What Is Scoliosis?

Scoliosis SpineScoliosis (Greek: skolios, “crooked”) is a condition involving abnormal curvature of the spine. Scoliosis affects five to seven million people in the U.S1.

Scoliosis can begin at any age. Its prevalence is 1-2% among adolescents and more than 50% in persons over age 602. It occurs more often in females3 and tends to run in families4.

Scoliosis may be idiopathic, congenital, or occur as a consequence of another condition. This condition is called idiopathic when no underlying cause can be identified5. Most cases of scoliosis are considered idiopathic, with an incidence in the general population of 0.2-3%6. Congenital scoliosis is present at birth, with an incidence of approximately 0.5 to 1/1,000 births7. Scoliosis as a secondary symptom of another condition may occur in concert with neuromuscular diseases such as spina bifida, cerebral palsy, and hereditary musculoskeletal disorders, including osteogenesis imperfecta, Marfan syndrome, Stickler syndrome, Ehlers-Danlos syndrome, and muscular dystrophies8,9. In other cases, scoliosis may arise from physical trauma10, spinal stenosis11, and bone collapse from osteoporosis12.

Scoliosis Spine ComparisonScoliosis may produce specific, progressive signs and symptoms resulting in lowered quality of life13. The main diagnostic criterion for scoliosis is spinal curvature exceeding ten degrees in a single plane. The spine may appear to bend in a “C” or “S” shape.

Spinal curvature is assessed by measuring Cobb’s angle, a radiographic measurement14. Although a single plane is used to establish the diagnosis, scoliosis is in fact a three dimensional deformity15; typically, this manifests in lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back)16. Other signs of scoliosis may include uneven musculature on one side of the spine, uneven hips, uneven leg lengths, imbalance, anxiety, and a prominent rib or shoulder blade caused by rotation of the ribcage17,18. In severe cases, which involve angles of greater than 25 degrees and have been reported in about 1.5/1,000 persons in the United States19, patients may experience difficulty breathing, pain, and reduced functionality. Infections and damage may also occur in the heart and lungs due to friction of the rib cage against these vital organs.

If scoliosis is neglected, spinal deformity may progress dramatically20. In general, treatment is based upon severity and location of the curvature, as well as the age of the individual. A scoliosis-specific rehabilitation program attempts to prevent, improve, or minimize the signs and symptoms of scoliosis by using exercises, braces, and other therapies21. Recommended treatment programs include physical therapy, occupational therapy, and chiropractic care. Surgery is usually reserved for patients whose curves are greater than 45 degrees, have a high likelihood of progression, and impair physiological functions such as breathing. Fortunately, most curves can be treated non-operatively if they are detected before they become too severe22.

Although scoliosis can have a dramatic impact on quality of life, its signs and symptoms can be mitigated with a variety of therapies. As with most medical conditions, early intervention in scoliosis is associated with improved outcomes.

At Arizona Pain, our goal is to relieve your scoliosis pain and improve function to increase your quality of life.
Give us a call today at 480-563-6400.

References

  1. “Scoliosis.” American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 20 Jul 2011. www.acatoday.org/.
  2. Trobisch P, Suess O, & Schwab F. (2010). Idiopathic scoliosis. Dtsch Arztebl Int., 107(49), 875-83.
  3. Trobisch P, Suess O, & Schwab F. (2010). Idiopathic scoliosis. Dtsch Arztebl Int., 107(49), 875-83.
  4. Giampietro PF, Blank RD, Raggio CL, Merchant S, Jacobsen FS, Faciszewski T, Shukla SK, Greenlee AR, Reynolds C, & Schowalter DB. (2003). Congenital and idiopathic scoliosis: clinical and genetic aspects. Clin Med Res., 1(2), 125-36.
  5. Trobisch P, Suess O, & Schwab F. (2010). Idiopathic scoliosis. Dtsch Arztebl Int., 107(49), 875-83.
  6. Giampietro PF, Blank RD, Raggio CL, Merchant S, Jacobsen FS, Faciszewski T, Shukla SK, Greenlee AR, Reynolds C, & Schowalter DB. (2003). Congenital and idiopathic scoliosis: clinical and genetic aspects. Clin Med Res., 1(2), 125-36.
  7. Giampietro PF, Blank RD, Raggio CL, Merchant S, Jacobsen FS, Faciszewski T, Shukla SK, Greenlee AR, Reynolds C, & Schowalter DB. (2003). Congenital and idiopathic scoliosis: clinical and genetic aspects. Clin Med Res., 1(2), 125-36.
  8. Ferrari A, Ferrara C, Balugani M, & Sassi S. (2010). Severe scoliosis in neurodevelopmental disabilities: clinical signs and therapeutic proposals. Eur J Phys Rehabil Med., 46(4), 563-80.
  9. Giampietro PF, Blank RD, Raggio CL, Merchant S, Jacobsen FS, Faciszewski T, Shukla SK, Greenlee AR, Reynolds C, & Schowalter DB. (2003). Congenital and idiopathic scoliosis: clinical and genetic aspects. Clin Med Res., 1(2), 125-36.
  10. “Scoliosis.” University of Washington Department of Radiology. University of Washington School of Medicine, 2007-2008. Web. 20 Jul 2011. www.rad.washington.edu/academics/academic-sections/msk/teaching-materials/online-musculoskeletal-radiology-book/scoliosis.
  11. Ploumis A, Transfledt EE, Denis F. (2007). Degenerative lumbar scoliosis associated with spinal stenosis. Spine J., 27(4), 428-36.
  12. Quante M, Richter A, Thomsen B, Köszegvary M, & Halm H. (2009). [Surgical management of adult scoliosis. The challenge of osteoporosis and adjacent level degeneration]. [Article in German]. Orthopade., 38(2), 159-69.
  13. Rigo M. (2011). Patient evaluation in idiopathic scoliosis: Radiographic assessment, trunk deformity and back asymmetry. Physiother Theory Pract., 27(1), 7-25.
  14. “Cobb’s Angle.” http://www.e-radiography.net/. Oldnall N., 22 Jun 2011. Web. 19 Jul 2011. www.e-radiography.net/radpath/c/cobbs-angle.
  15. Giampietro PF, Blank RD, Raggio CL, Merchant S, Jacobsen FS, Faciszewski T, Shukla SK, Greenlee AR, Reynolds C, & Schowalter DB. (2003). Congenital and idiopathic scoliosis: clinical and genetic aspects. Clin Med Res., 1(2), 125-36.
  16. “Scoliosis.” American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 20 Jul 2011. <http://www.acatoday.org/content_css.cfm?CID=2189>.
  17. Rigo M. (2011). Patient evaluation in idiopathic scoliosis: Radiographic assessment, trunk deformity and back asymmetry. Physiother Theory Pract., 27(1), 7-25.
  18. “Scoliosis.” Mayo Clinic Online. Mayo Clinic, 05 Nov 2010. Web. 20 Jul 2011. www.mayoclinic.com/health/scoliosis.
  19. “Scoliosis.” University of Washington Department of Radiology. University of Washington School of Medicine, 2007-2008. Web. 20 Jul 2011. www.rad.washington.edu/academics/academic-sections/msk/teaching-materials/online-musculoskeletal-radiology-book/scoliosis.
  20. “Scoliosis.” University of Washington Department of Radiology. University of Washington School of Medicine, 2007-2008. Web. 20 Jul 2011. www.rad.washington.edu/academics/academic-sections/msk/teaching-materials/online-musculoskeletal-radiology-book/scoliosis.
  21. Rigo M. (2011). Patient evaluation in idiopathic scoliosis: Radiographic assessment, trunk deformity and back asymmetry. Physiother Theory Pract., 27(1), 7-25.
  22. “Scoliosis.” University of Washington Department of Radiology. University of Washington School of Medicine, 2007-2008. Web. 20 Jul 2011. www.rad.washington.edu/academics/academic-sections/msk/teaching-materials/online-musculoskeletal-radiology-book/scoliosis.