Scoliosis

Scoliosis Treatment: Chiropractic Management is an Effective Solution

 

Scoliosis is perhaps the most recognised spinal deformity. Although this is the case, Scoliosis is in fact not a diagnosis but rather a descriptive term for the characteristic curved appearance that is evident in individuals.

 

Normally, when viewed from the side, the spine should have curves; but when viewed from the front, the spine should be straight. Scoliosis is a progressive, lateral curvature of the spine.

 

Scoliosis presents in the spine as an abnormal S-shaped curve (when viewed from behind). A normal spinal column is straight except for the normal lordotic and kyphotic curvatures when viewed laterally. If the curvature of the spine is directed towards the left, it is referred to as a levoscoliosis. Conversely, if the curvature is directed towards the right, it is referred to as a dextroscoliosis.

Scoliosis is most commonly seen in the thoracic and lumbar spines and primarily affects adolescents with various different classifications which are explored below:

  1. Congenital (caused by abnormalities at present at birth)
  2. Idiopathic (sub-categories include infantile, juvenile, adolescent and adult)
  3. Secondary (caused by deformities such as Spina Bifida, Cerebral Palsy or physical trauma)

Scoliosis is usually first seen in children between the ages of 10 and 15. However, it can occur in younger children aged 3 to 10 years (juvenile scoliosis) and in babies (infantile scoliosis). Scoliosis can also occur in adults with no previous history, due to spinal degeneration and advancing age. This is called De Novo Scoliosis.

 

 

RISK FACTORS

There are various important warning signs and risk factors to look out for in your children. These warning signs will enable you to detect the early progression of Scoliosis, ensuring you get prompt management before the problem worsens.

  1. Clothes not sitting correctly
  2. Abnormal posture – unlevelled shoulders and pelvis
  3. Abnormal head position
  4. Asymmetrical muscle development
  5. Unilateral prominent ribs and chest cavity
  6. Unequal gaps between arms and torso
  7. Family history of Scoliosis
  8. Unequal leg length

 

SCREENING PROCEDURES

Scoliosis screening should be regularly performed by not only parents but trained musculoskeletal professionals to ensure proper development throughout the growth and development years as early detection and treatment leads to better long term results. Two assessments, including the Forward Bend Test (Adam’s position) as well as spinal observation and palpation are the most sensitive testing measures to date.

 

The Forward Bend test involves having the child bend forward at the hips while keeping their legs straight. The child is instructed to reach towards the floor while the parent / examiner views the child from behind. If a unilateral prominence is evident, this is clinically indicative of Scoliosis. This prominence represents the thoracic rib cage.

 

Spinal observation and palpation is also of clinical importance. With the child seated and shirt removed observe their posture for the presence of an abnormal curvature. While slowly running your fingers up their spine you may also feel the curvature. Repeat this test in the standing position. If a curvature is observed or detected on palpation it is indicative of Scoliosis.

 

TREATMENT FOR SCOLIOSIS 

Conservative scoliosis treatments have the best result when the condition is detected early and treated with appropriate and proven methods. By combining treatments into a program tailored for each patient and adjusted according to response, it is often possible to avoid the more unpleasant, expensive, and dangerous options

CHIROPRACTIC


Chiropractic management of Scoliosis is largely dependent upon the age at which it is detected as well as curvature severity. If it is determined that Chiropractic treatment may be beneficial for your child there are a variety of techniques which may be used to not only reduce spinal curvature but also limit its progression.

 

Specific Manual Spinal Manipulation is the most commonly used therapeutic tool for Chiropractors and is commonly referred to as an ‘adjustment.’ This technique involves repositioning a joint which may assist with improving overall spinal curvature, flexibility, improving joint alignment, muscle relaxation, reduce pressure and reduce pain amongst other things.

 

Flexion-Distraction / Traction Therapy (stretching of the thoracic and lumbar spine) is a particularly effective technique for Scoliosis or as another form of joint mobilisation that involves gently stretching joints of the spine opening restricted spinal joints to improve spinal flexibility

 

Joint mobilisation (gentle stretching) is a more gentle therapy that is often used during acute phases of where or for those who dislike manual adjusting

 

Activator Technique (hand held instruments) used to facilitate enhanced joint movement and is suitable for all individuals and different level of severity

 

SOT pelvic blocking (mobilisation of pelvic joints) to facilitate the joint movement in the pelvis, and sacrum joints

 

MASSAGE


Massage for muscular tightness and tension is common for Scoliosis sufferers due to the abnormal spinal positioning. Specific massage and muscle releasing techniques are ideal for improving muscle tension and therefore relieving pain

 

EXERCISE PRESCRIPTION


Flexibility & Strengthening Exercise prescription is necessary. Specific exercises depend on the nature of the curvature and must only be recommended by a trained professional

 

SURGICAL INTERVENTION


Bracing is usually considered in cases where progression is expected. In some cases bracing may prevent the need for surgery and the process involves specifically designing a brace to fit the torso of the individual, almost like a corset. The brace places pressure to specific areas of the spine in order to attempt at straightening the curvature.

 

Casting involves a plaster mould being wrapped around the torso which is thought to assist with ‘moulding’ or permanently changing the position of the spine as the child grows and develops.

 

Spinal rods have been shown to straighten scoliosis curvatures however there are side effects which must be seriously considered prior to the procedure. Most commonly spinal rods are placed along the spine, however demonstrated negatives of this are usually chronic back pain as an adult, restricted movement and sciatica.

 

Usain Bolt talking about his Scoliosis

Usain Bolt getting a Chiropractic Adjustment

RESEARCH ON SCOLIOSIS AND CHIROPRACTIC

Spinal manipulative and rehabilitation techniques resulted in clinically significant improvements in Scoliosis severity. Villafane, J et al (2012). Manipulative and rehabilitative therapy as a treatment of idiopathic scoliosis without psychological sequelae: A case report. Journal of Chiropractic Medicine, 11(2); 109 – 114

 

Following a schedule of multi-modal Chiropractic management improvements were demonstrated both subjectively and objectively in radiographic changes, pain levels and overall disability. Morningstar, M. (2011). Outcomes for adult scoliosis patients receiving Chiropractic rehabilitation: A 24-month retrospective analysis. Journal of Chiropractic Medicine, 10(3); 179 – 184

 

Chiropractic care resulted in a reduction in overall spinal curvature in an adolescent with idiopathic scoliosis suggesting it is an effective scoliosis treatment option. Kao-Chang, C. (2008). Adolescent idiopathic scoliosis treated by spinal manipulation: A case study. Journal of Alternative and Complementary Medicine, 14(6); 749 – 751

 

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