Scoliosis: Causes, Symptoms and Treatment

Scoliosis

The normal shape of your spine includes a curve at the top of your shoulders and a curve at the lower end. However, Scoliosis is an abnormal curvature of the spine.

You might have scoliosis if your spinal cord is curved from side to side or in an S or C shape.

About 0% of the people have unidentifiable causes of Scoliosis, according to AANS (American Association of Neurological Surgeons).

The spine’s normal curves occur at the cervical, thoracic and lumbar regions, however, Scoliosis is a more complex, three-dimensional problem that involves the following planes of the spinal cord:

  • Coronal Plane
  • Sagittal Plane
  • Axial Plane

The coronal plane is a vertical plane from head to foot and parallel to the shoulders, the sagittal plane divides the body into right and left halves.

The axial plane is parallel to the plane of the ground

What is Scoliosis?

It is a sideways curvature of the spine that occurs most often during the growth of spurt just before a person hits puberty.

Most cases of Scoliosis are mild, however, some deformities continue to get severe as a child grows. Moreover, it can cause disability.

An especially severe spinal curve can reduce the space within the chest thereby making it difficult for the lungs to function properly.

ScoliosisDoctors often monitor children with mild cases of Scoliosis. They usually take X-rays to see if the curve is getting worse.

In most of the cases, treatment is not required, however, some children may need to wear a brace to stop the curve from worsening.

Others may require surgery to keep this disease from worsening and to straighten the curve cases.

Doctors usually diagnose this condition in the early years of a child’s life, especially in the first 7 years.

In some cases, the medical condition Spina Bifida can cause this condition.

Spina Bifida is a birth defect that occurs when the spine and the spinal cord do not form properly.

Common Types of Scoliosis

The major category of Scoliosis is Idiopathic Scoliosis, which refers to cases that do not have a definite cause.

It is broken down by ages group as:

  1. Infants: 0 – 3 years
  2. Juvenile: 4 – 10 years
  3. Adolescent: 11 – 18 years
  4. Adult: 18+ years.

Moreover, of these, adolescent idiopathic scoliosis is most common.

However, when the researchers know the cause of different types of Scoliosis, they include:

  • Congenital: in which spinal deformities are visible from birth
  • Neurological: When nerve abnormalities affect the muscles in the spine

Many doctors also categorize Scoliosis as Structural or Non-structural.

In Structural Scoliosis, a disease, injury, or birth defect causes a spine curve however in Non-Structural Scoliosis, they can fix the temporary curves.

Signs and Symptoms of Scoliosis

The signs and symptoms of Scoliosis are apparent from infancy or adolescence, however, they also depend on the age of the person.

Signs and Symptoms in Infants

The sign and symptoms in infants include a bulge on one side of the chest, consistently lying to one side with a curved position and in severe cases, problems with the heart and lungs.

If an infant does not get early treatment for Scoliosis, they are more at risk of problems later in life, like impaired heart and lung function.

Signs and Symptoms in Adolescents

This is the most common type and is often termed Adolescent Idiopathic Scoliosis.

It can affect people between 10 – 28 years of age.

Signs and symptoms include:

A person’s head may appear a bit off-center, ribs on each side may be slightly at different heights, one hip may be more prominent than the other.

Other signs and symptoms include one shoulder or shoulder blade higher than the other one, a person might be leaning on one side and the length of less is slightly different.

Moreover, some adults can also have degenerative scoliosis or adult-onset scoliosis.

This is due to side-to-side curvature of the spine caused by degeneration of the facet joints and intervertebral discs which are moving parts of the spine.

Degenerative Soliosisis a different form of scoliosis from the standard adolescent-onset scoliosis.

 

Signs and Symptoms

Some types of Scoliosis can cause pain in the back, however, it is not usually very painful.

Moreover, this symptom is more common in older adults.

What Causes this Disease?

These are some of the possible causes of Scoliosis.

Neuromuscular Conditions: This condition affects the nerves and muscles. it includes cerebral palsy, Poliomyelitis, and muscular dystrophy.

You can learn more about Neuromuscular treatments here.

Congenital Scoliosis: This means that the child was born with this condition.

It is rare at birth, however, it can occur if the bones in the spine develop abnormally when the fetus is growing.

Lumbar Spine: In this type, an individual appears to have a C-shaped curve in the lower section of the spine. This condition becomes apparent during early or mid-childhood. However, in cases of adult degenerative scoliosis, it may occur along with or as a result of other conditions.

Genes: Many researchers believe that at least one gene plays an important role in developing Scoliosis.

Leg Length: If one of your legs is longer than the other one, then you might develop Scoliosis

Syndromic Scoliosis: It can develop as a part of a medical condition including Down Syndrome or Marfan’s Syndrome.

Osteoporosis: Due to bone degeneration, it can cause Scoliosis.

Other Causes: Poor Posture, Carrying heavy backpacks, connective tissue disorders, and some injuries that can cause spinal curvature.

Diagnosis of Scoliosis

The first step to diagnose Scoliosis is Physical Examination, However, your doctor will also take some image tests to get a closer look at your spine.

Physical Examination

During the physical examination, your doctor will observe your back while you stand with your arms at your sides.

They will check for curvature in your spine and whether your shoulders and waist are symmetrical.

Physical Examination of ScoliosisNext, your doctor will ask you to bend forward, looking for curvature in your upper and lower back.

In some cases, they will also look for the signs and symptoms of degenerative scoliosis or lumbar spine.

Imaging

Your doctor may order the following image tests to look for Scoliosis. These tests include:

  1. X-Ray: This test creates a picture of your spine
  2. MRI Scan: It shows a detailed picture of the spinal bones and tissues around it
  3. CT Scan: It is a #-D Image of the body
  4. Bone Scan: It highlights the spinal abnormalities

You can visit our lab for tests and medical advice.

Image testsTreatment Options

Treatment of Scoliosis depends on different factors: the degree of spine curvature is the major one and the appearance of the lumbar spine or degenerative scoliosis.

Other factors are your age, your growth, type and amount of curvature, and type of Scoliosis.

However, the primary treatment options are Braces and Surgery. Let us discuss these options one by one.

Bracing

If a person is still growing and the curvature is more than 25 to 40 degrees, then the doctor will use braces.

These braces will not straighten your spine, however, they will prevent the curvature from increasing further.

This method is more effective for cases that are early diagnosed.

You may need to wear them for at least 1 to 23 hours a day until the curvatures stop growing. Its effectiveness increases with the number of hours you wear in a day.

BracesDoctors recommend that children should wear their braces until they reach adolescence and their growth stops.

There are 2 types of Braces:

  1. Underarm: These are made of plastic and fit closely to the body and are practically invisible. It treats lower spine curves and fits around the lower part of your body.
  2. Milwaukee: This brace starts from the net and covers the entire torso, however it does not cover the legs and arms. It addresses curves that underarm braces cannot address.

Surgery

Doctors recommend surgery to people who have a spine curvature of greater than 40 degrees. However, you need to talk to your doctor about these options and if you feel the curvature is interfering with your daily routine.

For this surgery, Spinal Fusion is the main procedure. Your doctor will fuse your vertebrae together with a bone graft, rods, and screws. The bone graft consists of bone or material like it.

SurgeryThe purpose of rods is to keep your spine in a straight position however, the screws hold them in place.

With time, the bone graft and vertebrae fuse into a single bone. However, as children grow, rods can be adjusted.

Some common risks of spinal fusion surgery are excessive bleeding, failure to heal, infection, pain, and nerve damage.

Pain Management for Scoliosis

Seek medical advice as soon as you notice the signs and symptoms in your child or an adult around you.

Certain medications can help to manage the pain of Scoliosis, although they will not help to correct the spine curvature.

Some techniques doctors recommend are hydrotherapy, massage, electrical stimulation, and back braces.

These methods will help to reduce the pain and discomfort.

Exercise: Exercise and stretching for Scoliosis pain symptoms can not fix the underlying issues however it is important for general wellness and helps you keep yourself flexible.

Pain ManagementMedications: Certain medications like Tylenol and Ibuprofen can help to reduce the pain, however, it is important to consult your doctor.

Chiropractic Treatment: This treatment may help in elevating pain and increase flexibility while living with Scoliosis.

Prevention and Cure of Scoliosis

To this date, there is no cure for Scoliosis however, good treatment options are available. Moreover, researchers are trying to find the causes of different types of Scoliosis.

As the cause of Idiopathic Scoliosis is not known, therefore you can not prevent it.

However, doctors speculate that doing certain exercises like yoga, pilates, etc may worsen the condition.

Moreover, Gymnastic activities and using trampolines are potential ways of making the condition of Scoliosis worse.

Outlook of Scoliosis

For mild to moderate curvate of the spine, it will not interfere with your daily routine, however, individuals with a severe form of Scoliosis have physical limitations.

Therefore, the long-term outlook depends on the severity of Scoliosis.

Living with Scoliosis can be difficult however, you can look for help to manage the signs and symptoms of Scoliosis. You may also want to look out for support groups as you can find encouragement and advice about dealing with Scoliosis on daily basis.

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