What is Scoliosis?

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What is Scoliosis?

Scoliosis is one of the oldest orthopedic conditions. It is a lateral curvature of the spine. It occurs when individual vertebral bodies twist around their own axis. The vertebrae are then stiffened in these sections. Bending forwards (kyphosis) and backwards (lordosis) can also occur. Scoliosis often develops as children grow, especially during the growth spurts of puberty. The physical deformation often causes mental problems in the patient.

Causes

Scoliosis is rarely congenital. They are usually acquired later. In the majority of cases (approx. 80%) no causes can be found. They are therefore among the “idiopathic” (structural) forms of scoliosis. It is believed that uneven growth of the back muscles and vertebrae triggers this form of scoliosis – one side grows faster, the other slower, causing the vertebral bodies to twist. In phases of growth spurts, especially during puberty, the curvature of the spine increases.

A distinction is made between functional scoliosis and structural scoliosis. Here, the spinal curvature is triggered by external influences. A different leg length, a change in the pelvic area, vertebral damage (e.g. due to inflammation, bone loss or
Bone cancer), paralysis, muscle, nerve and connective tissue diseases, protective posture due to pain (e.g. in the case of a herniated disc, tension) are possible triggers of functional scoliosis. It can be eliminated by treating the underlying disease.

Symptoms & Clinical picture

The bent spine and the associated misalignment means that the muscles are constantly tense. Pain in the back, shoulders, neck and headaches, but also pain in the knees and ankles can be the result. However, scoliosis does not necessarily have to be associated with pain. A crooked pelvis, unevenly raised shoulders, a hump in the ribs or a tilted head position are often noticeable.

Effects

Aside from the pain, in severe cases, spinal flexion can affect internal organs such as the heart and lungs. Then an operation may be necessary. The curvature of the spine is corrected and the spine is partially stiffened to prevent further bending. Professions that require prolonged sitting can only be practiced with difficulty or not at all.

Diagnosis

In the early stages, scoliosis is difficult to recognize. The lateral bending of the spine is usually only noticeable in later stages, when the already existing twisting of the vertebrae can no longer be reversed. This bend is most noticeable when the child bends forward. It can be C-shaped (to one side only), S-shaped (curve with countercurve) or even double-S-shaped. An unequal shoulder or pelvic position is often observed in scoliosis patients. Sometimes the head is held at an angle. In some cases, the ribs protrude differently or you can see uneven shoulder blades, a bulge in the loin area or a rib hump. The rib hump is best seen when the child leans forward.

Scoliosis is often diagnosed for the first time between the ages of ten and twelve. It is usually an incidental finding, since there are no symptoms at this point. The examination of the spine is an obligatory part of the youth health examination (J1) between the ages of 12 and 14. But the curvature of the spine is also always checked during preventive medical check-ups at the age of 4 and 5. The earlier scoliosis is detected, the easier it is to counteract twisted vertebrae during the growth phase with the help of special physiotherapy.

X-rays are part of the further diagnostics. The X-ray image allows an accurate determination of the extent of the curvature.

Therapy

If scoliosis is detected early in childhood and the curvature is not yet very pronounced (scoliosis angle up to 20°), physiotherapy exercises can be used to counteract further curvature. Attempts are made to strengthen overstretched muscles. In this way, they can counteract the twisting of the vertebrae with more tension.

There are various treatment methods for this, e.g. B. according to Lehnert-Schroth or the therapy according to Vojta. With Vojta therapy, specific areas on the arms, legs and torso are stimulated. This causes muscle reflexes. In the case of higher-grade scoliosis, patients are recommended to wear a corset in addition to physiotherapy.

A chiropractor invented a method that involves stretching and walking on a treadmill at the same time. For this purpose, the child is “hung” in a special holding device made of straps and brought into a straight and slightly stretched body position. This method improves twisting of the spine in many cases, even in adults.
An operation can be useful in the case of cosmetically disturbing rib hump and very pronounced scoliosis (scoliosis angle over 50°) or a very rapid increase in curvature during growth. An operation stiffens individual sections of the spine. Before the operation, the spine is stretched for about three weeks in order to optimally loosen and stretch the ligaments and muscles.

Prevention

Early diagnosis is important. If you notice postural problems in your child, you should definitely see a doctor. The earlier malpositions are recognized, the more successfully they can be treated. If scoliosis has been diagnosed, the children or young people should be introduced to sports that strengthen the back muscles. One of these sports is B. Swimming. Sports that put too much strain on the spine, e.g. B. Squash, artistic gymnastics, high diving should be avoided. Differences in leg length can be compensated for by special insoles in the shoes in order to avoid incorrect strain on the spine.

Bad posture, which does not always have to be an actual scoliosis, is becoming more and more common, especially among young people. It is still important that heavy objects, including the school bag, should not be carried on one side so that the spine is not put under the wrong load. The distance between table and chair, also in school, should be adjusted individually if possible. In a class of one year level, not all peers are of the same height.

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