When you look at someone's spine from the back, it should appear to form a straight line.
However, when a person has scoliosis, their spine will curve from side to side in the shape of the letter "C" or "S." While having a small curve in the spine is considered a mild concern, some people have severe curves that can lead to health problems, pain, and discomfort.
What is scoliosis, exactly, and how can it be treated?
What Is Scoliosis?
Scoliosis is a condition where the spine is curved sideways. This disorder is most commonly diagnosed in teenagers. At this point, experts are unaware of the cause of most childhood scoliosis, though it can also affect people with diseases such as muscular dystrophy and cerebral palsy.
Scoliosis Causes
The cause behind the most common form of scoliosis is unknown to doctors and researchers. However, it is believed that it can be genetic.
There are other types of scoliosis that are less common. These can be caused by:
- Muscular dystrophy, cerebral palsy, or other neuromuscular conditions
- Spinal infections or injuries
- Abnormalities in the spinal cord
- Chest wall surgery as a baby
- Birth defects that have an impact on the way the bones of the spine develop
There are a number of risk factors that make an individual more susceptible to the most common form of scoliosis. These include age, sex, and family history.
Scoliosis symptoms usually begin showing themselves around adolescence. Both females and males have roughly the same chance of developing mild scoliosis. However, females are much more likely to have cases that get worse and need treatment.
It is known that this condition can run in families. However, most adolescents that are found to have scoliosis don't have any history in their family of the disorder.
Scoliosis Symptoms
There are a number of signs and symptoms of this condition. Some of these include:
- Having an uneven waist
- Having uneven shoulders (one appears more prominent the the other)
- Having a prominence when bending forward on one side of the back
- Having one side of the rib cage jutting forward
- Having one hip at a higher level than the other
- Having one shoulder blade that looks to be more prominent than the other
In most cases of scoliosis, the patient's spine doesn't just curve side to side but also twists or rotates. This can lead to one side of the body having the muscles or ribs sticking out more noticeably than the muscles or ribs on the other side of the body.
Scoliosis Types
The most common form of scoliosis is idiopathic scoliosis, for which there is no known cause. However, there are also a number of other forms of this condition.
Congenital Scoliosis
This type of scoliosis begins during the development of the back before a baby is born. The spine can curve due to issues with the vertebrae, which are very small bones in the back.
In this type of scoliosis, the vertebrae might fail to divide properly or might not be complete. A diagnosis of this form of the condition might be spotted at birth or it might not be discovered until adolescence.
Congenital scoliosis can range widely in severity. It can come in a form that is quite mild or one that is life-threatening.
The nature and severity of the curve will have an impact on the outlook for children with congenital scoliosis. When a child has severe curvature of the spine, spine surgery and post-operative care can help their spine get on track for normal growth.
In Canada, congenital scoliosis along with other types of scoliosis is considered a disability.
Neuromuscular Scoliosis
Disorders like cerebral palsy, Spina Bifida, or spinal cord injury can cause neuromuscular scoliosis. The curvature of the spine in these circumstances is caused by muscles not being able to support the spine correctly because of damage.
Scoliosis can be caused by either muscular conditions or neurological conditions. Neuromuscular scoliosis occurs when a neurological condition impacts the body's muscle-nerve pathways.
Adult Denovo (Degenerative) Scoliosis
This is a type of scoliosis that impacts adults rather than adolescents. This usually begins to develop in a person's lower back. As you age, the joints and discs of the spine can begin to wear out and lead to this condition.
No form of scoliosis can be completely cured. However, with active treatment, the condition can be managed in adults.
Degenerative scoliosis most commonly occurs in people above the age of 65. In this type of scoliosis, the curvature of the spine is fairly minor. This means that surgery might only be suggested if the pain can't be alleviated through more conservative methods.
Adolescent Idiopathic Scoliosis
Idiopathic scoliosis is the name for scoliosis when the cause is unknown. Incredibly, doctors don't know exactly why the spine curves in as many as 80% of scoliosis cases.
Adolescent idiopathic scoliosis will not go away on its own. In fact, it is a progressive and incurable condition. However, this is a treatable condition.
Most idiopathic scoliosis cases begin to show symptoms between the age of ten and the end of adolescence.
How to Diagnose Scoliosis
The first step that a doctor will take to see if someone has scoliosis is a physical examination of the spine. Imaging tests might also be ordered in order for the doctor to look more closely at your spine. In addition, they will talk to you about your medical history and recent growth.
During the physical examination, your physician will have you stand with your arms at your sides so they can observe your back. They will take a look at whether your waist and shoulders are symmetrical and check for spine curvature.
They will also have you bend forward. This will let them determine whether there is incorrect curvature in the lower or upper part of your back. Doctors also sometimes perform neurological exams to check for abnormal reflexes, muscle weakness, and numbness.
There are a number of imaging tests that a doctor might order in order to take a closer look at your spine. These include x-rays, MRI scans, CT scans, and bone scans.
Scoliosis Treatment
There are a number of different factors that influence how scoliosis is treated. One of the major factors is the degree to which your spine is curved. Some of the things that will also be taken into consideration include:
- The type of scoliosis
- Your age
- The amount and type of curvature
- Whether you're likely to continue growing
Bracing and surgery are the two main treatment options for scoliosis.
Scoliosis Brace
If a person is still growing and the curve in their spine is more than 25 to 40 degrees, they might need to use a brace. Braces can help to prevent the curvature from increasing but they aren't able to straighten the spine. When cases are detected early, this is a more effective treatment method.
The two primary types of braces are known as Milwaukee and underarm. The Milwaukee brace covers the entire torso and starts at the neck. This brace doesn't cover the arms and legs and is used to help with curves that can't be addressed by the underarm brace.
The underarm brace fits close to the body and is made of plastic. For this reason, it is basically invisible to others. This type of brace fits around the lower part of the body and is used to treat curves in the lower spine.
Scoliosis Exercises
There are a number of stretches and exercises that can be done in order to help manage scoliosis. While scoliosis can't be cured through exercises, it can help to improve the general wellbeing of the patient.
Your healthcare provider will be able to provide you with recommendations for stretches and exercises that can help to support your spine and strengthen your muscles.
If you have been dealing with spinal problems, you have likely thought about visiting a chiropractor or another medical professional that focuses on spinal health. You can learn about the difference between a chiropractor and a physiotherapist here.
One alternative treatment that some people use to help restore normal movement and function as well as reduce pain from scoliosis is acupuncture. This is a treatment method that has its origins in ancient China. You can learn more about acupuncture here.
Some doctors will also suggest seeking chiropractic treatment to help increase flexibility and alleviate pain. However, you won't want to seek out the help of a chiropractor without first talking to your doctor. If you are going to visit a chiropractor, it's a good idea to f find one that specializes in this condition to ensure that the sessions don't actually worsen your pain and discomfort.
Scoliosis Surgery
Surgery is a treatment for scoliosis that is typically reserved for people that have curves in their spine that are greater than 40 degrees. If you've been diagnosed with scoliosis and you feel as those your daily life is being interrupted by the condition, talk to your doctor about the risks and benefits of this option.
The standard scoliosis surgery is spinal fusion. During this type of surgery, your vertebrae are fused together using rods, a bone graft, and screws.
Your spine is kept in a straight position by the rods, which the screws are responsible for holding them in the proper place. The vertebrae and the bone graft fuse into one single bone eventually.
As children grow, rods can be adjusted.
With all kinds of new modern medicine and treatments on the market, some people with scoliosis may even benefit from specific types of spinal implants.
There are a number of risks that accompany spinal fusion surgery. These include failure to heal, excessive bleeding, pain, infection, and nerve damage.
Scoliosis Risks If Left Untreated
If scoliosis is left untreated it can get worse over time and lead to serious long-term emotional and physical complications. When a person has severe curvature of the spine exceeding 50 degrees it can lead to rotation in the spine. This can cause heart problems and decreased lung capacity.
A condition known as spondylosis can develop from untreated scoliosis as well. This involves inflammation of the joints, the development of bone spurs, and the thinning of spinal cartilage.
There can also be an emotional impact of scoliosis on people. This is particularly true among children and teenagers. Physical pain and social isolation can result from the condition and the treatment.
If children don't receive the emotional support they need before, during, and after treatment, it can lead to an increase in behavioral problems.
It can be difficult to live with scoliosis. For this reason, there are a number of support groups that exist to help people with scoliosis to manage living with the condition. This lets you meet with other people who are going through something similar to you and who can give you advice and encouragement.
Do Provincial Health Care Plans Cover the Cost of Scoliosis Treatment?
Yes, provincial health care plans cover the cost of scoliosis treatment in Canada. If a doctor recommends treatment for scoliosis for you and you have a Canadian health care plan, your treatment is covered by insurance.
Seeking Help for Your Scoliosis
Without treatment, scoliosis typically gets worse. However, scoliosis treatment can help you manage the condition and improve the quality of your everyday life. If you think that you or your child might have scoliosis, you will want to talk to your physician about your options.
At Insurdinary, we offer health insurance that covers scoliosis treatment. To learn more, you can get a quote today.
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