Scoliosis

When viewed from behind, a back is ideally straight, with observable landmarks such as the knee creases, buttock creases, tops of the waist crests, shoulders and head being level. In scoliosis, there is usually an observable difference in the apparent heights of these landmarks. There will also almost always be an observable side-curve in the spine. Bending forward will often demonstrate one side of the ribcage to be higher than the other, due to the rotational effects of the vertebrae.

 

Scoliosis is the term applied to the sideways curvature of a spine.  There are several types of scoliosis, but the most common and dramatically obvious one is Adolescent Idiopathic Scoliosis (AIS). It occurs in puberty, affecting girls more than boys, with a ratio of about 8:1. Parents may first notice that their teenager looks like they’re “slouching”; or that clothes don’t seem to sit evenly. Symptoms may be mild such as the occasional vague back ache; the scoliosis itself is not painful however, symptoms tending to be secondary to strains and sprains.

 

While there is a recognised  familial predisposition, and it is thought be a developmental condition, the cause is still largely unknown and debate still continues as to aetiology. It does not tend to progressively get worse after puberty, except that the postural stresses placed on ligaments, muscles and vertebrae cause fatigue and aching much easier than in non-scoliotic people. Otherwise it tends to remain consistent throughout adulthood.

 

Most treatments have traditionally centred on optimising the “straightness” and balance of the spine, with various approaches such as Chiropractic, Osteopathy, Physiotherapy, exercise regimes, foot arch orthotics, Acupuncture and the wearing of corsets claiming modest improvements in curvature; but to date there is no recognised cure for AIS. The surgical implantation of metal “Thompson” rods along the spine to straighten it is a radical treatment that should only be considered in extremely deformed and dysfunctional cases, since the outcomes can be far worse than the original presentation.

 

Besides AIS, the word “scoliosis” is also loosely applied to any sideways curvature in the spine. For example, if one of the arches in your foot is flatter than the other; if one leg is shorter than the other; or if there is degeneration or an anomaly in the shape of a vertebra the pelvis may become unbalanced and drop lower on that side, with a compensatory deviation of the spine occurring higher up. These types of scoliosis are termed “Compensatory”. In this kind of case, the scoliosis is secondary to a structural or postural fault and may respond quite well to physical therapy interventions such as Chiropractic that aims to balance the posture and spine. It is rare for such cases to have as severe a curvature as that seen in AIS. In fact the vast majority of people diagnosed with “scoliosis” fall into this latter category. Symptoms such as back ache, headaches, sciatica etc. occur as a result of wear and tear or fatigue that more easily affects an unbalanced spine than a straight one. Due to one side of your body generally being slightly more developed than the other through genetic, dominance or other factors; a preponderance of injuries, habits, work and study related postural stresses, it would be fair to suggest that a mild scoliosis exists in all people, and while perhaps not structurally optimal, is nevertheless a reasonable finding not worthy of fear or grave concern. In such cases the treatment should not be directed at the scoliosis, but rather at the factors that precipitate it.

 

While trying to optimise the balance, function and structure of a spinal curvature is important to help you feel and perform at your best, some therapists prey upon the fears and anxieties of their patients and insinuate that if a scoliosis is left untreated, the patient will deteriorate to the observable deformity often seen in AIS sufferers (or worse, that they will end up in a wheelchair). Quite often they then propose lengthy treatment plans of 80, 90 or more visits in a year claiming to be able to “fix” it. There is no evidence whatsoever to substantiate such scaremongering or justify such a prospective treatment plan. Please visit the section How to spot a shonky Chiropractor for tips on avoiding unethical practitioners. At Synergy, our patients are assessed for postural distortions and functional limitations, with any treatment plan being constructed in strict accordance with Mercy Hospital guidelines. Patients are not treated for more than 6-8 weeks at a time, and they are given many self care strategies to minimise their dependence on treatment. Many people suffering from the effects of scoliosis might then find the occasional Chiropractic treatment to be a useful adjunct or “top-up” in helping them feel their best. When necessary, we also construct orthotics to balance and support the arches in your feet, since foot weakness and pronation is a common factor in many postural conditions. We also perform Cranial therapy based on the protocols of Sacro-Occipital Technic, which aims to balance the membranes of the brain and spine. Empirical evidence suggests that it may be of benefit in cases of Scoliosis.