Scoliosis

“Scoliosis” comes from a Greek word meaning “curved” or “bent”. It was invented by the ancient Roman doctor Galen. We do not know how many Romans had scoliosis, but today the disease occurs in 0.47-5.2% of people.

What is scoliosis?

If you look at a healthy person from the back, his or her spine will look like a straight line. Scoliosis is a curvature of the spine in a straight line so that it looks like the letter “C”.

With scoliosis, the spine can bend both to the right and to the left, with curvatures occurring both in the thoracic and lumbar spine. Sometimes the spine is bent in both parts – then it will look like the letter “S”.

Not every curvature of the spine has the “right” to be called scoliosis. For many people, the spine only slightly deviates from a straight line, but this does not in any way interfere with life and practically does not spoil the appearance.

We can talk about scoliosis only if this diagnosis was made by a doctor who relied on the results of an X-ray examination of the spine. And it should be treated only if the disease causes health problems or if there is a risk that the curvature of the spine will intensify over time.

Five facts about scoliosis

  1. “Scoliosis” is not synonymous with “poor posture”. This disease cannot be provoked by hunched over a table or carrying a bag on one shoulder. Physiotherapy, special exercises and devices that help to monitor the correct posture do not help with scoliosis;
  2. Women suffer from scoliosis ten times more often than men;
  3. “Female” scoliosis is more dangerous than “male” – it often progresses to a condition that requires treatment;
  4. Pregnancy does not make scoliosis worse. Scoliosis also does not affect the outcome of pregnancy – a mother suffering from scoliosis can give birth to a healthy baby;
  5. Scoliosis affects not only children but also adults. As a rule, “adult” scoliosis is a continuation of a disease that began in adolescence. However, with age, as the ligaments and joints gradually wear out, the curvature of the spine can develop even in a person who has lived his/her entire life with a straight back. This is called “degenerative scoliosis” and usually develops after age 60.

Why does scoliosis occur?

All variants of scoliosis can be divided into three large types:

Idiopathic scoliosis

The most common form of scoliosis occurs in 80% of cases. It develops in adolescents 10-15 years old during a growth spurt before puberty. The exact causes of acquired scoliosis are unknown, but if a person has close relatives (for example, a parent, sibling) with idiopathic scoliosis, the risk of developing idiopathic scoliosis is increased.

Congenital scoliosis

Congenital scoliosis is a rare disease that occurs in only 1 in 10 thousand newborns. It develops due to errors in the intrauterine development of the spine. Sometimes the first signs are noticeable even during the intrauterine ultrasound examination.

Neuromuscular scoliosis

Neuromuscular scoliosis is a symptom of rare and severe neurological and muscle diseases. Neuromuscular scoliosis occurs in 20% of children with cerebral palsy (CP), 60% of people with myelodysplasia (congenital underdevelopment of the spinal cord), and 90% of people with Duchenne myodystrophy. This type of acquired scoliosis usually progresses faster than idiopathic scoliosis and often requires surgical treatment.

How to understand that scoliosis is developing?

As a rule, the symptoms of congenital and neuromuscular scoliosis appear early. With idiopathic scoliosis, the situation is more complicated – after all, there are no warning signs until the beginning of adolescence.

Take your teenager to a doctor in these cases:

  • one shoulder is higher than the other;
  • the head is displaced relative to the body;
  • the shoulder blades are at different heights;
  • the ribs are located asymmetrically;
  • цhen a teenager bends down, the right side of his/her back is different from the left.

But if a teenager complains of pain in the back or legs, if he/she has problems with digestion or urination, most likely, it is not a matter of scoliosis. In this situation, you need to urgently consult a therapist or neurologist.

How is scoliosis diagnosed?

The doctor must visually examine the patient. If the doctor suspects scoliosis, the patient will be sent for an x-ray of the back, from the neck to the pelvis.

When the patient brings the X-ray, the doctor will measure the angle of curvature of the spine, which is called the “Cobb angle”. This will help determine the degree of the disease progression and select the treatment.

  • Cobb angle is less than 10° (scoliosis I degree) – no disease, this is a variant of the norm;
  • Cobb angle 10-15° (scoliosis II degree) – this is scoliosis, but treatment is usually not required. If the patient is a teenager, then he/she needs to be periodically examined by a specialist until the end of puberty. This will help to identify the aggravation of scoliosis in time and take action. In boys, puberty occurs when they start shaving every day; in girls, about two years after the onset of menstruation;
  • Cobb angle 20-40° (scoliosis III degree) is scoliosis in which treatment is required. If the patient is a teenager and there is no treatment, the disease will gradually worsen. As a rule, in this situation, the doctor prescribes a scoliosis bracket for a teenager (it is also called a scoliosis brace) – this is a special hard vest made to an individual measure, which must be worn for about 13 hours a day. The brace helps the back to form correctly. For adults, braces can no longer form the back. They are only prescribed to relieve back pain. Wearing braces is always harmful because it weakens the muscles;
  • Cobb angle 40-50 ° (scoliosis IV degree) – surgery may be required to correct scoliosis. If this is not done, over time, scoliosis can worsen and lead to deformity of the chest and heart and lung problems.

Can I prevent scoliosis?

Today we cannot claim that scoliosis can be prevented. But some preventive procedures – for example, physical therapy (exercise therapy) or swimming in a pool – may help prevent or cure scoliosis.

Moreover, there is no qualitative evidence in randomized trials that physical therapy – specifically scoliosis-specific exercise, chiropractic therapy, electrical stimulation, or biofeedback – has any effect.

But you can’t say that it doesn’t make sense at all. Exercise therapy and swimming are excellent methods of preventing pain, which can provoke scoliosis.

How to live with scoliosis?

Scoliosis in adult patients is most often asymptomatic, and symptoms are usually noted over the age of 50.

Considering how many people complain, for example, of pain in the waist, it is difficult to say that it was scoliosis that provoked them. To live a full life and reduce discomfort, you may follow all the same rules for the prevention of pain syndromes: daily adequate physical activity and physiotherapy exercises.

Nevertheless, if the pain does appear, it is important to figure out whether scoliosis is directly related to it. Treatment of scoliosis in adults is individualized depending on the etiology, severity of symptoms and quality of life.

To select treatment, it is necessary to contact a specialist. Depending on what kind of pain syn-dromes you have, the doctor may prescribe both simple analgesics and glucocorticosteroids. If conservative methods of treatment do not help, the doctor may suggest surgical interventions.

The main thing is not to delay treatment.

Summing up

  1. Scoliosis is a disease, not a synonym for “bad posture”. Moreover, most people live with scoliosis and do not face any problems;
  2. Nevertheless, in some people (in women more often than in men), scoliosis begins to worsen with age. This can lead to tangible health problems. To avoid problems in the future, a child or adolescent with signs of scoliosis should be examined by a doctor;
  3. For most people, the best medicine for pain in scoliosis is exercise therapy, swimming and other moderate and healthy sports activity.