What is Scoliosis?
Scoliosis is a condition in which a person’s spine has a curve and is rotated to some degree. The formal diagnosis is a curve with a Cobb Angle of greater than 10 degrees of lateral deviation of the spine from its central axis; curves of less than 10 degrees are unlikely to progress.
The reality is that most of us aren’t perfectly symmetrical and have some kind of spinal curve or rotation. For the majority of us it’s subtle and unproblematic, although this can change if your anatomy has other things to deal with as you get older… like the effects of injury or compensational changes due to repetitive strain or chronic prolonged sitting, which can put pressure on your musculoskeletal system (muscles, ligaments, joints etc.) in ways that depend on your unique physical makeup.
Scoliosis curves are usually “S” or “C” shaped and they can be stable or change and increase over time. They are often categorised as Functional or Structural:
A Functional Scoliosis is non-structural, meaning the apparent spinal curve isn’t fixed and it’s the body’s strategy for dealing with things like pain or muscle spasms, or a difference in leg length. This type is regarded as easily reversible.
In a Structural Scoliosis the spine itself is curved. This type is most commonly described as idiopathic, meaning that the cause is unknown. This includes Infantile Ideopathic Scoliosis (0-4 year olds), 90% of which resolve spontanteously, Juvenile Ideopathic Scoliosis (4-10 year olds), and Adolescent Ideopathic Scoliosis (10-18 year olds), which often occurs during rapid growth periods.
Structural Scoliosis can also be the result of known causes such as congenital conditions (present at birth) such as spina bifida which affects the formation of bones; nerve or muscle disorders such as cerebral palsy, Marfan’s syndrome or muscular dystrophy.
Physical effects may include a rib ‘hump’ (a prominence on one side of the back due to the rotational part of the scoliosis), shoulder height asymmetry, and/or torso ‘lean’ (a shift of the body to one side).
Is Scoliosis serious? How is it treated?
Scoliosis is very common and very often asymptomatic. You may be aware of a curve in your spine as an adult or older adult, but have no experience of adverse affects.
Back pain can occur if the curve in the spine puts pressure on the intervertebral discs or surrounding structures such as ligaments, muscles, nerves or facet joints – just like someone who doesn’t have any noticable curve. It can also impact how other joints function, as shoulders and hips, and conservative (non-surgical) treatment, such as osteopathy or physiotherapy, can be very beneficial in addressing these associated issues.
In Juvenile Idiopathic Scoliosis, bracing is often recommended when the Cobb ankle is 20 degrees or more and surgery may be recommended at 40 degrees. But these are arbitrary standards and treatment depends on an individual’s progress and experience. Speak to your GP if you notice changes or are concerned. Any teenager with a Cobb ankle of 10 degrees or more should be observed regularly so that any progression of the curve can be monitored. It’s very rare for a severe scoliosis to interfere with breathing. Extreme cases, where the scoliosis progresses to become “life-threatening”, are exceptionally rare.
The goal of treatment is to prevent the scoliosis from progressing and reducing associated symptoms such as pain and discomfort. In summary, taking a multi-disciplinary approach, which might include both conservative and interventional treatment, can be really useful.
How I can help with Scoliosis
As with other musculo-skeletal issues causing injury, strain or pain, you will cope and recover faster if you are relatively active on a regular basis – keeping strong and flexible makes a bit difference to all aspects of health. It’s also important to be respectful of pain rather than be fearful of it; this is easier with understanding and knowledge of conditions and symptoms.
Having pain does not mean don’t move, in fact the less you move the longer it is likely to take for symptoms to resolve. Exercise is powerful medicine.
If you have pain and you think it’s the result of scoliosis, conservative (non-surgical) treatment may provide significant relief. Working with me will involve looking at your whole musculo-skeletal system, addressing movement patterns with specific active movement strategies that counteract the effects of a scoliosis. This can also encompass associated issues further afield which you may or may not think are linked.
The following videos from Intrinsi Osteopathy show movement strategies that can be effective in counteracting a scoliosis. The movements described depend on your scoliosis and how it has developed (where and in what direction) so you may wish to seek help with how this applies to you specifically. This is where I can help, along with providing individualised hands-on treatment to aid the process. This combination can be powerful in addressing problems associated with scoliosis. Results are always individual and depend on causative and maintaining factors, as well as prior history.
Speak to an Osteopath about Scoliosis
If you are looking for help and support when dealing with Scoliosis, don’t hesitate to contact me using the form below: