Scoliosis of the spine is a commonly known condition of the back. Scoliosis is the abnormal sideways curvature of the spine and can be classed as either functional or structural. Treatment for most people with scoliosis involves using conservative care, such as chiropractic, and in extreme cases surgery. Chiropractors are trained to do orthopaedic testing namely Adams Test and take & read x-rays to determine if there is a true scoliosis.
What Is Scoliosis
Scoliosis is a spinal deformity that shouldn’t be confused with the normal curvatures of the spine (kyphosis & lordosis).
Scoliosis is defined as a curvature in the coronal plane, which is an anatomic description. Scoliosis can be be both sideway (lateral) bending with or without rotation of the spine. Scoliosis can occur at different levels of the spine and so can be either ‘C’ shaped, one curve, or ‘S’ shaped 2 curves.
Scoliosis Information Video
httpv://www.youtube.com/watch?v=jQOuNeV2W7Y
Rate of Scoliosis in the UK
The prevalence of scoliosis in the UK can vary according to, but according to research of NHS records¹ is between 5.75/100000 to 2.8/100000.
Scoliosis is most commonly found in children and teenagers as their spines are growing and stops progressing when skeletal maturity is reached.
Scoliosis Screening
A qualified healthcare professional, such as a chiropractor, can make the final diagnosis of a scoliosis via a physical examination and confirmed on x-rays.
However, you can try see for yourself if a scoliosis, in someone you know, is suspected by asking these questions:
1. Is one shoulder blade more prominent?
2. Is one shoulder higher than the other?
3. Does one hip seem higher than the other?
4. Is there noticeable rounding or hunching of the shoulders?
5. With arms by the side whilst standing is there more space between one arm and the side than the other?
These are some basic things that you may spot that could make you suspect a scoliosis in your child or a friend/family member.
Causes of Scoliosis
Most cases of scoliosis have an unknown cause or other in other words idiopathic scoliosis.
The two classes of scoliosis are either functional or structural.
Functional Scoliosis
This is usually a ’soft’ or non-rigid abnormal curvature in the spine. This may be due to poor posture, muscle imbalance, functional leg length differences due to muscle contractions or pelvic imbalance etc… So this is not a major concern as a change in movement pattern can usually rectify this situation quickly.
Structural Scoliosis
This is the more true long-term form of scoliosis. The most common type of structural scoliosis is adolescent idiopathic scoliosis. This is usually detected between the ages of 10-18. Again the cause is unkown however there may be a family history of scoliosis so a genetic link is likely.
Some other types of structural scoliosis are:
* infantile (before 3 years) and juvenile (3-10 years) idiopathic,
* congenital – e.g. hemivertebrae
* neurological – e.g. spinal tumors
* traumatic – e.g. fractures
* metabolic – e.g. rickets
So as you can see there are many different types of scoliosis so it is important to have a healthcare professional, assess yourself or your child to help you find out which type of scoliosis it is.
Especially in children it is important to monitor and classify a scoliosis. I remember a GP friend whose child developed a scoliosis because of spinal tumours. She felt so bad for missing the scoliosis, but it was a rare case of spinal cancer in a four year old.
So just get an opinion from a doctor, if needs they will refer for an x-ray to determine the Cobbs angle used to measure the severity of a scoliosis curve.
How to Treat Scoliosis
As mentioned earlier conservative care, is considered the best option to manage any pain related to a scoliosis of the spine.
When determing what treatment is needed it is common to use the Cobb Angle. Cobb angle is a radiographic measurement done on an x-ray to determine how big of an angle the curve(s) are in a scoliosis.
- A Cobb Angle less than 25° only conservative care should be considered,
- Cobb angle of 25°-45° spinal bracing, such as a Boston brace, & conservative care,
- Over 45° scoliosis angle is a surgical candidate.
Conclusion on Scoliosis
Scoliosis is an abnormal sideway curve of the spine that typically occurs in children and teenagers for no apparent reason.
To fully diagnose a scolisis x-ray with measurement of the curve will be needed. Curvatures greater than 25° using Cobb angle may need more intervention than just observation.
Scoliosis needs to be monitored in children and teenagers as their spines are still growing as a scoliosis can get worse in these age groups. Your doctor may refer your child for x-rays every 6-12 months to reassess the Cobbs angle used to measure a scoliosis. Cobbs angle on a x-ray greater than 45° surgery is considered.
Further Reading:
1. Goldacre, M., Fairbank, J. (2006) Geography of scoliosis in England. Journal of Bone and Joint Surgery – British Volume, Vol 90-B, Issue SUPP_III, 436-437