While most people have heard of scoliosis, there are aspects of the condition that some find surprising. It’s when people start to research the condition’s cause, prevalence, and various forms that they see how mystifying a condition it can be.
Put simply, scoliosis is defined as an abnormal sideways curvature of the spine that coincides with spinal rotation; it’s also progressive and has no known cure.
To get a better understanding of scoliosis, this article will address additional questions related to prevalence and genetics. Lastly, we will explore the different types of scoliosis and treatment for each classification.
Did you know scoliosis is far more prevalent than most people realize? It’s found throughout the world, develops across a wide range of socio-economic sectors, and can be diagnosed at any age.
Current estimates put close to seven million people living with the condition in the United States alone; that’s 2-to-3 percent of the population. It’s also the most common spinal deformity amongst school-aged children.
A common debate regarding scoliosis is whether or not it’s considered to have a genetic component. While there’s been a lot of speculation about the inheritability of the condition, as it seems to run in families, we’ve yet to isolate a single gene, or gene mutation, responsible for its development. Instead, the general consensus amongst experts is that the condition is considered ‘familial’.
The description of scoliosis as familial might seem the same as saying it’s genetic, but they’re quite different. While it might be more likely that a person will develop the condition if a member of the family has it, what’s sometimes overlooked is that families share a lot more than just their genes.
As the majority of the condition’s forms have no known single cause, familial factors thought to be potential causes for the connection could be environmental, socioeconomic, diet, lifestyle, common responses to stress, and even posture.
This represents one of the most mystifying aspects of the condition as we don’t truly understand how and why it develops. Although we see it repeating in families, twin studies have shown one twin developing the condition, while the other doesn’t, or each developing wildly different forms of the condition.
Despite efforts made to attribute a single cause to the condition’s development, we’ve yet to succeed.
The vast majority of known diagnosed cases of scoliosis are classified as ‘idiopathic’. Idiopathic means the condition’s cause can’t be tied to one specific source. Instead, the condition’s regarded as ‘multifactorial’, meaning its development and progression is thought to be the result of a unique set of variables that vary from person to person: another mystifying aspect of the condition.
Adolescent idiopathic scoliosis (AIS) is by far the most common form of the condition. Adolescents between the ages of 10 and 18 represent the most common age of diagnosis, which also happens to be the most important time for treatment as risk of rapid progression is high.
Amongst that group, adolescent girls are more likely to develop the condition; this is partially attributed to the rapid growth and development patterns of females going through puberty.
One thing we know for certain is that growth is the number-one trigger for progression. We also know that cases of idiopathic scoliosis account for 80 percent of known diagnosed cases; the remaining 20 percent fall into one of four categories: congenital, neuromuscular, degenerative, and traumatic. In these forms of the condition with known causes, scoliosis develops as a secondary complication of a disease or condition.
I’ve never treated two of my scoliosis patients the same way; this is because the condition develops across a wide spectrum with vastly different severity levels and symptoms. Determining a patient’s severity level is the most important classification. It’s based on measurements obtained via X-ray, such as the Cobb angle, that assesses how much the spine deviates from a straight alignment.
I can tell everything I need to about a patient’s condition by comprehensively reading their scoliosis X-ray. The Cobb angle measurement is taken by measuring the tilt of the vertebrae at the apex of each curve. The degree of curvature places it on the condition severity scale and classifies it as mild, moderate, or severe.
Combined with other factors, such as the location of the curvature along the spine, the condition severity classification helps determine the best course of treatment moving forward.
The spine has three main segments: cervical, thoracic, and lumbar. Cervical refers to the upper back and neck; thoracic refers to the middle back, and the lumbar section is the lower back.
While scoliosis can develop anywhere along the spine, the most common site is the thoracic region. Each section of the spine has a natural healthy curve. Those curves make our spines flexible and strong.
When scoliosis develops and the spine starts to lose its healthy curves, the body responds by putting in bad curves, and this can throw the entire biomechanics of the spine off balance. Once this happens, depending on the severity level of the condition, we can start to see some of the symptoms and complications of living with scoliosis.
What most people want to know about scoliosis is how it impacts day-to-day life. As a progressive condition, it’s most likely that, at some point, every condition will get worse as it’s in its very nature to do so. This represents another mystifying aspect of the condition as no one can predict just how much, or how fast, a patient’s scoliosis will progress.
The way children and adolescents experience living with the condition varies greatly from what an adult might experience. The biggest difference is pain. At first thought, a spinal deformity that causes the spine to rotate and bend unnaturally would seem to cause a lot of pain, but this is more characteristic for adults with the condition.
In children and adolescents who are constantly growing, pain is often a nonissue. This is because of the absence of compressive forces on a growing spine that’s continuously lengthening. This might sound like a good thing, and for young people living with the condition, it most certainly is, but the flip side of that is it can make the condition very difficult to diagnose.
The most common complications of living with scoliosis, as you can likely guess, are the physical changes the abnormally-curved spine can cause. Again, this varies greatly depending upon condition severity, but in cases that are more severe in nature, often changes to posture and gait are the big indicators. Physical symptoms of living with scoliosis can include:
While these aforementioned symptoms are important signs to look for, it’s also important to understand that many of these symptoms don’t become noticeable until the condition has progressed in severity, or are only likely to be spotted by an expert who knows exactly what to look for.
This is a further mystifying aspect of the condition; it’s progressive nature makes it very important to catch early on, but in terms of children and adolescents with the condition, the absence of pain and overt symptoms makes it that much harder to diagnose in its early stages.
Adults living with scoliosis experience it very differently than children and adolescents. Scoliosis is a lot easier to diagnose in adults because having reached skeletal maturity, the spine is no longer experiencing the lengthening motion associated with growth, meaning pain due to the compressive forces of gravity becomes a very-real issue.
When the spine experiences compression due to the scoliosis, that spinal tension can adversely affect the entire spine’s biomechanics; this is why when we treat a patient’s scoliosis, we’re not just assessing and treating the spine at the site of the scoliosis, but along its entire length.
Most often, when an adult with scoliosis comes in to see me, it’s due to pain, but what surprises some people is that the pain isn’t always expressed in the neck and back. When scoliosis is present in adults, most scoliosis-related discomfort is felt as radiating pain in the arms, legs, and feet. This is due to the compression of the spinal nerves, tissues, and surrounding muscles.
Also, most adults with scoliosis were adolescents with the condition; they just didn’t know they had the condition and carried it with them into adulthood, when its symptoms became more pronounced and noticeable.
As mentioned earlier, scoliosis is a progressive condition with no known cure, but that doesn’t mean we don’t know how to treat it and manage its progression in an effective and sustainable way.
Here at the Scoliosis Reduction Center, our number-one goal of treatment is to first address the underlying structural issue causing the symptoms, and we do this through a series of scoliosis-specific chiropractic adjustments. Once we know what’s happening with the spine, we know how to manipulate it to move in the direction we want it to. We want to eliminate the bad curves and restore the healthy curves as possible.
Once we’ve achieved a curvature reduction, we augment those results with sustainable at-home exercises the patients can do to help strengthen their spine, its surrounding muscles, and increase overall flexibility.
When it comes to treating adolescent idiopathic scoliosis, the condition’s most common form, the focus is staying ahead of progression. As this stage is characterized by rapid unpredictable growth spurts, we know it can progress quickly, so we are constantly tweaking our treatment plans to stay ahead of the curve.
A big part of treating adolescents and children with scoliosis is monitoring: monitoring how much they are growing and how that growth impacts their scoliosis.
Although the larger a curvature is, the more likely it is to progress, with adults, growth isn’t a big factor, so progression tends to be slower and doesn’t need to be monitored as closely as with our younger patients.
Our treatment goal with treating adult idiopathic scoliosis is to return the curvature to where it was before the patient started experiencing symptoms and pain. From there, we work closely to maintain that reduction so the patient experiences relief and a functional improvement in terms of flexibility and mobility.
Scoliosis is a condition that’s been around for centuries. As the leading cause of spinal deformity amongst school-aged children in the United States, screening is often the best preventative measure. Although there’s nothing we can do to prevent the condition from developing, the earlier a patient receives a diagnosis, the sooner treatment can be started. While it’s never too late to start treatment, scoliosis treated in its earlier stages has a much higher success rate.
Living with scoliosis is easier for some than others. Children and adolescents are often unaware there is even an issue, as pain is rarely present. In adults, this is very different as the compressive forces of gravity come into play.
The physical changes that can accompany scoliosis, such as changes to the body’s symmetry and gait, vary greatly from patient to patient. The largest determination of this variance is where the condition falls on the severity scale. The more severe the curvature, the more likely it is that internal and external symptoms will increase and become more noticeable to the untrained eye.
Here at the Scoliosis Reduction Center, we’ve treated all ages and forms of the condition from mild to extreme. Our success rate is something we’re extremely proud of as most of our patients experience positive changes in as little as a month.
We work closely with each and every patient to determine the best course of treatment that addresses the individual needs and characteristics of any given condition. We’ve made great strides showing patients that living with scoliosis doesn’t mean having to rewrite their entire lives, and this helps change the narrative surrounding the condition as a whole.
Nalda, Tony - Scoliosis Hope