Scoliosis is a curvature of the spine with a curvature to one side. The spine in people with scoliosis does not grow in a straight line, but curves to the right or left, resembling the letter C or S. The ratio of men to women with scoliosis is 1:7 for severe curvature that requires treatment. Most cases of scoliosis are mild and appear in individuals between the ages of 12 and 14 years. The development of severe curvature can lead to lung and heart problems, as well as body deformities. The main ways to detect and treat scoliosis are by monitoring the curve, wearing braces, or spinal surgery.
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Part 1 of 3: Getting a Diagnosis
Step 1. Look for visible physical abnormalities
Visible physical abnormalities are usually obvious features before a diagnosis is made. Most people will see a doctor when spinal abnormalities are obvious. This abnormality is seen in the asymmetrical shape of the waist, shoulders, ribs, or spine. Scoliosis is usually present in the body without pain.
If a person has severe pain related to scoliosis, a full examination should be done to determine the cause
Step 2. Recognize the symptoms of scoliosis
Because scoliosis is usually mild, it is not easy to detect. Parents are not always aware of this condition in their child, because its development is slow and almost no changes can be seen or felt. In developed countries, screening for scoliosis is mandatory in some schools, and teachers or school nurses are often the first to notice the condition. Here are the signs of scoliosis:
- Shoulders are uneven.
- One of the shoulder blades protrudes.
- Uneven waist or hips.
Step 3. Visit a doctor for an examination
Scoliosis can develop at any time during adolescence, and a visit to the doctor is important once you notice a curvature in you or your child. The doctor will ask the patient to bend forward toward the floor, so that the curve is more visible. The doctor will also take X-rays of the patient's back to confirm any curvature. From the results of this examination, treatment options (if any) will be described.
- If the curve is judged to be mild, the doctor will monitor the patient to make sure the curve is not getting worse.
- Age, gender, type of arch and their location will be considered when deciding what treatment to give.
- In addition, the doctor will evaluate the patient's family history and associated pain.
Step 4. Know how to define scoliosis
Because everyone's spine is slightly different, there isn't just one way to define how scoliosis looks and progresses. Sometimes the curve is small and sometimes it's very obvious; sometimes spinal curvature occurs in more than one place and sometimes only in one place. Here are the five main factors that doctors consider when diagnosing scoliosis:
- Arch shape. Scoliosis can be structural with curvature from side to side and twisting of the spine, or non-structural with curvature from side to side without twisting the spine.
- Arch location. The spine located at the very top of the back, called the apical vertebrae, is used to define scoliosis.
- Curve direction. As part of the individual's developmental picture, the doctor will determine whether the curvature is left or right. These considerations are important for determining treatment and knowing the problems that may arise if the spine interferes with internal psychological processes.
- Big arch. The angle and length of the arch are also measured. This measurement will help determine the severity as well as the corrective alignment that must be achieved to return the spine to its more natural state.
Step 5. Rate your scoliosis on a scale
The Lenke Classification is a scoliosis classification system that was first introduced in 2001. This system is widely used to determine the severity of scoliosis, especially in adolescents. The components of this system include:
- Type of arch-graded on a severity scale of 1–6.
- Lower spine (lumbar) modifiers-rated on an A–C. scale
- Sagittal thoracic modifier-Rated with (-) negative, N, or (+) positive
- The modifier, which measures what is called the Cobb angle, determines the value (-), N, or (+), depending on the kyphosis (curvature) angle of the spine.
Step 6. Determine what is causing the scoliosis
Currently, 80% of cases of scoliosis are unknown, although there is evidence to suggest that the condition may run in families. Cases with no known cause are called idiopathic scoliosis. The appearance of this condition can occur at any time from infancy to adolescence. The remaining 20% have obvious causes, including:
- Cases caused by a disorder at birth, called congenital scoliosis, are much more severe and usually require extensive treatment.
- Neuromuscular scoliosis, which can cause problems as the spine grows. This condition develops in people who have other disorders, cerebral palsy, spinal cord injury or nervous system damage.
- Functional scoliosis, the spine develops normally but becomes abnormal due to problems in other parts of the body, such as a shorter leg or back muscle stiffness/cramps.
Step 7. Know some of the possible complications
In the majority of cases, the spinal curvature is relatively minor and does not require treatment. The doctor will only monitor the development of the curve to find out how it progresses, and only suggest treatment if the curve changes over time. However, severe scoliosis can cause disfigurement of body parts, breathing problems, prolonged back pain, and obvious deformities.
- Once detected, all types of scoliosis should continue to be monitored.
- The scoliosis treatment program will be tailored to your situation and on a case-by-case basis. The doctor will examine and provide the best treatment program.
Part 2 of 3: Undergoing Treatment
Step 1. Notice the curvature of the spine
The doctor will advise how often you or your child should check in for X-rays if the arch gets worse. Doctors will usually recommend checkups every 4 months. As a child develops, the arch usually stops developing, so it doesn't require any treatment. But if the scoliosis gets worse, further treatment may be needed.
Step 2. Put on a support if necessary
A brace is the first choice of treatment for scoliosis, which is considered moderate, where the curve is between 25 and 40 degrees. A brace is also recommended for progressive cases, i.e. when the curve grows more pronounced. This tool is usually only used when the bones of people with scoliosis have not stopped developing, because it does not have a significant effect on bones that are already fully developed. The use of braces is usually discontinued when the patient enters puberty. Braces can help prevent the arch from getting bigger, but they usually don't automatically improve the condition.
- There are two types of supports, namely soft supports and hard plastic supports. The type of brace your doctor recommends depends on a number of factors, such as the location and size of the arch, as well as the patient's age and activity level. The sex of the patient is also important, as girls have a greater risk of developing scoliosis than boys.
- Some braces are worn only at night, while others have to be worn almost 23 hours a day. Wearing the brace as often as recommended is very important to make sure the tool is working properly.
Step 3. Ask the doctor about spinal fusion surgery
This method is a last resort in severe cases of scoliosis which can cause disability, breathing or heart problems. Spinal fusion surgery is usually only recommended after the patient has passed puberty, when braces are no longer the right choice, and arch development due to bone growth has decreased.
- Spinal fusion surgery is an operation that connects the vertebrae together so that they cannot bend. Your doctor may also choose to implant a metal rod or similar device to prevent the spine from curving again after surgery.
- This procedure varies depending on the type of scoliosis and the age of the patient. Your doctor will assess the severity of your condition as well as your response to other treatments to determine if this procedure is an option. Most patients with neuromuscular scoliosis will eventually need this surgery to correct the curvature in their spine.
Part 3 of 3: Considering Alternative Treatments
Step 1. Try exercise
The results are inconclusive, but they do highlight the idea that physical activity might help prevent scoliosis from getting worse. If your child has mild scoliosis, talk to your doctor about healthy and safe options for physical activity. Team sports and other types of physical exercise will usually also be recommended.
- Physical therapy can provide the same benefits as exercise or physical activity.
- Physical activity can also help adults with scoliosis.
Step 2. Try chiropractic manipulation
Research shows positive results in patients who take part in chiropractic care. Patients in the specific study reported positive psychological benefits immediately after completing the treatment program, with the positive benefits continuing 24 months later. Chiropractic manipulation is based on an exercise program used to prevent the natural development of scoliosis in adults.
- If you decide to have chiropractic care, make sure you see a licensed chiropractor who does not promise what is not scientifically backed up. In America, for example, patients can find a chiropractor through the search feature on the American Chiropractic Association website.
- To find a good chiropractor, ask your doctor for a recommendation. You can also ask friends or family. Before making a treatment appointment, talk over the phone or in person about the chiropractor's practice, how it operates, and whether he or she can help you with chiropractic manipulations.
- Ask about pain treatment. If scoliosis is causing pain, you may need to consider treatments that relieve pain but don't correct the curve. Scoliosis can cause back pain that can be treated with alternative medical practices. You can take over-the-counter medications, such as NSAIDs, or anti-inflammatory injections if the pain isn't too severe. Apart from that, there are also several other treatments to relieve pain.
Step 3. Acupuncture is a method that helps relieve pain from scoliosis
According to one study, acupuncture also helps reduce the curvature of the spine by up to 10 degrees.
- There is also no evidence that chiropractic care can make a difference in scoliosis arches, but it can help relieve scoliosis-related pain.
- Try yoga or massage to relieve back pain. These methods have not been shown to affect the curvature of the spine, but they are both safe and effective for back pain because they relax and strengthen muscles.
Step 4. Try biofeedback
Biofeedback is an alternative treatment that is recommended to relieve the symptoms of scoliosis. With biofeedback, you become sensitive to your body's reactions and learn to control them through your actions. There was one study conducted on scoliosis patients who received a warning from a biofeedback device every now and then that their posture was incorrect and asked to correct it.
Although no large, long-term studies have been conducted, nearly 70% of patients saw improvement during these studies
Step 5. Ask your doctor for information about electrical stimulation
There are alternative methods that may relieve the symptoms of scoliosis in children. To be eligible for electrical stimulation, a child must have at least a spinal curvature of less than 35 degrees, have idiopathic scoliosis, and have bones still growing for up to two years. Electrical stimulation should be done in conjunction with physical therapy. This type of treatment is done by attaching an electrical stimulation device to the child. Electrodes are placed between the ribs on the side of the chest or torso, just below the armpit, in line with the most curved area of the back. The cycle of electrical stimulation is usually done at home throughout the night, so stimulation is carried out on the muscles for up to eight hours while the child is asleep.
- The effectiveness of this treatment and the level of electrical stimulation provided are continuously checked by physical therapists.
- Although this treatment is still somewhat controversial, most studies show that the combination of electrical stimulation treatment and physical therapy has a more lasting effect on children than the combination of braces and physical therapy.
Tips
- You know your own body. Pay attention to your posture and back if you have been diagnosed with scoliosis. Assess yourself carefully to determine whether the treatment you are undergoing shows benefits or not, and whether over time the positive results continue to be felt in your spine.
- Do not try to repair your own bones with the help of your family, unless they are experienced doctors. Unprofessional attempts can displace the vertebrae, irritate the spinal cord, and cause pain.
