Scoliosis is defined as a sideways curvature of the spine occurring most often during the growth spurt just before puberty.
As of current, the sole cause of scoliosis is unknown and although it is known to be caused by numerous conditions such as cerebral palsy and muscular dystrophy, for the majority of cases, it is not quite as simple.
Signs and symptoms of scoliosis may include uneven shoulders, asymmetrical prominence of shoulder blades, uneven waist or asymmetrical hip heights and although most cases are mild, spinal deformities can worsen, especially in those of a young age.
Approximately 3% of adolescents are reported to have some level of scoliosis with many cases found unnecessary for treatment. However, for those patients who do require treatment, there are a number of different options to be faced and decided upon for the best results.
When is it time to visit the doctor?
Before attempting to self-diagnose and self-treat, it is important to seek the advice of a healthcare professional who can assist with both diagnosis and next steps to treat scoliosis.
If you or somebody that you know notices the signs or symptoms of scoliosis (uneven shoulders or waist, and asymmetrical prominence of shoulder blades or hip heights) in yourself or your child, it is best to seek medical advice from a professional.
For younger patients, mild curves can occur without the knowledge of the parent due to gradual and painless development. It is therefore often the case that teachers, friends, or sports teammates first bring attention to the condition.
One of the first options given to those suffering from scoliosis is to simply strengthen and stretch the back muscles with physical exercise to reduce pain.
The type of exercise opted for is irrelevant providing that the back is kept moving and general advice is to choose an enjoyable sport or activity to improve adherence. As a result of exercise, those with the condition may notice weight loss, thus also reducing the strain on the back.
As a method of pain relief, some do benefit from specific stretching and exercises suggested by a physiotherapist, although this is unlikely to improve the spinal curvature. However, for all those suffering from scoliosis, it’s always a good idea to first speak with a healthcare professional before beginning a new exercise regime.
For some, spinal injections can provide relief when irritation or pressure is put on the nerves that surround the spine, often causing pain, numbness or a tingling sensation.
According to Kate Huber, chief editor at NJGamblingFun “The pain, often felt in the lower back, traveling as far to the feet, can be alleviated with injections of steroids and/or a local anesthetic may provide temporary help. The results do only tend to last a number of weeks or months and do not usually provide a long-term solution. Naturally, although these spinal injections may help with pain management, they are unlikely to solve any spinal curvature.”
An increasingly popular method of treating scoliosis comes in the form of a scoliosis brace, a back brace that can be used to shift the position of the spin.
By bracing the torso and restraining the spine in the correct position, patients are able to find pain relief in taking pressure away from delicate areas.
Aside from pain management, according to HealthcareWeekly, scoliosis braces are also considered as an alternative to surgical intervention if a patient is not of adequate health to undergo an operation.
Although most adults with scoliosis will not be required to opt for any surgical procedures if the patient shows a particularly bad example, lumbar decompression surgery may be considered.
Patients with severe negative effects of scoliosis disease will be considered for surgery when showing either a particularly severe or worsening in the curve of the spine, severe back pain with insufficient alternative treatment or irritated or squashed nerves in the spine.
Different types of surgery
Due to the complex nature of the spine, a number of techniques rather than a sole one-size-fits-all approach can be adopted at the discretion of the surgeon for optimum results.
Of the various options available, there are three which are the most common of which a combination of the techniques is often used:
- Laminectomy – in which a section of one of the spinal bones (vertebrae) is removed to relieve pressure on the affected nerve
- Discectomy – in which a section of one of the discs between the vertebrae is removed to relieve pressure on a nerve
- Spinal fusion – in which two or more vertebrae are joined (fused) together in order to stabilize, strengthen and straighten the spine
Although typically completed by a traditional surgeon, robotic surgeons are slowly making their way into the healthcare industry to provide a more reliable method.
Risks of surgery
Naturally, as with any form of surgery, there is an associated risk that should be considered before deciding.
As scoliosis is a spinal disease, the major operation can be difficult and can take upwards of a year to fully recover. With such difficulty and complexity in a spinal operation, there are a number of serious risks and potential consequences of the surgery to be made aware of:
- Failure to reduce the pain – surgery is not guaranteed to reduce pain caused by scoliosis and although can be effective for all pain, is generally better at relieving pain radiating to the legs, rather than pain radiating in the back
- Damage to the spinal nerves – the spinal nerves are responsible for the feeling in the legs and damage to these can result in permanent leg numbness/weakness, or, in rare cases, some degree of paralysis
- Wound infection or blood clot – as found in the majority of surgical risks
In conclusion, there are a number of treatment approaches that can be adopted for patients suffering from scoliosis.
Although the advice of a health professional should be the number one priority, those with the condition will often find exercise and/or physiotherapy to be of benefit.
For those with more severe cases, surgical intervention may be necessary or, for pain relief or for those too ill for surgery, a scoliosis brace can be worn.