It’s spinal health week, so let’s talk some more about spines.
When we look at a spine from the back, we usually see a straight line from the neck to the hips. Scoliosis is an abnormal side-to-side curve of the spine that appears as either a C shape or an S shape. These curves vary in degree – some so subtle they cannot be seen with the naked eye, others very pronounced. Generally, these curves happen in the thoracic spine – the middle area of the back, or the lumbar spine – the lower back.
Types of Scoliosis
There a number of different types of Scoliosis, but generally they fall into two main categories.
Idiopathic Scoliosis
Idiopathic Scoliosis is generally found in infants, children and adolescents, and affects about 2% of the population. It is often diagnosed during adolescence, when rapid growth occurs. Idiopathic Scoliosis rarely causes pain, but should be observed and monitored for increasing curvature.
Degenerative Scoliosis
Degenerative Scoliosis starts in adulthood and affects up to 68% of the population. It is most common in people over 65.
Degenerative Scoliosis is caused by the degeneration of the facet joints – small bones that stabilize the vertebrae, which is the same process that causes osteoarthritis of the spine.
How do we diagnose Scoliosis?
In children and young adults the Adam’s Forward Bend Test is used to check curvature. The patient bends from the waist to touch the toes. The health professional assessing them looks for either a hip or shoulder that appears higher or more prominent than the other, an uneven waist or a tilt to the side.
The Cobb method is used to measure the curvature of the spine so that progression can be carefully monitored.
Diagnosis of Degenerative Scoliosis is generally made by x-ray.
What are the symptoms?
People with Idiopathic Scoliosis generally experience no pain, although the condition may progress over time.
Degenerative Scoliosis does cause pain, although not all patients suffer from this. People who do, experience pain similar to osteoarthritis of the spine. They may also feel stiffness in the mid to lower back and numbness, pain and weakness in the feet and legs. Generally, the pain is caused by inflammation of the degenerating facet joints, but may also be caused by muscle strain.
How do we treat Scoliosis?
Treatment for Idiopathic Scoliosis generally involves monitoring the progression of the problem. Because there is usually no pain, intervention is only made when the curvature of the spine reaches a point where progress may lead to disfiguring deformity, or in rare cases where the curve might compromise lung and heart function.
In treating Degenerative Scoliosis the key to relieving pain and preventing future pain is to maintain strength and flexibility in the back. Chiropractic adjustments and manipulation will help to keep the facet joints mobile. Your chiropractor may also prescribe therapeutic and functional exercises to assist the treatment. Massage is also used to keep soft tissue flexible and mobile. Anti-inflammatories may help to reduce the inflammation between the joints. Maintaining a health weight is also important, as this will reduce the pressure on the degenerating joints.
In very rare cases a custom fitting brace may be recommended to limit movement in the back, which can reduce pain.
If you have scoliosis it is important to understand the treatment options. At Precision Health Spine & Sports Clinic we can provide chiropractic, massage and dietetic help that will allow you to manage your condition. Call us for more information or to make an appointment.