Scoliosis
by Jennifer Martin, D.P.T.
If you have scoliosis, you usually know it - either you found out about it during a screening at school or during a physical.
Scoliosis is a curvature of the spine when viewing the body from the front or back, rather than from the side. We expect to see a natural 'double S' curve in the spine when looking from the side, but not when looking from the front or back. From the front, your spine should appear relatively straight.
The curves created by scoliosis form a 'C' or 'S' when viewed from the front or back, and may also include a rotational component, as if you are permanently turned to one side. Scoliosis can occur in the neck, upper back (thoracic spine), low back or throughout the entire spine.
Scoliosis can often progress, particularly in adolescents, so it is important that scoliosis be identified early so that you become consistent in an exercise program that will correct your scoliotic curves and prevent further progression. Upon diagnosis, an X-ray is usually taken to find out the type of scoliosis and the degree of the curve.
The alteration in the natural alignment of your spinal curves can create asymmetric stresses on your muscles, joints, discs, ligaments, and in more severe cases, the internal organs, which can have an impact on your health.
This obviously can then cause back pain in the region of the spine involved or in other areas that attempt to compensate for the curve. This does not mean that having scoliosis does not naturally mean that you will have back pain, neck pain or upper back pain.
What Causes Scoliosis?
Scoliosis can be congenital (you were born with it), it can happen due to other abnormalities at birth, or it can manifest as you develop from childhood to adolescence. Almost 80% of all cases of scoliosis are considered "idiopathic", meaning "without known cause".
You can also develop scoliosis as a result of degeneration or arthritic changes that lead to breakdown in parts of the spine - this can result in scoliotic changes. Sudden physical trauma can alter the shape of the spine, leading to a scoliotic curvature.
Scoliosis can also develop because of constant postural and movement imbalances that create an alteration in spine alignment. Weakness on one side of the spine can lead to scoliosis.
It is not known why, but girls are more likely to have scoliosis than boys. There is speculation among natural health practitioners and the National Scoliosis Foundation hormones may be part of the picture.
In the case of degenerative and postural imbalances that cause scoliosis, the root of the problem lies in the patterns that we continue to practice over time that ultimately lead to the spinal adaptation we call scoliosis.
Here's an Example of a Real World Cause of Scoliosis...
Let's say you travel for work and carry your briefcase on your right shoulder every day. It is very heavy and causes you to lean to your right as you walk. Over time, your muscles start to shorten and get tight on the right side of your low back.
You then begin to twist your back slightly to compensate for the heavy weight. Although it does not bother you immediately, over the years you start to develop low back pain and stiffness, and you notice that your right shoulder appears lower than your left. It is a natural change your body makes to adjust to the external stresses placed on your system.
Another Example
You work at a desk sitting in front of a computer for 8 hours a day. You are on the phone frequently and always hold your phone on the right side of your head. You mouse with your right hand, and you are frequently leaning over into your drawer on the right to pull out files.
Soon you begin to get pain in the left shoulder blade and a prominence in your left rib cage and shoulder blade region. This can be indicative of a scoliosis in the upper back (thoracic spine).
Common Remedies and Solutions
Since scoliosis is often progressive in the young, frequent check-ups are done every 3 - 6 months to determine whether there is progression or improvement. Bracing is commonly recommended, based on the amount of the curve and the progression of the scoliosis. The spine will naturally revert to it's original alignment once a brace is removed.
When the curve is greater than 40, when measured on X-ray, surgery is often recommended. Metal hardware is implanted to prevent the curve from increasing. Surgery does not restore the spine to it's original alignment.
For back pain symptoms due to scoliosis, NSAIDs are often prescribed. With a dedicated program of appropriate postural and movement reeducation, flexibility, and muscular stabilization scoliosis can be reduced or remedied in most cases.
