Each June, the Scoliosis Research Society seeks to increase awareness among the American public about this spinal condition. One of the goals of Scoliosis Awareness Month is to call attention to the availability of scoliosis screening programs for children. Scoliosis and related conditions are the primary reason for early consultations with pediatricians and other specialists.
According to the American Association of Neurological Surgeons, scoliosis is defined as an abnormal condition of the spine that affects up to 3% of the United States population. In some cases, scoliosis patients are able to grow out of their condition as they develop past their pediatric stages; however, if left untreated, the spinal deformity can lead to a loss of lung capacity and poor health. In a large population-based study, the prevalence of scoliosis in asymptomatic school-age children was found to be 2.8%. The number of young children who will eventually need surgical correction of their scoliosis is substantial. Some may even require early surgery, as this treatment will prevent the development of associated chronic diseases.
By virtue of focusing their practice on spinal and musculoskeletal health, chiropractors are very familiar with scoliosis, and the treatments they provide can significantly reduce the likelihood of patients having to submit to surgery. The American Chiropractic Association estimates that most of the 7 million people living with this condition in the United States will not have to undergo surgery; however, quite a few scoliosis patients tend to experience a lower quality of life because of their compromised anatomies.
The anatomy of the spine is naturally curved in the following three regions:
And three planes:
Spinal curvatures serve two important functions: Keeping our heads straight and absorbing shock energy from impact and motion. To a great extent, these functions are intrinsic to musculoskeletal health, motor skills, posture, balance, and body mechanics. We can think of the coronal plane as the one that splits our abdominal and dorsal muscle mass; we use it as a point of reference when measuring the curvature of the spine in degrees.
The Cobb method of spine curve measurement is the most widely accepted diagnostic for scoliosis. When evaluating x-ray or tomography imaging, healthcare professionals look for an abnormal lateral curvature that exceeds 10 degrees; this would indicate scoliosis, but treatment would be optional unless symptoms are severe and quality of life is being negatively impacted. Measurements greater than 25 degrees are significant and should be treated as early as possible. When spinal curvatures at the frontal plane exceed 45 degrees, chances are that patients have already experienced the following symptoms:
- A general feeling of stiffness
- Fatigue caused by overcompensation
- Lower back pain
- Numbness of the lower extremities
People who are familiar with chiropractic care will recognize the aforementioned symptoms as the reasons that prompted them to seek spinal adjustment. It is not uncommon for some patients to be diagnosed with scoliosis when they visit chiropractors as adults; they may wonder why this condition was not detected between the ages of 10 and 15, which is the most typical age range for onset diagnosis. Many public school systems in North America conduct scoliosis screenings by means of incorporating an exercise called the Adam’s Forward Bend Test, which is also a staple of Military Entrance Processing Stations in the U.S. In essence, this test involves bending forward at the waist with the feet close together; the goal is to observe the curvature of the spine when the trunk is at 90 degrees.
The Adam’s test is not a diagnosis. The only means of confirming scoliosis is through diagnostic imaging, which should be ordered if a lack of symmetry or abnormal curvature is noticed. Other typical signs of scoliosis may include:
- A tendency for the trunk to lean to one side.
- Uneven hips.
- Misalignment of the shoulder blades.
- Misaligned rib cage.
- Clothes that fit asymmetrically.
- Awkward gait.
The spine has a “single” curve that starts in the front or back and passes through the middle (called the main curve). The main curve typically starts laterally and curves around the ribs and thorax, then moves towards the back. The curvature increases with age. At the age of 12 years, most curves are less than 10 degrees.
Scoliosis is not usually visible unless it is very large or causes symptoms. In addition to spinal curves, a person with scoliosis often has an “asymmetry” in torso growth.
There are two types of scoliosis: right-sided and left-sided. This is because the right and left sides of the body grow at different rates. Scoliosis on the right is most common in girls and in the thoracic region. Scoliosis on the left is most common in boys.
Scoliosis and Chiropractic Therapy
Treating scoliosis patients for the purpose of improving their lives is certainly within the scope of chiropractors. Since this is a musculoskeletal condition, many patients are diagnosed at chiropractic clinics. If they are diagnosed as adults, this does not necessarily mean that the condition was missed during their adolescent years; to this effect, idiopathic scoliosis is quite common, and the precise cause is unknown. There is a congenital aspect to scoliosis, but this is not as common as the idiopathic origin of the condition.
Chiropractic treatment is often recommended as a smart option for scoliosis patients regardless of whether they have been prescribed braces. Patients whose abnormal sideways spinal curvature is greater than 40 degrees tend to go through corrective surgery, but many of them seek chiropractic therapy afterward in order to adjust their spines and improve their overall health in their post-surgical period of recovery.
Chiropractic adjustment of the spine is a hands-on approach that doesn’t involve any drugs or surgery. It is conducted through very gentle motion. The chiropractor gently adjusts your joints and spine for the purpose of providing stimulation conducive to better health. Many of the treatments are performed with a very low-force approach, and the chiropractor may need to apply only a bit of pressure in order to affect a change.
It is easy to understand how spinal adjustment can alleviate scoliosis pain; after all, the soft tissue surrounding the vertebrae holds numerous nerve clusters that can be constrained by the abnormal curvature of the spine. Thus, chiropractors are able to provide relief in this instance because their work can directly affect these spinal nerves. This is different than with medication therapy, where one drug can exert various side effects that can sometimes exacerbate a patient’s condition. The hands-on nature of chiropractic care is a great alternative to medications because multiple sessions promote a cumulative beneficial effect.
Physical Therapy for Scoliosis
There is another reason that explains why chiropractic care is often recommended for scoliosis patients – a large percentage of people who undergo spinal corrections are left with long-term debilitating pain that often isn’t related to the original injury. They are left with long-term back problems as a result of the surgery. Patients who see a chiropractor before the corrective surgery has been completed will often be treated with the goal of alleviating pain at its root. Pain can be treated by way of medication and surgery, but some patients choose chiropractic care as a means to avoid or reduce pain and suffering.
Chiropractors do not limit their scoliosis treatment to spinal adjustment; proper biomechanics play a major role in this regard, which is why scoliosis patients have often been prescribed stretches and special exercises intended to improve their physical movements. Let’s keep in mind that Olympic athletes such as the legendary Jamaican sprinter Usain Bolt achieved great athletic feats despite their scoliosis conditions; another athlete that comes to mind in this regard is Natalie Coughlin, an American swimmer who won numerous medals during the 2008 Olympics in Beijing. What Bolt and Coughlin have in common aside from scoliosis is that they consciously submitted to considerable physical therapy and focused training that strengthened their cores, thus making their spinal condition an afterthought.