Idiopathic Scoliosis, flat-earth thinking, and better ways to solve the problem during puberty.

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When you think about idiopathic scoliosis which is a medical term that simply says that the cause of the curvature is unknown, it conjures up ideas of braces, surgically implanted rods, and several other health concerns. The book Cheating Mother Nature. what you need to know to beat chronic pain has discussed why our current management schemes for idiopathic scoliosis are often inadequate since the mechanism behind the developing curve is often missed when you only look at the curve rather than the whole person. Treatments for scoliosis have not changed much which still include watching, waiting, screening the spines of adolescent children, and bracing to prevent the progression of curves. This flat earth approach to care is resulting in many children having to live with advanced spinal curvatures which may have been either prevented or be reduced using methods that are safe and cost effective. Most cases of scoliosis are discovered in school by screening students.   The screen involves having the student bend over and then looking to see if there is a rib hump or some other type of abnormality.   If there is an abnormality, the patient is sent to their family doctor who sends them out for an x-ray to determine the percentage degrees of the curve.   If they see a curvature, then they are monitored over time to watch for progression which can occur during growth cycles.  If the curve progresses past 25 degrees in a growing child, bracing, is normally recommended to prevent further progression. Typically, patients who have a curve also have mechanical asymmetry and perhaps a mechanism that caused the curve to develop. Ironically, a simple screen of the feet and the child's body mechanics can is not performed during school or most physician screenings. The resulting curve may be able to be reversed somewhat by addressing the underlying postural and mechanical causes. Most children are unaware that they have a developing curve or why they have one. The mechanism that causes this is then labeled idiopathic which means that the cause is unknown.

Perhaps a different type of the second opinion is needed.

Chiropractors are knowledgeable about the musculoskeletal system and understand movement and how to restore it.  They also are by training holistic in their approach to diagnosis and treatment.  While this may seem out of the box for many of us raised on the specialist model, the truth is that chiropractors are primary care for the musculoskeletal system. This approach also makes them ideal for managing and treating a child who is developing scoliosis. Rather than looking at the curve or rib hump, a chiropractor will evaluate body mechanics, body symmetry, and foot mechanics which may cause asymmetry in a growing body.  Scoliosis is more common in women, which may have to do with their wider pelvis which causes even more strain on the body from asymmetry.

What should you expect from a chiropractic evaluation and treatment?

  • A thorough holistic history and evaluation are performed including flexibility, squats, and overall mechanical symmetry, and functional health.
  • Treatment includes manipulation of dysfunctional joints to improve mobility, myofascial release of the soft tissues, and then exercises to retrain the region.  X rays are common with scoliosis patients to determine the degree of curve.
  • Off-the-shelf foot orthotics if indicated may be recommended to balance the pelvis.
  • After a period of care, a reevaluation by x-ray can help determine curve progression or regression.   It is not unusual to see a spinal curve reduce/regress by a few degrees after chiropractic care in a growing adolescent.
  • Once the patient achieves maximal improvement, the patient is then evaluated periodically to make sure there is no more progression of the curve.
  • The chiropractic approach to scoliosis can be quite helpful when the curve is caught early enough.  Usually, curves under 30 degrees are easily amenable to chiropractic care and patients are very satisfied with their chiropractic experiences.
Whom should you see first for scoliosis?  All roads lead to the chiropractor.