Scoliosis Treatment & Pain Relief in St. Louis, MO
Scoliosis is a condition that is generally associated with an unnatural curvature of the spine to the right or left in children. It can happen to any part of the spine but is most often associated with two common spinal regions; the lower part of the back which is known as lumbar scoliosis and the chest area which is commonly called thoracic scoliosis. The resultant curvature of the spine can be barely noticeable to extremely severe.
It is a condition that is highly idiopathic (has no known cause) as is the case with over 80% of the people that have it. Children who have the condition often outgrow it but those who don’t need to seek treatment or it can cause serious spine, pelvis, chest, lung and heart damage.
Symptoms of scoliosis
Here are some of the ways in which doctors and other medical professionals determine that a patient may have scoliosis:
- One shoulder may be slightly or markedly higher than the other
- A person’s head is not centered right above the pelvis as it should be
- The patients ribcage is often not symmetrical
- One of a person’s shoulder blades is more pronounced than the other
- A hip can be more prominent on one side of the body
- Clothes seem to hang awkward
- The person suffering from scoliosis often leads to one side
- It usually makes leg lengths very uneven
- The patient may experience back pain; this happens very infrequently with scoliosis for some reason
Here are some signs and symptoms that commonly indicate scoliosis in babies:
- A pronounced bulge on one side of the baby’s chest
- The baby chooses to constantly lay on one side in a somewhat curved position
Note: In the most extreme cases the heart and lungs may not function properly and chest pain and shortness of breath may result.
Risk factors for scoliosis
Here are the most common risk factors associated with scoliosis:
It often occurs during a major growth spurt that usually happens just before puberty.
It is well documented that females have a much higher risk of having worse scoliosis symptoms than men.
- Family History
Genetics seem to play a part in who gets scoliosis too. Those who have this condition often have close relatives that have experienced it also.
What causes Scoliosis?
Here are some of the most common causes of scoliosis:
- Idiopathic scoliosis – by far the most number of scoliosis cases have no known cause.
- Neuromuscular conditions – these are conditions that usually affect the many nerves and muscles that are found throughout the body. As much as 20% of all scoliosis cases are thought to be attributed to such neuromuscular conditions as muscular dystrophy and cerebral palsy. In these types of cases it is not uncommon for a child to not be able to walk or stand up straight; this only compounds the problem because it inhibits proper growth.
- Congenital scoliosis (Is always present at birth for those who have this condition) – this is very rare and occurs because of abnormal bone growth when a fetus is developing in the womb.
- Genes – There are genes that have been identified that are linked to scoliosis. One gene, GPR126, is highly present during the growth years and plays a significant part in development.
- Leg length – uneven leg length is not only a symptom of scoliosis but can be a cause of it also.
- Other causes – such things as overuse of backpacks, bad posture and improper exercise routines may also cause scoliosis.
How scoliosis is diagnosed
As with most medical diagnosis the process will usually start by with a physical examination from the patient’s doctor who is a general practitioner. They will take a good look at the patient’s spine, hips, shoulders, ribs and leg length. Often after the initial diagnosis is made an orthopedic specialist will become involved in the treatment.
Here are some of the tests that will often be used to confirm the doctor’s diagnosis and help determine a course of chiropractic therapy to correct the scoliosis:
This is a test that will not only confirm the presence of scoliosis but will also tell the doctor the severity of it.
- Magnetic resonance imaging (MRI)
This test creates detailed images of such soft tissues as muscles, nerves, disks and the spinal cord.
- Computed tomography (CT)
This test creates cross-section images that can show abnormalities of your spine.
- Bone scan
This test is done by injecting a radioactive material into a patient’s bloodstream. A special scanner helps diagnose the extent and characteristics of a person’s scoliosis.
Treatments for Scoliosis
In the vast majority of children scoliosis will correct itself on its own and does not generally need to be treated with a brace or surgery. A doctor will just recommend a follow up schedule to monitor the patient’s curvature that should be strictly adhered to.
In those cases that do require treatment the following factors will help to decide the course of that treatment:
As far as scoliosis is concerned females have a much better chance than males of having progressive scoliosis.
- Severity of the curve
It is well known when diagnosing scoliosis that the larger the curve of the spine the better the chance that the condition will worsen over time. This is more characteristic of S-curves than it is of milder C-curves.
- Curve Location
A curve that is located towards the center of the spine is much more likely to progress than a curve located elsewhere.
- Bone maturity
The chance of progression is much lower if a patient’s bones are no longer in a growth stage. It is also a fact that braces are more effective when bones are still growing.
Doctors have experienced some success guiding severe cases of scoliosis back into place using plaster casts. These help guide the spine into its normal position as the patient grows. The cast is attached to the outside of a patient’s body and is never removed until the cast is changed or the healing of the spine is complete. The cast will need to be changed on a regular basis because children are constantly growing in most incidences.
Milder cases of scoliosis can be treated effectively with braces in most instances. Doctors tend to recommend this more often in cases where the bones are still growing. This helps to prevent more curvature to the patient’s spine but will not help guide the spine naturally back into place or cure the problem. Most people who wear scoliosis braces are instructed to wear them 24/7 because the longer they are worn the better they tend to work. The braces are not nearly as restrictive as a plaster cast. If the treating physician has Ok’d physical activity for the patient the brace can even be removed for short periods of time to participate in that.
Surgery (spinal fusion)
In the most severe cases of scoliosis surgery may be necessary. The type of surgery that is used to correct this condition is what is known as ‘spinal fusion surgery’. It has two purposes; to reduce the curvature of the spine and to prevent the spinal curvature from progressing. During the procedure two or more vertebrae are connected with bone grafts and these may be additionally held in place by rods, hooks or screws while the bone heals.
The operation typically lasts four to eight hours in duration and the associated hospital stay is 1 to 10 days. It is usually about four to six weeks before a child may be able to attend school again. A brace may need to be worn after the operation too. The surgical patient will have to return approximately every six months to have the rods extended. Once the spine has grown properly surgery will be needed to remove the rods.
A treating physician must carefully weigh the benefits versus the risks of doing surgery to correct scoliosis. Here are some of the risks concerned with this type of surgery.
- Rod displacement – Spinal fusion surgery uses rods to hold the spinal correction in place. In about 5% of all scoliosis surgical cases these rods will move from their ideal position. This does not result in pain but many times when this happens the person will need more surgery to correct it.
- Pseudarthrosis – In less than 5% of the cases involving scoliosis surgery a patient’s spine does not take the graft properly. When this happens it can result in such things as mild discomfort, loss of some of the effectiveness of the surgery and may constitute the need for further surgery to be done.
- Infection – Developing an infection is a risk after any type of surgery and is by no means limited to scoliosis surgery.
- Nerve damage – In less than one percent of the cases where spinal fusion surgery is used to correct scoliosis nerve damage results. This type of nerve damage can be anything as minor as a little numbness or as severe as paraplegia. That is why a neurologist is always there during any scoliosis surgery so the risk of nerve damage is minimalized.