they have a higher risk of curve progression.

Both juvenile and adolescent scoliosis normally curve at the right thoracic spine and develop into double curves.

Type Of Scoliosis Based On The Root Cause Of Curvature

1. Idiopathic Scoliosis

There is no known reason for most scoliosis cases, which is why there is no overall treatment that will be successful for all.

Those that have no clear cause are called idiopathic scoliosis. It affects about 2 to 3% of the population, and also runs in families.

Lastly

It is more commonly found in girls than in boys and develops during the middle or late childhood when the child is going through a rapid growth spurt.

There are also cases of scoliosis that are congenital or present at birth.

Some may also develop due to some other neurological conditions like cerebral palsy, spinal muscular atrophy, or spina bifida.

While scoliosis might affect any part of the spine, it is mostly observed in the thoracic and lumbar spines.

In these cases

The vertebrae are curving to one side and may even rotate.

This makes the shoulders, waist, or hips look uneven.

The spine develops a C-shape so that the hips and the shoulders appear to tilt low on one side.

The body will attempt to correct this and keep the head in the middle to curve the lower part of the spine into the other direction.

This is when it starts to form an S-curve.

2. Structural Scoliosis

Structural scoliosis arises from issues where the musculoskeletal system develops.

Specifically, when the spine loses the flexibility of the rotated vertebrae. They then become fixed, and when the thoracic vertebrae are affected, the rib cage may become rigid as well.

In these cases, the spine does not have the mobility required for a reversal of the spine’s extreme curvature.

3. Functional Scoliosis

On the other hand, functional scoliosis is caused by muscle imbalance, a discrepancy in leg lengths, and tissue inflammation.

It might also be due to an injury to an intervertebral disc that follows with a secondary muscle spasm. When the patient is lying down or bending, the curve disappears.

There may be some ways to correct this misalignment and prevent health problems in the future.

What Are The Symptoms Of Scoliosis?

Patients themselves do not really feel any symptoms, nor do they realize that their spine curve has changed.

Instead, they may notice other signs like clothes not fitting anymore or that their posture is not straight.

Sometimes, parents or teachers may observe an asymmetry.

When the spine curves, the body tries to adapt so that the head stays in the middle above the pelvis.

Because of this, patients may notice their shoulders and hips to be uneven so that a sleeve or pant leg appears shorter.

When the vertebrae rotate, the waist appears uneven, and patients may notice that their pants or skirts tend to twist to the side.

The most common and visible signs of scoliosis include uneven shoulders, hips, breasts, or nipples.

They may also notice a prominent shoulder blade wings on one side, or simply a tendency to lean to the side. Lastly, when bending forward, a bump can be seen on the side of the spine.

Once these signs are detected, the patient should be examined by an expert.

This may be a pediatrician in children, a physician, an orthopedic surgeon, or even a physiotherapist.

In some cases, functional scoliosis, early detection, and treatment can help avoid further health issues and correct the spine’s curvature.

Because untreated scoliosis can become severe, it is important to get a professional’s advice to avoid problems.

Severe scoliosis may one day exert too much pressure on the internal organs like the lungs, liver, heart, and others.

Breathing and cardiovascular function may suffer if scoliosis is not managed.

Although having scoliosis has no pain symptoms, the curving and rotation of the spine may eventually manifest in some pain that is coming from muscles, ligaments, or joints when there is uneven pressure on them.

How To Diagnose Scoliosis

In the case of schoolchildren, they are first observed to be suffering from scoliosis during the school’s screening program conducted by the school nurse, doctor, or another qualified individual.

A forward bend test, also called the Adams test, is conducted to check for any prominent ribs or spinal changes, both of which may be scoliosis signs.

The test is conducted by having the child bend forward very slowly at the waist, much like when diving into the pool.

The doctor or nurse will carefully observe the spine from behind.

Suppose there are any signs or symptoms of scoliosis. In that case, the patient is referred to the family doctor to once again check out the spine and identify a probable cause of scoliosis.

There is no need to do an x-ray, especially if it is not needed to diagnose it.

This will then lessen the child’s exposure to radiation, neither necessary nor good for growing children.

Only in severe cases are x-rays needed and helpful in viewing the vertebrae’s rotation or tilt radiologically when there are signs of unevenness or other changes.

However

If the doctor thinks the root cause is a tumor, an infection, or even issues in the nervous system, an MRI may be requested.

If there is an x-ray done of the spine, the doctor will study the curvature using a Cobb method technique. It will search for the location and measure the degree of the curve.

If there is more than a 10-degree curve, it is considered to be scoliosis.

Part of the treatment plan requires the maturity of the skeleton or bone growth. This may also be accomplished through an x-ray.

The Risser sign is used on these x-rays to observe whether the child is still growing or not.

The stage of growth and the amount of the spine’s curving affect the treatment approach.

The Treatment Options

Based on the factors like the stage of the child’s growth and the patient’s age, various treatment options are available.

First of all, there are also instances when no treatment is required, as it may go away on its own.

This is common to infantile scoliosis, where up to 90% of cases will resolve itself, or the child will grow out of it.

Other methods to treat scoliosis may be to use a brace, use an exercise plan, or have surgery.

Adults who have lingering effects of childhood scoliosis might still consider exercise as a treatment plan. Still, most of these approaches are most likely to be effective when they are started as soon as possible, especially before the patient stops growing.

Beyond the age and skeletal maturity, the patient’s severity of curvature is another excellent factor in pinpointing a treatment option.

Of course

The patient and the family (especially in the case of minors) also have a say or can choose a path based on their preferences.

Physical exams and x-rays may be conducted regularly over the treatment course to check whether the treatment is working or not.

Usually, patients with a curvature of fewer than 45 degrees may be offered a brace or exercise as a treatment approach. Still, those are quickly changing, or those with more than 45 degrees might be recommended to opt for surgery.

Option 1: Observation

The doctor is likely to propose observation when the spine curve is less than 30 degrees, and the patient has stopped growing.

Otherwise, the recommendation is to go for treatment, depending again on several factors.

Option 2: Bracing

Braces are the traditional approach for scoliosis, specifically those with curves that are slow to progress.

It is much more successful once it is done early on. However, this treatment’s disadvantage is that physical activity becomes restricted while the patient has the brace on.

This might lead to the weakening of muscles, especially in the core.

Two types of braces are used, the Milwaukee brace and the Boston brace (also called a thoracolumbosacral-orthosis or TLSO).

Various research has shown that braces for scoliosis effectively control the curves and prevent the condition’s progression.

However, it is important to note that it does not correct the spine’s curving in a majority of the cases.

Instead

It just prevents the curvature from becoming worse.

Moreover, if the curve is more than 40 degrees or double curves, bracing might be less effective.

Typically these braces are worn the whole day but:

Some doctors approve removing it for 2 to 3 hours every day, allowing the kids to participate in sports (also with the physician).

But in general, sports that need flexibility or involve a lot of body contact are prohibited or not possible.

This treatment type will usually last for two years or until there are no more signs of further spinal curvature changes.

The doctor will regularly monitor through follow-up visits or regular x-rays, especially if there are rapid changes or the patient is undergoing a growth spurt.

Option 3: Exercise

For a long time, braces were the standard and the most accepted treatment approach for scoliosis. This is because previous studies have discounted the success of the exercise.

However, researchers have revisited this outcome and discovered that the patients in these previous studies have not faithfully followed the exercise regimen.

This is the reason why there were no positive effects or changes that were observed in the past.

With the widespread use and the development of technology, it becomes easier to monitor changes due to exercise, like checking on muscle function.

It has been observed that scoliosis patients have an asymmetry in their muscle function, specifically an unevenness in strength when rotating the trunk.

This affects the posture:

On the body’s appearance, it may bring about pain. In worse cases, it may even hinder the lung’s ability to function fully, especially when the curve is located in the thoracic spine.

Now physiotherapy offers another treatment option other than, or together with, the brace.

Not only does it remove the disadvantages of the brace, like hindered flexibility, it also keeps the muscles stronger than when the spine is braced.

Physiotherapy

Using a specifically prepared and appropriate exercise program can stop or slow the progression of scoliosis.

At the same time, patients can experience less pain and improve their posture and appearance.

It will also retain the normal functioning of the lungs.

The recent guidelines state that:

Physiotherapy or exercise is a good approach for those with curves less than 45 degrees. It may benefit all those with scoliosis by strengthening the core muscles that have been affected by the disease.

Studies are also showing a combination of physiotherapy and braces as an effective approach to scoliosis.

Option 4: Surgery

In severe cases, surgery is necessary to install metal rods and screws to straighten the spine.

The vertebrae become fused to correct the curve.

However, only a tiny amount of scoliosis patients may need surgery, normally those with curves of more than 50 degrees or more.

Patients who have not seen any success in bracing may also be in line for surgery.

The surgery is minimally invasive due to new techniques. It is done to possibly prevent the spinal curvature’s progression and improve the appearance by reducing the existing deformity.

After the procedure, post-rehabilitation physiotherapy will help the patient get back on their feet stronger than before.

What To Expect At Your Physiotherapy Treatment

The First Meetings

As with other scoliosis treatment options, physiotherapy is tailor-fit to the needs of the patient.

This means, in the first few visits to the clinic, the physiotherapist will ask questions and look at all x-rays and tests conducted to understand the specific condition of the patient.

It is also important to mention whether other treatments have been recommended or other professionals have been consulted.

A physical examination will also occur, using the hand to feel the spinal curve in various positions like standing, sitting down, or in a face-down position.

How the patient moves is also of great interest, so the physiotherapist will ask the patient to do some actions to assess the spine’s movements, like bending to the side, twisting, and leaning back and forward.

They will also most likely search for a thoracic rib hump; the more this is pronounced, the bigger the curve is.

Other parts of the body that should be affected by scoliosis will be carefully observed.

 Specifically

They will check the shoulders, the hips, the neck, and the low back in motion.

If needed, certain exercises can be done to maintain their strength and motion.

After the physiotherapist can gather all the evidence, they will be able to determine how scoliosis affects the day-to-day movement.

The Treatment Part

Of course, the next step is to design a specific exercise program that can be done either at home or at the clinic.

Especially if the child is still young, the parents may provide parental support or assistance.

The exercises that have been specifically designed for the patient may include stretching exercises from the back to behind the legs.

 In terms of exercises, there are quite a few to be done.

Strengthening the buttocks area will ensure proper support for both the thoracic spine and the lower back.

Patients should also expect spinal rotation, side bending of the spine, and core stability exercises.

In some cases, providing the patient with items that build resistance can lead to halting or even reversing the curvature.

It is highly important always to get advice from the physiotherapist to ensure that the exercises are properly done (should be observed).

Incorrect movements or using a lot of weight may make scoliosis worse or might even lead to pain. If necessary, more repetitions might be done to correct an imbalance.

To counteract the effects of scoliosis on the lungs and breathing, the physiotherapist will require breathing exercises and cardiovascular activities.

Of course, maintaining good posture will also be of great help, so patients will be instructed on keeping it for as long as possible.

Even simple things such as posture, a proper way of sitting, walking, and standing have adequately done can cause a considerable difference.

The Outcome

Compared to those who use back braces, patients who are following an exercise regimen may report an overall improvement in muscle tone and strength beyond just an improvement in spine curvature instead of bracing, which may not even allow the use of the important muscles in the back.

Conclusion

Of the three treatment approaches, physiotherapy is emerging as the new favorite.

Physiotherapy itself already offers scoliosis patients with a long list of procedures to correct their curvature or relieve them of pain.

Some of these examples may include manual therapy, joint mobilizations, and even resistance exercise.

Just make sure that when you choose physiotherapy to deal with scoliosis, you turn to a professional who has experience in this condition not to waste time and energy.

Ensure that he or she also has tailor-fit the treatment after consulting with you, the patient, to know that it will be more effective.

Physiotherapy offers a unique approach to dealing with scoliosis.

While braces have immobilized patients in the past, new therapies use movement and exercise to correct the spine’s abnormal curvature.

Research has proven its effectivity, whether as a stand-alone option or combined with other scoliosis treatments like braces.

Sources:

 http://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/adolescent-idiopathic-scoliosis

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004085/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296853/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132192/