SCOLIOSIS

Scoliosis causes the spine to curve to the left, the right or both. The angle of the curve may be small, large, or somewhere in between. If the curvature is more than 10 degrees on an X-ray, it is considered scoliosis. Doctors often describe the curves as “C” and “S” shaped.

Scoliosis can develop at any age. It most often appears between the ages of 10 and 12 years or during adolescence. Infantile scoliosis is rare but can affect people before the age of 3 years.

For most cases of scoliosis, the cause is unknown. The medical community calls this idiopathic scoliosis. In other cases, scoliosis may come from cerebral palsy, muscular dystrophy, or spina bifida. Alternatively, it may be a birth abnormality.

People who have scoliosis tend to lean to one side when standing. They may also show signs of:

• Curvature in the back 
• Head is not centered directly above the pelvis
• Hips, waist, or shoulders that appear uneven
• One shoulder blade protruding
• Ribs that stick out further on one side of the body

Beyond physically visible symptoms, other signs of scoliosis include:

• Abnormal reflexes
• Pain in the lower back
• Fatigue from muscle strain.
• Numbness and pain in the legs
• Stiffness in the back

Spinal curves fall into two categories:

Structural

• These tend to be lateral (sideways) curves of the spine.
• A structural curve is permanent
• It often results from a medical condition or injury such as:
  • Marfan syndrome
  • Cerebral palsy
  • Poliomyelitis
  • Birth injuries
  • Tumors

Nonstructural

• A nonstructural spinal curve is temporary.
• The curvature is side-to-side; the spine’s structure is still normal.
• It is usually caused by an underlying condition such as:
  • Difference in leg length
  • Muscle spasms
  • Inflammatory conditions that cause muscle spasm, such as appendicitis

In either case, a doctor will try to find and correct or treat the cause. 

Doctors and nurses often check for scoliosis in routine exams. They will have their patient bend at the waist so it is easy to detect asymmetry of the trunk and spinal curve. This initial screening can detect potential problems, but cannot completely determine the exact type or severity of the curvature. 

Radiographic tests such as an x-ray, spinal radiograph, CT scan or MRI are necessary to accurately diagnose Scoliosis.

Although braces tend to be the most common and effective form of treatment for scoliosis, your doctor might recommend a combination of the following treatments:

• Pain Management
  • Non steroidal anti-inflammatories (NSAIDs)
  • Injections
    • Nerve blocks
    • Epidural steroid injections
    • Radiofrequency nerve ablation
    • Injections tend to be reserved for people who also have degenerative disc disease.
• Physical Therapy
  • Physical therapists work to mobilize joints and stretch muscles to improve range of motion and alleviate pain.
  • Electrical Stimulation delivers painless electrical currents to specific nerves in order to improve range of motion and alleviate pain.
  • Myofascial release is a type of massage that addresses tightness in the fascia. Fascia is the connective tissue that supports your muscles, bones, and organs. 
  • Ultrasounds probe affected areas and promote circulation while decreasing inflammation and pain
  • Ice and Heat therapies can be done at home. A combination of ice and heat promote circulation, combat inflammation and improve range of motion.
• Surgery
  • For patients whose symptoms did not respond to conservative treatments, surgery might be the only option.
  • Early surgical intervention is key in severe cases. Scoliosis progresses with time. Getting spinal surgery sooner rather than later if necessary will keep your symptoms from worsening.
    • The most common type of scoliosis surgery is called spinal fusion. 
  • In rare cases, the bone might fail to heal and another surgery will be necessary. Complications of spinal surgery may include:
    • Bleeding 
    • Infection
    • Pain or nerve damage
• Casting
  • For infants with scoliosis, doctors may opt for plaster casting instead of bracing to help the infant’s spine grow into the proper form.
  • Because infants grow rapidly, the doctor will need to change the cast regularly.
• Braces
  • In children with mild scoliosis whose bones are still growing, braces can prevent further progression of the curve. A brace won’t necessarily cure or reverse scoliosis, so other therapies might be prescribed in combination. 
  • The most common form of braces for scoliosis are made from plastic. They are contoured to conform to the body so they’re almost invisible under the clothes. They fit under the arms and around the rib cage, lower back, and hips. 
  • Braces are more effective if they are worn as often as possible. It is possible to remove the braces to participate in sports or other physical activities.
  • Braces as a treatment tend to be discontinued after the bones stop growing.