Scoliosis is a medical condition where the spine is curved sideways. The curves affect different areas of the spine. For example, the curve can occur only on the upper back (Thoracic spine). It can curve to the right side, looking like a reverse C or to the left looking like a C curve. The curve can also occurs in the lower back (Lumbar spine). Similar to the thoracic spine, the curve can go to the right or left of the lumbar spine. Moreover, the curve can also make an S curve, where the thoracic spine curves to the right and lumbar spine compensates  and curves to the left. Another  S curve can also be present  at the neck . For example, the neck curves to the left, the thoracic spine compensates and curve to the right and the lumbar spine curves to the left.

Keep in mind that scoliosis is a three-dimensional condition. As the curvatures occur, that is the spine going sideways, the spine also rotates toward the concave side of the curvature. Furthermore, the pelvis and the shoulder rotate, usually in the same direction, but the ribs cage  rotates in the opposite direction. This creates a backward rib hump ( ribs come out in the back) in one side and on the opposite side the ribs come out in the front. The end result of the distortion mentioned above deforms the rib cage, making breathing difficult. Furthermore, the head position will also change on top of the neck to compensate for the curvature below, leading to neck pain

The distortion of the spine and rib cage as well as the shifting of the body cause some muscles to shorten and others to lengthen. These compensations decrease mobility in the ribs, the spine and increase pressure on the joints, resulting in pain and discomfort.

Studies showed that 38% of scoliosis is due to genetic factors. Genetic factors are involved in the shape of the scoliosis curve and the risk for the curve progression. Moreover, scoliosis run in families and there is high chance that children from parents who have scoliosis will develop scoliosis. There is a DNA test patients with mild scoliosis and between the ages of nine to thirteen can take to predict the risk of developing progressive scoliosis. The test allows the physician to offer early intervention to patients with high risks and prevents scoliosis progress to the point it causes severe pain or require major surgery.

Scoliosis is usually classified into structural and non-structural (functional). Structural scoliosis is loss of spine flexibility, the vertebra is fixed and the rib cage is rigid. It is usually congenital (born with it), and is also associated with neuromuscular disease such as spina bifida, Marfan’s syndrome, muscular dystrophy and poliomyelitis. However, if caught early, specialized scoliosis physical therapy is beneficial.

The non-structural scoliosis or functional scoliosis is reversible. It is usually associated with poor posture, leg length inequality, and guarding for sciatica. Patients usually recover from this form of scoliosis. Posture education, correction of leg length inequality and specialized scoliosis muscle lengthening can resolve the condition.

If you want to learn more about the treatment of scoliosis, call the STARS physical therapy.

by Raj Issuree, MPT

 

References:

Gorman KF, Julien C et al. The genetic epidemiology of idiopathic scoliosis. Eur Spine J 2012; 21(10): 1905-1919.

Shakil H, Iqbal ZA et al. Scoliosis: Review of types of curves etiological theories and conservative treatment. J Back Musculoskel Rehabil 2014; 27(2): 111-5.

Good CR. The genetic basis of adolescent idiopathic scoliosis. J spinal Research Foundation 2009; 4(1): 13-17.