Introduction
Scoliosis is a type of spinal curvature that can be split into functional and structural scoliosis. Functional scoliosis is usually caused by poor posture and leg length discrepancy (LLP). On the other hand, structural scoliosis is unknown in nature and can be due to congenital or neuromuscular problems. Scoliosis affects 0.4 – 7% of the Asian population and females are eight times more predisposed as compared to males. When scoliosis develops, the spine bends sideways and rotates along its vertical axis. Not all spinal curvatures are considered as scoliosis. Only spinal curvatures that are more than 10° are classified as scoliosis. Some patients with scoliosis require surgery while most do not as it may be helped depending on the type of scoliosis and the symptoms.
Types of Scoliosis and Diagnosis.
Functional scoliosis is due to poor posture or a functional leg length discrepancy (LLP) causing uneven pelvis which then deviates the spine over time. This can cause the individuals to lean more on one side compared to the other creating an appearance of a scoliosis. This type of scoliosis is easier to help or treat depending on the severity and age of the patient.
Structural scoliosis is a defect to the spinal vertebrae, legs, or neuromuscular system itself. This type of scoliosis typically is the result of a malformation to the sacrum, lumbar, thoracic, or even the leg length. A child with an underlying neuromuscular condition is at higher risk for developing scoliosis. A straight spine requires normal muscle balance and strength in the torso. In conditions such as cerebral palsy, spina bifida and muscular dystrophy, the muscles are often weak and unbalanced, leading to the development of a spinal curvature.
For parents, you can observe your child by having them stand straight with legs closed and hands put down. Check for the difference in shoulder height, rib cage protrusions, shoulder blade height, waist/hip height, and buttock level discrepancies. If suspected scoliosis, have a chiropractor do a spinal check on your child. Early detection is pivotal in the treatment plan.
Diagnosis is through the orthopedic test known as the Adam’s test first. It is performed by the practitioner to have a rough image of the spine before suggesting any further investigations. If the practitioner suspects a scoliosis, an x-ray is first. Your chiropractor will then analyze the x-ray and check on the Cobb’s angle which is the most widely used measurement for scoliosis.
Scoliosis is diagnosed if your Cobb’s angle is > 10 degrees. However there are also categories of severity depending on the amount of curve. Normal: <10 degrees; Mild: 10-20 degrees; Moderate: 20-40 degrees; Severe: >40 degrees.
Treatment for Scoliosis
Scoliosis can worsen with time but most stop progressing once reaching 17/18 years of age which is usually when you’ve reached structural maturity. However, some individuals with scoliosis tend to worsen even after they’ve hit structural maturity. Some severe outcomes of untreated scoliosis include difficulty breathing, back pain and discomfort, difficulty doing certain activity, appearance distortion, and inability to play certain sports.
Treatment for scoliosis in the range of mild and moderate are bracing, chiropractic treatments, physiotherapy, and individualized exercise regime depending on the curvature of the spine.
Gonstead chiropractors analyze your spine and adjust specifically tailored to your condition to help reduce joint pressure and subluxations. Specific exercises are also given to educate the patient on how to straighten their posture and spine. This sounds easier said than done but the patient has to be motivated and determined to carry out the maintenance treatment and exercise. Such as the teeth braces, a person has to continue wearing their retainers after the braces have been removed. If not, their teeths will continue to slip back into its former position. Spinal braces exist but in the modern day today, not many practitioners use them unless in severe cases.
The progression of scoliosis can be prevented by seeking your local chiropractor. If your children have signs of scoliosis, do bring them to see the chiropractor soon as the condition is more manageable before they hit structural maturity. If you have scoliosis and you have reached structural maturity, how can Chiropractors help?. People with normal straight spines do have spinal issues as well due to age, weight, lifestyle, and many more. People with scoliosis are the same but with an added muscular and spinal pressure due to the nature of the curvature.
Surgery is only recommended if the individual has severe scoliosis or a curve that has worsened to more than 50 degrees. Surgical intervention for scoliosis is not very common and in some cases where the symptoms are too uncomfortable, some individuals choose to do surgery as well. In our practice, we also see many individuals with scoliosis >50 degrees but choose not to undergo surgery. Instead, they seek alternative care such as chiropractic care or physiotherapy.
