Scoliosis

Scoliosis affects 5 to 7 million people in the United States. More than a half million visits are made to doctors’ offices each year for evaluation and treatment of scoliosis. Although scoliosis can begin at any age, it most often develops in adolescents between the ages of 10 and 15. Girls are more commonly affected than boys.

Because scoliosis can be inherited, children whose parents or siblings are affected by it should definitely be evaluated by a trained professional. Chiropractors specialize in the spine and nervous system and take a holistic approach to evaluating and treating scoliosis. If you are interested in having you or your child’s spine and nervous system checked after reading this blog, please contact us if you are interested in any further information.

In this blog, we will discuss the most frequently asked questions regarding scoliosis:

What is scoliosis?

What causes scoliosis?

What are the symptoms of scoliosis?

How is scoliosis evaluated?

What is the treatment for scoliosis?

What is scoliosis?

Scoliosis defined:

Any lateral deviation of the spine from the mid-sagittal plane

Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes.

Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated. In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible.

Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.

What causes scoliosis?

There are many causes of curves in the spine. When the spines normal curvatures are altered, it affects the rest of the spine from the neck to your tailbone. The most common types of scoliosis seen in our office can be divided into two categories:

1. Structural: Structural scoliosis involves changes in the anatomy of the vertebra and/or facet joints. A rib hump appears on the convex side that cannot be actively corrected.
   
2. Functional (non-structural): In functional cases, the patient can actively correct the scoliosis by changes in their posture. Normal mobility is seen in side bending and the rib hump disappears when bending forward.
   

One of the most common causes of scoliosis is also the most easily treated. Many types of functional scoliosis found in adults and children can be identified and managed with conservative chiropractic care and do not require invasive surgeries. Many times, a difference in the lengths of the legs or an unbalanced pelvis can cause scoliosis. As the muscles around your spine adapt to the imbalance, other problems may appear.

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, affecting heart function, and decreasing the overall function of the entire nervous system and tissues of the body. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers. Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, but it is the perfect time to begin gentle, non-invasive treatment through Spinal Pelvic Stabilizers and chiropractic adjustments to prevent progression of the curves. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.

How is scoliosis evaluated?

Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.

Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis.Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.

Full spine x-rays are extremely helpful in diagnosing and treating scoliosis. Locating the primary areas contributing to the curvature and the magnitude of the scoliosis is used to guide treatment recommendations. In many chiropractic offices, many different points are measured and evaluated to determine uneven leg lengths or pelvic imbalances that may be contributing or causing the scoliosis. Scoliosis from structural imbalances is easily correctable without drugs or surgery. Please read on …

What is the treatment for scoliosis?

Typically, there are generally 3 treatment options for scoliosis according to the medical profession— careful observation, bracing, and surgery.

Careful observation is the most common “treatment,” as most mild scolioses do not progress. The medical approach takes a “wait and see” approach at this stage. If it progresses further, bracing may be recommended. Bracing is generally reserved for children 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.

We evaluate and treat scoliosis much differently. What do we do differently?

We perform quick, simple, and non-invasive tests that determine your type of scoliosis – functional or structural. We then carefully inspect your posture and look for imbalances in legs and pelvis. We perform a digital foot scan to evaluate the arches in your feet. Pronation is often seen in one or both feet in individuals with scoliosis.

The loss of arch height that occurs with excessive pronation initiaties a series of postural faults and changes.

• Internal rotation of the tibia and femur
  
• Pelvis drops on the pronated side during stance and gait
  
• The pelvic tilt lowers the sacral base causing imbalance
  
• The lowest freely moveable vertebra to the side of the shorter leg
  
• A lateral spinal curvature develops in the lumbar spine due to lack of balanced support from the lower extremities
  
• If the functional curvature progresses into the thoracic spine, it may cause a slight rib hump
  

Adjustments are very important in addressing functional scoliosis. Curves increase the amount of stress and pressure put on joints, muscles, and nerves surrounding the spinal column – and chiropractors are experts in releasing and removing these stresses around the spine called subluxations.

The use of custom-made Spinal Pelvic Stabilizers to reduce pronation can provide substantial correction for most short legs without the need of a heel lift. In some cases, a heel lift is needed to balance out the leg lengths. With Foot Levelers custom orthotic stabilizers, heel lifts can be built in if needed at a very reasonable price. These custom-made stabilizers provide support and balance to your foundation and skeletal structure. Custom orthotics are commonly covered through most insurance plans, it is recommended that you check with your insurance company to see if “Custom-molded orthotics typically billed as L3020″ are covered in your policy.

Remember, without a solid foundation, everything else breaks down!

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