After birth, the skeletal system continues to grow and develop. One of the most important elements of the skeletal system is the spine, which protects the spinal cord and supports the upper body. Scoliosis is a medical condition affecting this area of the skeleton. This problem is treatable, particularly if detected early.
What Is Scoliosis?
The spine is made up of 24 individual bones or vertebrae. These are connected and supported by ligaments, muscles and other tissues such as intervertebral discs. When viewed from the side, the spine has some natural curvature designed to handle body movement and weight. When viewed from the back or front, however, the spine is fairly straight. Scoliosis, simply defined, is abnormal sideways curvature of the spine. Although doctors don’t know for sure what causes the majority of cases of scoliosis, conditions such as muscular dystrophy, injuries, infections and birth defects sometimes play a role. Most commonly, scoliosis happens during growth spurts that occur in puberty. Statistically, girls are more at risk than boys.
Why Is Scoliosis a Problem?
At a minimum, scoliosis can cause problems with appearance – the sufferer looks as though they are not balanced. Such an demeanour can result in low self-esteem. In moderate to severe cases of scoliosis, the curvature of the spine creates pain because some muscles are working harder than others, and because bones are not in the proper position to handle the weight of the upper body. In the worst-case scenario, the curvature of the spine can interfere with the function of internal organs such as the lungs and heart.
How Do Doctors Test for Scoliosis?
Doctors can perform a variety of tests to confirm whether scoliosis is present. A very basic test sometimes used for screening in schools and similar facilities is the bend test – when a child bends over as if touching his toes, any curves in the spine become easier to see with the naked eye. Doctors also sometimes do basic neurological reflex tests to check that the spinal cord is functioning properly, as well as muscle tests to check for weakness on one side of the body. Physicians rely on imaging technology such as computerised tomography (CT) scans, X-rays and bone scans, as well.
What Treatments Are Available for Scoliosis?
Very mild cases of scoliosis generally do not need treatment. If a doctor decides a person needs treatment, options include:
• Braces – Perhaps the most common scoliosis treatment, braces slowly try to realign the spine into a normal position. They can prevent the scoliosis from worsening but are effective only if the bones are still growing. They do not reverse curvature that is already present. Braces come in two major types: underarm (most common and comfortable for lower spine curves) and Milkwaukee (cumbersome but better for upper spine curves).
• Physical Therapy – In some instances, curvatures of the spine occur and worsen because muscles of the torso are too tight on one side. The tight muscles pull the spine out of alignment over time. Physical therapy can relax these tight muscles so the pull on the spine is not so great. It also can strengthen the muscles on the opposite side of the body that are not used to compensating for the pull. Postural training can be part of this treatment.
• Chiropractic Adjustments and Massage – Manual chiropractic adjustments try to reposition the bones of the spine into better alignment. The benefit of this is that the spinal adjustments can reduce pressure on the spine in a matter of seconds, which can alleviate pain. On the other hand, adjusting the spine without also eliminating muscle tension that pulls on the spine makes chiropractic care ineffective, as the tension will undo the adjustment eventually. Chiropractic care thus typically is used in conjunction with massage, and good chiropractors do at least basic massage before and after every adjustment. Chiropractic care and massage are best for mild cases of scoliosis.
• Electrostimulation – In this treatment, a very low power electrical current is put through the muscles around the spine. Although sufferers barely notice the muscular contractions the tiny current causes, the contractions are enough to strengthen the muscle. Similar to physical therapy, this technique thus gives the muscles a way to compensate for the muscles that are or were tight.
• Biofeedback – Biofeedback involves using sophisticated technology to monitor the level of activity within the muscles around the spine. Using biofeedback, scoliosis sufferers can learn where their spine is truly aligned, even if the new position feels odd initially. It is an objective method of showing the sufferer how to change their posture. Biofeedback also shows doctors where the most significant areas of stress are and provides a foundation for designing physical therapy and exercise regimens.
• General Exercise – Exercise keeps the spine healthy and flexible, making it easier to correct mild curvatures. It also works like physical therapy and electrostimulation in that it corrects the imbalance in muscular tension. Isometric exercises are ideal.
• Surgery – Surgery is a last resort option for treating scoliosis. It is used only for severe cases that are not treatable via other means. Most commonly, spinal surgery for scoliosis involves spinal fusion.