Scoliosis
Scoliosis effects about 6 million people in the United States. There are over 500,000 visits to doctors’ offices each year because of scoliosis. Scoliosis usually begins at an early age, most often between the ages of 10 and 15. It is more commonly found in girls than boys. Because scoliosis can be inherited, kids with parents or siblings with scolosis should be examined by a doctor of chiropractic.
What Is Scoliosis?
The nervous system constantly works thru muscles, reflexes, and posture to control and keep our spine straight. If there is a lateral (sideways) curvature of more than 10 degrees, it is called scolosis. If the curve is less than 10 degrees, it is called a postural change. Often times the vertebrae are rotated and other curves are involved.
In 80% of the cases the cause of scolosis is unknown (idiopathic). There are two types of scolosis: Functional and Structural. Functional scoliosis is caused by postural problems, muscle spasms, pelvic tortion, or leg length inequality. Structural scoliosis does not improve with spinal manipulations and can be caused by birth defects & trauma.
What Are The Symptoms Of Scoliosis?
Decreased activity level, pain, reduced lung function, or affecting heart function are some of the syptoms of scoliosis. Lowered self-esteem and other psychological problems, as well as being teased by their peers are also possible because of the age at which most scoliosis occurs.
The good news is that 80% of people with scoliosis have less than 20 degrees of lateral curvature or deviation and are typically not a great concern. Thankfully, unless you are trained in what to look for, the general population would not even notice these scoliotic spines. But if the scoliotic curve is mild it is still a good idea to have frequent checkups to make sure the curve does not worsen, especially in a growing child or adolescent.
How Is Scoliosis Evaluated?
Start with a thorough history and physical examination. Detailed tests and a more in-depth evaluation can be done if a scoliotic curvature is present.
Radiographs (X-rays) are used to help measure the degree and location of the curves, any other cause not found on physical examination, and to make sure none of the other bodily organs are affected by the scoliosis. Wrist x-rays are used to determine the skeletal age of the person and probability of progression. X-rays may need to be re-taken every 3 months or every year to help determine prognosis.
A Scoliometer™ might also be used. This is an inclinometer used in measuring the amount of curvature in a person’s spine. It is non-invasive and painless. A Scoliometer™ is not a screening device, but tool used to help gauge progression. A Scoliometer™ is similar to a level and is placed across the back at the peak (apex) of the curve. The amount of tilt in the back is estimated in degrees.
Does Scoliosis Get Worse?
Typically, no. Most of the cases are mild and do not worsen.
However, girls with a scoliosis of more than 25 degrees or more, and who have not had their first menstrual period are most at risk. Girls generally grow quickly 1 year before their 1st period and their scoliosis progresses rapidly. If they have already had their 1st period their growth rates are slower and their curvatures will progess more slowly.
What Is The Treatment For Scoliosis?
There are generally three treatment options for scoliosis: 1) careful observation, 2) bracing, and 3) surgery. Careful observation is the most common “treatment,” since most scoliosis cases are mild and do not progress and very few cause physical problems. Bracing is usually reserved for cases who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.
Chiropractic adjustments, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, adjustments and exercise may help.
Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.
