A common cause of back pain is scoliosis but what is it, is it serious ?
How do I deal with it ? .
What do Usain Bolt, Richard III and Kurt Cobain all have in common ? They all have ( or had ! ) a spinal scoliosis.
Scoliosis is a medical condition affecting the curvature of the spine. It can be either structural when the actual shape of the bones are fixed in that position, or postural or adaptive, tight soft tissues pulling the spine into a curvature. The condition is characterised by an abnormal sideways curvature and associated twisting, causing the spine to resemble an "S" or a "C" shape rather than the normal straight alignment. While scoliosis can occur at any age, it is most commonly diagnosed during adolescence when the skeleton is very active and growing quickly. In this blog, we will delve into the causes, symptoms, and various treatment options available for individuals living with scoliosis.
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Types of scoliosis
You know how medics love to catagorise conditions and scoliosis is no different, there are four main types or categories.
Idiopathic Scoliosis: This is the most common type of scoliosis, and its exact cause remains unknown ( idiopathic is posh fo r' we don't know ' ) It typically develops during adolescence and interestingly is more common in girls than boys.
Degenerative Scoliosis: This type of scoliosis is typically seen in older adults and is caused by the degeneration of the spinal discs and joints
Congenital Scoliosis: This type of scoliosis is present at birth and is often the result of abnormalities in the development of the spine.
Neuromuscular Scoliosis: Conditions such as cerebral palsy, muscular dystrophy, or spinal cord abnormalities can lead to neuromuscular scoliosis due to the weakened muscles that support the spine.
This blog will concentrate primarily on the first two categories as it's the ones we are most likely to see and address in clinic. ( The second two types tend to be picked up and treated by the neurological teams as these patients often have a range of co-existing conditions that need ongoing specialist care. )
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Symptoms and signs of scoliosis
Scoliosis symptoms can vary depending on the severity of the curvature. Common signs and symptoms include:
Uneven shoulder height
An uneven waistline
One hip appearing higher than the other
A visibly curved spine
Back pain or discomfort
Reduced flexibility or mobility
Often patients will report hemlines and waistlines on dresses and trousers not sitting level, one shoulder strap constantly slipping off the shoulder etc but it's important to remember that no human body is completely symmetrical.
" Assymmetries in the body are common and not always a sign of a scoliosis "
Diagnosing scoliosis
Diagnosing scoliosis usually begins with a physical examination by a healthcare provider. Often people present in clinic with a backpain that has grumbled away in the background for years and their therapist picks up anomolies when examining and testing. When we check you in clinic and if scoliosis is suspected, the following diagnostic tests may be recommended:
X-rays: X-rays provide detailed images of the spine and help determine the degree and location of the curvature.
MRI or CT scans: These imaging techniques may be used to investigate any underlying causes of scoliosis, such as congenital abnormalities.
Emphasis is on the word ' may ' in that last paragraph..... imaging, whilst useful and interesting, isn't always necessary in order to confirm a diagnosis and in many cases doesn't change the treatment on offer. If a scoliosis is changing then it may be warranted but in many cases it's possible to treat well on the basis of what is preented in clinic.
Treatment options for scoliosis back pain
Treatment of scoliosis depends on several factors, including the age of the individual, the degree of curvature, and the underlying cause. Here are some common treatment options:
Observation: Mild cases of scoliosis may only require regular monitoring to ensure that the curvature does not worsen as the individual grows. This is by far most common in adolesence and childhood when the skeleton goes through huge changes and scoliosis is most '
Bracing: For adolescents with moderate curvature, a back brace may be recommended to prevent further progression. The brace is usually worn for 16-23 hours a day and can be effective in halting the progression of the curve.
Physiotherapy & Sports Therapy: Exercise, joint stretches and soft tissue techniques can help improve spinal flexibility, strengthen core muscles, and alleviate pain associated with scoliosis.
Surgery: Severe cases of scoliosis, or those that continue to progress despite other treatments, may require surgery. Spinal fusion or insertion of stabilising rods is a common surgical procedure to correct and limit the curvature.
Pain Management: Scoliosis can cause chronic pain and many benefit from pain management techniques such as medication, Acupuncture, or Physio & massage care to alleviate discomfort, stregthen muscles and improve mobilty so the back is supported..
How you can help yourself
Listen to your health care providers, they really do know what is best. Surgery is always reserved for a scoliosis which is either increasing in severity or is starting to compromise underlying organs by sqashing them. Spinal surgery is a big deal for anyone so it's not something offered lightly and not for purely cosmetic reasons, although this is certainly a consideration when discussing treatment options.
In our clinic Physio, Acupuncture, Sports and massage therapy all play a huge role in maintaining muscle length, strength and function especially Pilates as it targets the exact muscles required. I'll leave you with a quote from the Lightening Bolt himself !
“When I was younger it wasn’t really a problem. But you grow and it gets worse. My spine is really curved bad. But if I keep my core and back strong, the scoliosis does not really bother me. So, I don’t have to worry about it as long as I work hard. The early part of my career, when we did not really know much about it, it really hampered me because I got injured every year.”
I think the Olympic Gold may be beyond us but a pain free life shouldn't be !
Conclusion
Scoliosis is a condition that affects millions of people worldwide, and, as with all conditions, early detection and treatment is advised for managing its progression and minimising its impact on daily life. If you suspect you or a loved one may have scoliosis, it is important to consult with a healthcare professional for a proper diagnosis and personalised treatment plan. With the right approach, individuals with scoliosis can lead healthy, active lives and effectively manage their condition.