Scoliosis Treatment: Scoliosis is defined as a curve of the spine of 10 degrees. Scoliosis causes an abnormal side-to-side “C” or “S” shaped curve to the spine. It can affect any part of the spine, but the chest area and the lower back area are the most common areas. However, doctors offer various scoliosis treatment options and exercises/rehabilitation programs that patients can do at home or the gym.
Scoliosis often appears in children. For most cases, treatment is not needed, as the curve corrects itself as the child grows. However, based on the degree of curvature and the child’s age, a combination of bracing and physical/chiropractic therapy is recommended.
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Types of scoliosis:
Scoliosis normally becomes apparent from infancy or adolescence.
Infants symptoms can include:
Some types of scoliosis can cause back pain but not a great deal.
If left untreated, problems can develop later in life, i.e., impaired heart and lung function.
The most common form of scoliosis appears in adolescence. It is known as Adolescent Idiopathic Scoliosis. It can affect children from the age of ten.
Idiopathic means that there is no known cause.
Symptoms may include:
See a doctor if there are signs or symptoms of scoliosis in your child. Mild curves can develop without the parents or child knowing because they appear gradually and most often do not cause pain. In fact, often, teachers, friends, and teammates are the first to notice the abnormal curvature.
A doctor will usually recommend a follow-up every four to six months to monitor the curve at the clinic and with X-rays.
Casting can be utilized instead of bracing for infant scoliosis to help the infant’s spine go back to its normal position as it grows. This is done with a cast made of plaster of Paris.
If a patient has moderate scoliosis and the bones are still growing, a doctor may recommend a brace. This prevents any further curvature but does not cure or reverse it. Braces should be worn throughout the day and at night. The more hours the patient wears the brace, the more effective it is.
Braces do not restrict what a child can do. If the child wants to take part in physical activity, the braces can be taken off.
When the bones stop growing, the braces are no longer used.
There are two types of braces:
A study found when bracing is used on 10-15-year-olds with idiopathic scoliosis, it reduces the risk of the condition worsening or requiring surgery.
Various exercises are suggested, along with various strategies. They all aim to realign the spine, rib cage, shoulders, and pelvis, to achieve normal, proper posture.
A study found that there is growing evidence that exercise can help treat scoliosis. However, more work is needed to find which exercises are the most effective and beneficial.
Severe cases can progress over time. A physician may recommend spinal fusion. This surgery reduces the curve of the spine and stops it from becoming worse.
Surgery involves the following:
Bone Grafts: two or more vertebrae (bones of the spine) are connected with new bone grafts. Sometimes, metal rods, hooks, screws, or wires hold part of the spine straight during the bone/s heal.
Intensive Care: the operation lasts 4-8 hours. After surgery, the child is transferred to an ICU (intensive care unit), where they are given intravenous fluid and pain relief. In most cases, the child will leave the ICU within 24 hours but may have to remain in the hospital for a week to ten days.
Recovery: children can usually go back to school after 4-6 weeks and take part in sports, possibly one year after surgery. In some cases, a back brace is needed to support the spine for about 6 months.
The rods are surgically removed when the spine has grown. The patient will return to the hospital every 6 months to have the rods lengthened. This is usually outpatient care, so the patient does not spend the night.
A doctor will recommend spinal fusion if the benefits are believed to outweigh the risks.
The risks include:
A neurosurgeon may be present during this surgery.
Risk factors include:
Adult Scoliosis is defined as a curve in the spine of 10 degrees or more in a person eighteen years or older.
As we age, our spine begins to deteriorate. It starts to weaken, which may also cause it to curve. Some people never have any symptoms. While others experience leg pain, numbness/tingling when walking, and/or back pain.
The most important part of scoliosis treatment begins with an accurate diagnosis. Adult scoliosis can sometimes be diagnosed by only observing the back of the curve is severe and has obviously changed the spine’s structure. But the best way to identify adult scoliosis is withstanding X-rays.
Adult scoliosis falls into two categories:
Adult Idiopathic Scoliosis: With this type, patients have had scoliosis since childhood or as teenagers, and then they grow into adulthood. However, in some cases, they were not diagnosed until adulthood. There is no known cause of idiopathic scoliosis, but there is a great deal of genetic work to answer this question.
Adult “De Novo” or Degenerative Scoliosis: This type develops in adulthood. Degenerative scoliosis develops as a result of disc degeneration. This is the normal wear and tear of the lower back from the aging process, leading to the development of a curve in the spine. As the disc degenerates, it loses height. If one side of the disc degenerates faster than the other, the disc starts to tilt. As the tilting continues, more pressure is placed on one side of the spine, and gravity causes the spine to bend and curve. The more discs that degenerate, the more the spine starts to curve.
Adult scoliosis symptoms can include:
Adult scoliosis treatment is individualized and based on the specific symptoms and age of the patient.
Correcting scoliosis in adults usually doesn’t require surgery. Many scoliosis treatments offered are non-operative, including physical therapy, chiropractic treatment, and spinal injections. Non-operative treatment options are utilized to help treat scoliosis pain and maximize function.
A specialist may recommend surgery as a treatment option for adults if non-operative treatments do not relieve the pain or symptoms. Surgery may also be needed for patients whose curves are progressing or are starting to experience symptoms, i.e., numbness, weakness, or pain. In general, curves greater than 45 degrees are best treated with surgery.
The goal through surgery is to first remove the pressure on the nerves. Scoliosis treatment through surgery offers the least invasive and safest procedure while relieving scoliosis pain and preventing the curvature from getting worse.
Many who have scoliosis are told to limit activities. However, physical activity can help people with scoliosis, as it is less likely to be symptomatic. If overweight, weight loss can help reduce scoliosis symptoms. And it is important to monitor bone density and seek treatment if osteoporosis is present.
The joints of the spine need to be repositioned as a priority. For any long-term benefits, there is a lot more that needs to accompany these repositioning adjustments. The muscles need to be relaxed, and the brain needs to be retrained to use the muscles and spinal joints differently than what the spine was accustomed to. For scoliosis treatment to be effective, all of these things need to happen together. This type of scoliosis treatment consists of massages, stretches, and exercises, along with scoliosis-specific adjustments.
Specific scoliosis treatment goes outside of the traditional guidelines to stabilize the curve. Aiming to correct the spine into a classic spinal curve gradually, scoliosis-specific adjustments are precise and gentle. This technique can help people from all walks of life. People who have already had surgery and don’t want it again, people trying to avoid surgery, and teenagers who don’t want to wear a brace.
Most people think of scoliosis as a sideways curve of the spine, but it’s a bit more complicated.
The spine should have three curves:
Scoliosis forces the spine in a different direction for one or more of these three natural curves.
People with scoliosis are, for all intents and purposes, double-jointed in the neck. This hypermobility makes the joints unstable and puts them at a higher risk of injury and dislocation if not treated gently. There is no twisting or turning of the neck in scoliosis-specific adjustments. Scoliosis-specific adjustments use a precision mechanical adjusting instrument to adjust the neck and other joints of the body.
The first step to restoring the proper curves in the spine is to re-center the head. While the patient is sitting up, and adjusting instrument is used to deliver precise but gentle force into the neck’s bones. This force works to coax the neck into the ideal position. Adjustments can also be performed on the back and hips, which depends on the measurements of the spine from the x-rays.
Some chiropractors claim to be trained to diagnose and treat scoliosis; however, their knowledge is limited. It is important to start a dialogue with your doctor to ensure you receive care from a chiropractor trained to diagnose and treat scoliosis. If the chiropractor is not producing the results promised or adjusting the treatment to yield them, it may be time for a new chiropractor.
Outside of the chiropractic adjustments, an individual needs to spend one to two hours a day doing exercises to achieve optimal results. Exercises include balance training, strength training, and for severe cases, the scoliosis traction chair elongates the spine and uncovers the nerves with vibration. As the curve decreases, one can also decrease the exercises, as well.
We are often asked what doctors are looking for when assessing a new patient with scoliosis. How much will we be able to help? The answer is different due to each patient’s unique case. Here are a few general signs we look for.
We look at how rigid the spine is that we will be working with. This will indicate how much upfront work needs to be done before we can effectively start repositioning the spine.
We focus on more than just discs, muscles, and bones. We factor in the spine’s nerves, specifically, how much tension is being placed on these nerves. A theory of why scoliosis develops is to relieve tension being placed on the nerves of the spine. While there is no proof, we see it as a major player, not just in the spine’s shape but also in the quality of life. Alleviating nerve tension can help you feel better and quicker as you move forward, creating the shape of your spine.
Sensorimotor integration (SMI) is the term for how well the brain can communicate with the body. Miscommunication between the brain and body can lead to all sorts of issues, which includes scoliosis. Scoliosis treatment requires retraining the brain to use the body, specifically the spine, in a way/s that it has grown unaccustomed to.
This involves a series of balance-related tests to see how well things are aligned from the outset. The tests are repeated throughout treatment to chart improvement. This is a major aspect of treatment that many traditional chiropractors overlook when it comes to scoliosis treatment.
The greatest factor we look at when determining how much progress we can make with a new patient is the level of commitment that a patient is willing to put in.
Like all types of treatments, part of the treatment plan takes place at home. The same is true with scoliosis treatment. If you are dedicated to a treatment plan, you are far more likely to reap the benefits.
You need to be your own advocate. What matters to you, makes the most sense for your lifestyle, and what do you want to achieve? It is necessary to establish a dialogue with your doctor and chiropractor to empower yourself and control your spinal health.
If you or someone you know has Scoliosis or Adult Scoliosis and needs correction, contact Injury Medical & Chiropractic Clinic today at (915)-850-0900
The information herein on "Scoliosis Treatment?" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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