Have you been diagnosed with scoliosis of the spine?
Do you wonder how chiropractic treatment can help?
First, it’s important to look at exactly what scoliosis is, and the degree of curve that you have.
Let’s start with the spine…
Our spines consist of 33 bones (called vertebrae) and due to their shape and size, they naturally produce slight curves from front to back. This is where we get the characteristic lower back arch, and a slight rounding of the upper back. The definition of scoliosis is “an abnormal sideways curvature of the spine” (i.e from left to right). This can either be as a single curve (known as a “c-curve scoliosis”) or 2 or more curves (an s-curve scoliosis).
What causes scoliosis?
Most causes of scoliosis are unknown, although certain conditions such as muscular dystrophy and cerebral palsy can be responsible. It can also be hereditary, or result from a birth defect or injury to the spine. Generally, it is noticed just before puberty (ie during a growth spurt). Although 10% of adolescents have some degree of scoliosis, less than 1% will require medical treatment. Girls are 5 times more likely to experience progression of spinal curves, and as a result, they generally require treatment more often than boys.
Scoliosis is classed as structural (if curve is fixed, often due to bony changes), or functional (ie due to muscular issues). In adult scoliosis, the most common cause is age related degeneration such as osteoarthritis. It may have been present in childhood however, and was only discovered due to back pain!
If I have scoliosis – What can I do?
There are three main treatment options: observation, braces or casts, or surgery. Physical exercise and soft tissue manipulation, can also help. The degree of scoliosis is usually measured with “Cobb’s Angle”. Between the upper and lower borders of vertebrae at each end of the curve, we draw parallel lines. By then drawing perpendicular lines from these, and measuring the angle produced when they cross, the result is the “angle of curvature”.
The minimum Cobb angle for defining a scoliosis is 10 degrees. Cobb angles between 15 and 20 degrees are likely to be treated just with exercise. Of course, regular check-ups are vital especially for young patients.
If a spine has a moderate curve of 20-40 degrees, doctors may recommend a rehabilitation program or wearing a back brace.
If you have a Cobb angle of 40-50 degrees, surgery may well be advised. This can either be by traditional fusion, or more recently by a relatively new treatment called VBT (vertical body tethering). This method straightens the spine with a flexible rod, reducing curves without fusing bones together.
It is important to note that surgery is not the “best” solution for every case of scoliosis. In some instances, physical therapy that aims to strengthen and stabilise the spine is the preferred option. Anti-inflammatory injections may also relieve some of the symptoms, reducing the impact of the scoliosis on daily life. According to research, patients who chose not to undergo surgery did not always experience worsening of the curves. The deciding factor on choosing surgery was how much the scoliosis was interfering with the patient’s normal day-to-day routine.
Does scoliosis just affect the spine?
The sideways curve of the spine could also cause some degree of rotation or twisting. In turn, this may alter the position of the ribs (e.g one side may stick out more). This means that scoliosis curves can interfere with breathing. Other problems can also start to develop due shoulders and hips being unlevel. Over time, this may lead to further referred pain through the neck, or even lower in the knees.
How can chiropractic treatment help?
Chiropractic treatment focuses on adjusting and improving joint mobility. Although it cannot instantly “straighten” a spine, it can help improve function, quality of movement, and posture – reducing pain and increasing comfort. You may need time to adjust to any joint repositioning, learning how to use your body differently than normal. Remember too that the supporting muscles should also be looked at. An effective treatment program may combine soft tissue therapy (ie massage), exercises and scoliosis-specific stretches. Your chiropractor can look at affected areas and then offer advice to help minimise long-term symptoms.
Do you know if you can still have chiropractic treatment with a fused spine, or with metal rods fitted? The answer is yes! Your chiropractor will focus can use different methods and tools for gentle yet effective adjustments on areas that require treating. A rehabilitative exercise program may also be advised, to allow you to continue to care for your spine at home.
So if you or someone you know has scoliosis, have a chat with us about how chiropractic care can help.