Non-surgical Treatments for Scoliosis
If your child is diagnosed with a sideways curvature of the spine, also known as scoliosis, then there are some things you should know. Most cases of scoliosis involve only a minor spinal deformity and self-correct as the child grows, but it is important to detect this condition early to take preemptive action if necessary. Severe cases of scoliosis can be debilitating and may require surgery.
In most circumstances, a child with scoliosis will only need monitoring to ensure that the curvature does not worsen. This monitoring most often consists of x-rays on a periodic basis. If the curvature is less than 20 degrees and the patient reaches adulthood, there is often no further need for x-ray imaging.
This condition may present as a C- or S-shaped curve of the spine. It is more common in females than males. If the scoliosis is serious and untreated, it can lead to chronic pain, breathing problems and diminished stamina.
What Causes Scoliosis
In about 80 percent of scoliosis cases, there is no recognizable cause of scoliosis. In the other 20 percent, there are structural and nonstructural causes. In nonstructural cases, the spine functions as it should, but other factors like muscle spasms or appendicitis interfere with spinal growth. Normally, when these other issues are resolved, the scoliosis also is corrected.
Structural scoliosis, however, is usually caused by a defect in the spine. There are many health conditions that may cause such defects including:
- Muscular dystrophy
- Cerebral palsy
- Down syndrome
- Marfan syndrome
- Birth defects.
Although most cases of scoliosis have no known cause, there is usually a genetic link. If you or someone in your family has scoliosis, make sure that your doctor knows so that they can test your children.
What Happens If You Have Scoliosis
Although the initial signs of scoliosis may only be visible with high resolution medical imaging, almost anyone can detect it in children when they reach a certain age. There are some telltale signs of scoliosis including the following:
- One shoulder is higher than the other
- The head is not centered
- The hips are not at the same height
- The ribs may protrude on one side
- The arms may not hang straight down
- When bending forward, the two sides of the back are not equal in height
If you do have scoliosis, the first signs usually appear around ages 10 to 15 when the growth spurt occurs. In most scoliosis cases, the symptoms are minor, and the child will outgrow the condition without harm. That is why the child is usually monitored closely at first for signs of a worsening condition. Girls should be monitored more intensively, as they are 10 times more likely to experience deterioration than boys.
Scoliosis is usually a childhood condition, but it may also sometimes arise in adults. In older adults with degenerating bones or joints in the spine, there may damage or thinning of spinal discs—cartilaginous cushions that lie between spinal vertebrae. This may cause the spine to tilt to one side. Adult scoliosis is usually accompanied by back pain, weakness or numbness.
Treatments for Scoliosis
If your doctor suspects that you have scoliosis, then they may take x-rays, CT scans or an MRI to confirm it. If scoliosis is found, then there are a number of considerations before a course of treatment is chosen.
- Gender—there is a higher risk of worsening spinal curvature among girls
- Curvature severity—more pronounced curves are more likely to deteriorate
- Curve pattern—if there is an S-shaped curve, that is more likely to worsen than a C curve
- Spinal location—curves in the middle of the spine are more prone to deterioration than those in the upper or lower spine
- Age of child—the older the child, the less likely that the curvature will progress
If the child has a curvature of less than 20 degrees, then the physician will usually opt for observation. This monitoring will include periodic x-rays.
However, if the curve is between 20 and 40 degrees, your doctor will probably recommend wearing a back brace to stop the curvature from worsening—but they do not straighten what is already curved. Although the back brace will be made from hard plastic, they may be rigid or elastic. The exact kind of brace will depend on the current state of the scoliosis and will be designed by an orthotist.
The child should wear the brace from 16 to 23 hours a day, depending on the doctor’s orders. Most patients are able to wear it unobtrusively beneath loose clothing. The child typically wears the back brace until their growing years are completed.
The purpose of the brace is to stop increased curving that would necessitate surgery. Studies show that long-term use of braces for 16 or more hours a day is effective. In most cases, your doctor should check your condition every six months using some kind of imaging technology.
Option for Severe Scoliosis
If your child has scoliosis with a curvature between 45 and 50 degrees, then the condition is likely to worsen. Not only will the curvature become more severe, but it may affect vital organs like the lungs. In order to prevent this, your doctor may recommend a spinal fusion surgery. A spinal fusion procedure may also be recommended if the scoliosis is producing severe or crippling pain in the back or legs; the surgery can help relieve pressure on the spinal nerves causing the pain.
A spinal fusion surgery has been proven to stop progression of scoliosis. The purpose of the surgery is to fuse the curved vertebrae of the spine into one large bone. This prevents the vertebrae from growing any further which would worsen the curvature. Unfortunately, a spinal fusion surgery cannot correct the curvature that has already taken place.
The actual procedure may take from 4 to 8 hours to complete and involves a bone graft. It typically takes about 2 to 4 weeks to recover from a spinal fusion surgery.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
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