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Scoliosis

What’s all the talk about scoliosis? What does scoliosis really mean?
Can chiropractors provide treatment for scoliosis?

Chiropractic X-RayAt Complete Care Chiropractic Clinic we’re going to try and answer the scoliosis questions.

The word scoliosis is just another “Umbrella term”. Umbrella terms are commonly used to give a general non-specific meaning or diagnosis of a condition. We avoid general “umbrella terms” like “disc bulge”, “sciatica” and “scoliosis”, instead we use evidence based medicine to give our patients diagnoses specific terms.

Scoliosis means a curve in the back?

When most people talk about scoliosis they think of a curve in their back and that’s correct. Scoliosis is a curve in the back as seen in the (coronal) plane, the postero-anterior view or simply as seen from behind. Well humans aren’t perfectly symmetrical so it’s normal to have small asymmetrical differences in our spine.

Evidence based literature tends to suggest that scoliosis below 35 degrees is not significantly linked with back pain and is only clinically significant if above 35 degrees and progressing. This is most commonly seen in adolescents / teenagers. If “true” scoliosis is detected either surgery, bracing or careful monitoring is required by a specialist at regular intervals over a timeframe until the scoliosis is deemed to be non-progressing.

What if the scoliosis is “true” scoliosis and above 35 degrees and is progressing?

Other factors and reasons why the scoliosis has reached such a significant level (above 35 degrees) are investigated right from the start of scoliosis detection before a decision is made about treatment for scoliosis. There are many associated congenital anomalies and idiopathic diseases that are linked with scoliosis.

There are several types of scoliosis and various diseases and skeletal anomalies link with it:

Congenital scoliosis (examples)

  • Hemi-vertebra – Being born with bones in the spine that are wedge shaped (wedge shaped vertebra), or hemi-vertebra are particularly noted in the mid-back (thoracic spine) and can offset the normal spinal curvature. Congenital scoliosis can cause the deviations in coronal spinal curve development, leading to a scoliosis above 35 degrees.
  • Leg Length discrepancy – One limb shorter in length than the other can lead to scoliosis but only if significant differences are apparent. Leg length discrepancies may affect twisting of the pelvis, lower back and mid back.
  • Klippel-Feil Syndrome (Non-descent of the scapula during development)
  • Idiopathic scoliosis –The most common Scoliosis and has no known cause or definitive link to back pain.
  • Developmental scoliosis – May be due to an inherited disease and some are linked with scoliosis.
    Examples include:

    • Marfan syndrome (Connective tissue disorder)
    • Ehlers-Danlos syndrome (connective tissue disorder)
    • Muscular dystrophy (progressive skeletal muscle weakness)
    • Cerebral palsy (Damage to motor control centers in the developing brain)
    • Neurofibromatosis (Nerve tissue tumors)

Symptoms of Scoliosis

  • An elevated shoulder (one higher than the other)
  • Leg length inequality
  • Winging scapula (One side of the rib cage appears higher than the other
  • Pelvic unleveling /antalgia

Scoliosis X-RayHow can chiropractors detect scoliosis?

Chiropractic assessment of posture and spinal movements are used to assess scoliosis at Complete Care chiropractic clinic and schools. The forward bending Adam’s test is an example of a simple method chiropractors use to determine scoliosis.

How do chiropractors do the Adam’s forward bending test?

A chiropractor will ask the patient to reach their arms out in-front of them to bring the scapulae (wing bones) out of the way of the back. The patient then slowly forward flexes from the hips, bending forwards as the chiropractor assesses the humping in the back. A positive Adam’s test is reached when there’s a detectable difference in asymmetry between right and left thoracic curvatures.

Can chiropractors assess whether the scoliosis is “true” or due to muscle tightness?

Chiropractors can assess whether a scoliosis is structural or functional (can potentially change) with the prone lying side bending test.

The chiropractor will ask the patient to lie on their front and gently pulls the lower extremities sideways as they watch the spine. If the scoliotic curve straightens then the test signifies the scoliosis is functional and can potentially be addressed non-surgically.

X-Ray referral to assess the degree of the scoliosis curve

A plain film radiograph demonstrates scoliosis and measurements can be made to determine the degree of scoliotic deviation within the spine.

What can chiropractor do to treat scoliosis?

It is incorrect to say that chiropractors can treat scoliosis, instead chiropractors can help correct and restore joint dysfunction in non-scoliotic joints but not spinal curvatures like scoliosis. Chiropractors will make a professional decision to provide treatment to patients with scoliosis but not specifically to treat scoliosis. Patients with true progressing scoliosis above 35 degrees need medical evaluation and possible surgery or bracing.

What surgery is required for scoliosis above 35 degrees?

The Harrington Rod is used to fuse the spinal segments and straighten up the curve. This Rod is inserted through the back and vertebral bones to give support in posture correction.

What scoliosis braces are used to correct scoliosis?

The Milwaukee or Boston Brace have been the most commonly used forms of scoliosis bracing techniques. The braces are worn for large parts of the day and can be socially inhibiting for those having to wear them as an aid to management of their progressing scoliosis.

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Complete Care Chiropractic | (08) 9204 1010