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Scoliosis Symptoms, Risk Factors & Causes You Need to Know About
March 4, 2016
Despite the fact that it’s a fairly common problem — affecting about 5 percent of children and adolescents and about 2 percent to 3 percent of the general population — the causes of scoliosis still aren’t well-understood. It’s a lifelong spinal condition that results from the spine becoming “off center” and growing sideways, so it winds up curving in the shape of an “S” or “C” and causing a lot of back pain.
Unfortunately, when many patients get a diagnosis of scoliosis from their doctors, they’re told it’s “idiopathic,” meaning the cause isn’t entirely known and therefore treatment can be very difficult. (1)
For decades, it was somewhat of a mysterious disease and thought of as a difficult problem to help treat. While there’s no definitive cure for scoliosis, what we’ve learned in recent years is that the way best to reduce symptoms and stop it from progressing is to address its underlying cause, eradicating the spinal problem that’s formed at its root. Bracing techniques, anti-inflammatory prescription medications and spinal fusion surgery might be the norm still today and can help ease pain and symptoms, but unfortunately they come with risks and don’t fully address what’s happening below the surface.
While there still isn’t a complete cure for scoliosis even with natural treatments, some people can see improvements from 10 percent to 30 percent within just several months when undergoing certain chiropractic adjustments and using targeted spinal exercises. Most importantly, these treatments can also help stop the spinal curvature from further progressing and therefore prevent unnecessary surgeries that cannot be reversed once performed.
Signs and Symptoms of Scoliosis
Symptoms commonly appear during adolescent years, especially during the growth spurt around the time of puberty, but older adults with back pains can be diagnosed with scoliosis for the first time too.
What does scoliosis look like and feel like in the body? Some of the most common signs and symptoms include: (2)
- Pain in the back (up to 90 percent of scoliosis patients report feeling pain, which is the most primary concern for many patients)
- A leaning of the entire body toward one side
- One shoulder blade is higher than the other
- One hip seems to be raised compared to the other
- An uneven waistline
- The head is off-center above the shoulders and might not appear directly above the pelvis or midline
- The spine appears to be growing sideways and developing into an “S” shape or a “C” shape (research shows that S-shaped curves tend to worsen more often than do C-shaped curves, and curves located in the center thoracic section of the spine worsen more often than do curves in the upper or lower sections) (3)
- Tingling sensations or acute numbness in the limbs, finger or toes
- Loss of balance
- Accelerated aging of spinal discs
- Decreased lung volume
- Psychological distress and anxiety (especially in children or teens if they need to wear a back brace, which can feel embarrassing)
Facts About Scoliosis: Prevalence, Risk Facts and Complications
- Scoliosis is the No. 1 spinal problem affecting school-aged children. The primary age of onset and diagnoses is between 10–15 years old. (4)
- Reports show that around 80 percent of scoliosis patients receive an idiopathic diagnoses, meaning there is no definitive cause or “cure” for their condition. This leaves many patients and their families feeling uncertain and frustrated about the outcome, although there’s hope that natural treatments can make a big impact.
- The exact causes still aren’t known, but contributing factors include: birth defects (congenital scoliosis, which means the scoliosis has a hereditary origin), spinal cord injuries, and problems with muscle and nerve functions, such as muscular dystrophy. (5)
- Many patients and their concerned families are given one of three treatment options: either “wait and watch” the spine for progression, use bracing, or undergo surgery — all of which come with drawbacks.
- Each year scoliosis patients make more than 600,000 visits to private physician offices. An estimated 30,000 children are put into spinal braces to help treat the condition, while 38,000 patients undergo spinal fusion surgery.
- Complications can occur when muscles and tissues of the body become deformed by months or even years of the body compensating for abnormal twisting and bending of the spine. These complications can continue even after bracing or surgery.
- During the “watch and wait” period, many cases continue to progress, even past the point of skeletal maturity. Some studies have found a mean progression of 2.4 degrees per year over the course of five years, and in adolescents scoliosis on average progresses more than 10 degrees after 22 years.
- Aside from affecting good posture, scoliosis can negatively impact quality of life, cause pain, impair normal lung functions, disturb sleep, and reduce the ability to exercise and live normally. Poor body image is also common, and repeated X-rays might also raise the risk for serious problems due to radiation exposure.
How Does Scoliosis Develop?
Scoliosis is essentially one symptom of a deeper biological problem. It results in mechanical dysfunction of the spine, although the degree to which this occurs and exactly how it impacts the spine’s curvature and alignment differs from one patient to another. While scoliosis treatment approaches work best when they’re customized and take into account the patient’s unique history, there are several things that seem to work well for the majority of patients:
- improving diet
- receiving chiropractic care
- practicing targeted spinal exercises
Scoliosis patients can experience a wide range of symptoms and severity depending on how much the disease has progressed; basically no two patients have the exact same spinal alignment, degree of damage, bone density or spine curvature. Many people show some signs of abnormal spinal alignment, but doctors don’t usually worry about this unless the curvature of the spine is off by more than 10 degrees.
For some people, what starts out as minor spinal curvature worsens when the spine twists on its center, which causes the rib cage to be pulled away from its normal alignment. When someone has a spinal curve greater than 30 degrees, the condition is more likely to progress, sometimes going all the way to a 60-degree curvature, which can cause complications such as respiratory problems and trouble breathing normally.
On average, people with scoliosis suffer a 14-year reduction in their life expectancy, due to strain on the heart and reduced amount of oxygen supplied to the body. (6) Scoliosis is also associated with lung impairments, headaches, shortness of breath, digestive problems, chronic disease, and hip, knee and leg pains.
The Underlying Causes of Scoliosis
Scoliosis patients hail from all walks of life. Children, middle-aged adults and senior citizens can all develop this condition, but for some reason it affects more women/girls than it does boys/men. While both sexes can certainly develop scoliosis, estimates show that two to three times as many females deal with it than males. (7)
Mild scoliosis is extremely common in the general population but not normally acted upon. The risk for some form of scoliosis goes up with age, and recent studies have revealed that the prevalence of scoliosis may be as high as 68 percent within the elderly population. It affects about 3 percent to 5 percent of all adolescents and usually shows up during the prepubescent or teenage years. Research shows patients are diagnosed most often between the ages of about 10–15.
The exact causes of scoliosis aren’t known or agreed upon at this time. It seems to be a combination of genetic, lifestyle and environmental factors, such as: (8)
- a patient’s diet
- family history/genes
- abnormal bone development
- hormonal imbalances
- possibly problems with the brain recognizing proper symmetry, alignment or orientation
Risk Factors for Scoliosis: Who Suffers Most?
Over the years, there’s been a lot of theories thrown around, but we know scoliosis patients usually have several things in common: (9)
- Eating a poor diet, having low nutrient intake (especially magnesium deficiency or low vitamin D and vitamin K)
- Hypermobility, such as being “double-jointed” or having a “sunken chest” (Pectus excavatum)
- Poor posture
- Delayed puberty and hormonal problems in teens (a form of low estrogen, hyperestrogenism)
- For women, being post-menopausal or having low estrogen levels (hypoestrogenism), since estrogen plays an important part in building bone density
- Having a low body weight, not eating enough calories to sustain a healthy body mass
- Being a competitive or elite athlete, which can sometimes contribute to low body weight, weak bones and nutrient deficiencies
- Suffering from other conditions that can appear concurrently with scoliosis, including: connective tissue diseases, sciatic nerve pain, mitrial valve prolapse (a problem with the formation of heart valves), bleeding tendencies, down syndrome, osteoporosis, osteopenia
- Having a genetic predisposition that affects bones and spinal health (scoliosis runs in families, and certain mutated genes seem to up the risk for inherited forms of scoliosis)
Some people assume that genetic factors are mostly to blame for scoliosis formation. It’s true that genes play a part. Some research has found that there is a recurrence of scoliosis among family members about 25 percent to 35 percent of the time. This is believed to be due to certain gene mutations that affect how our bones use and store calcium. Still, genes aren’t thought to be the sole reason for the disease. (10)
When it comes to having a predisposition to scoliosis, it’s important to remember that our genes aren’t our fate. There’s a lot we can do to help offset hereditary factors that make us more susceptible to developing any diseases, including scoliosis. For example, a healthy diet can essentially help balance our nutrient levels (including calcium and magnesium) and can help turn on or off certain genes that affect our growth and development.
Now that you understand what does contribute to the development of scoliosis, it helps to clear up some myths about the types of things that don’t. It’s a common misconception that carrying heavy objects, sleeping in certain positions or injuries lead to scoliosis, but this isn’t supported by research. These types of day-to-day activities can lead to bad posture like forward head posture and cause other problems or aches and pains in the back, but they aren’t the primary reasons for scoliosis forming.
Diagnoses of Scoliosis
Historically in schools, kids were given a “forward bend test” so a doctor or nurse could check the curvature of their spines and look for abnormalities in the rib cages. To some degree, this is still performed today, but recently it’s been shown that these tests can miss cases of scoliosis. That’s why it’s usually not the most dependable or sole form of screening for children, especially in those who are most susceptible to scoliosis, such as children with a family history. (11)
A type of genetic testing for scoliosis is now commonly used called the ScoliScore AIS Prognostic Test, which looks for certain genes that affect spinal development and shows the likelihood of an adolescent developing serious spine abnormalities. It’s believed to be a very accurate test (about 99 percent accurate according to some standards) and luckily predicts whether or not a slight curvature in the spine is likely to progress into a worsened condition. This helps prevent patients from undergoing unnecessary treatments and surgeries at a young age. (12)
If you suspect you or your child might have scoliosis, your doctor will likely perform X-rays to look at the spine, measuring the spinal curve, looking at the angle of different vertebrae and checking if there’s a side to which the spine curves more. Many doctors diagnose scoliosis using the Cobb Method to assign a numerical value to the curve of the spine, which shows how far the spinal vertebrae are off-center from the midline. (13)
Treating Scoliosis Naturally
Over the past few decades, we have come to learn that “watching and waiting,” spinal bracing and surgeries to correct scoliosis are not always effective and usually are risky. Recently, studies have shown that chiropractic or osteopathic manipulative therapy, in combination with deep tissue massage and physical therapy to strengthen the core, can have significant, positive results in people with scoliosis.
Scoliosis cannot be cured — it can only be controlled. This makes it similar to diabetes and high blood pressure, since all are lifetime commitments to stop progression. It’s been found that the sooner a scoliosis patient can begin correction, the better the results will be. However, there are notable problems with the most standard treatment options in some cases:
- A 2007 study found that 23 percent of patients who wore a brace still ended up undergoing spinal fusion surgery in comparison to 22 percent of patients who did nothing.
- Bracing is commonly emotionally scarring, especially for children and adolescents who deal with higher rates of body image issues, pain, skin and bone problems, and impairment of normal functions. One study found that 60 percent of patients treated with a spinal brace stated that it handicapped their lives, and 14 percent considered the experience to have left a psychological scar.
- Whether spinal bracing helps stop progression or not, the benefits are lost once the brace is removed, and surgery is still commonly needed.
- Spinal surgery can cause permanent inflexibility and loss of certain functions, even disabling and difficulty sitting, standing, carrying, bending at the waist, participating in sports, lying on backs or sides, lifting, performing household chores, and driving a car.
Lifestyle Changes and Chiropractic Care Can Help Treat Scoliosis
To help stop scoliosis from progressing, I recommend making lifestyle changes and seeking help from a chiropractic physician who’s trained in structural correction and targeted spinal exercises, such as the type taught and offered by the CLEAR Institute
The 2004 article, “Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series,” published by Drs. Morningstar, Woggon & Lawrence in BMC Musculoskeletal Disorders, changed the way we look at scoliosis treatments and offered support for chiropractic care. (14) Since 2004, other studies have also shown support for chiropractor intervention and targeted exercises over bracing and surgery.
Unlike surgery or bracing, reductions in the Cobb Angle of the spine achieved through these methods is also correlated with decreased scoliosis complications and pain, along with improved lung function, physical functioning and better quality of life overall. These methods also pose less risks in terms of causing permanent damage, give the patients the opportunity to help treat their own conditions, tend to cost less than traditional treatments, and expose the patients to far less harmful radiation from recording X-rays.
Final Thoughts on Scoliosis
- Scoliosis affects about 5 percent of children and adolescents and about 2 percent to 3 percent of the general population. It’s the No. 1 spinal problem affecting school-aged children. The primary age of onset and diagnoses is between 10–15 years old. While both sexes can develop it, estimates show that two to three times as many females deal with it than males.
- Some people can see improvements from 10 percent to 30 percent within just several months when undergoing certain chiropractic adjustments and using targeted spinal exercises. Most importantly, these treatments can also help stop the spinal curvature from further progressing and therefore prevent unnecessary surgeries that cannot be reversed once performed.
- Scoliosis symptoms include back pain, leaning body, uneven shoulder blades, uneven hips, uneven waistline, off-center head, spine appears to be growing sideways and developing into an S or C shape, tingling sensations or acute numbness, loss balance, accelerated aging of spinal discs, decreased lung volume, and psychological distress and anxiety.
- On average, people with scoliosis suffer a 14-year reduction in their life expectancy, due to strain on the heart and reduced amount of oxygen supplied to the body.
- It’s a common misconception that carrying heavy objects, sleeping in certain positions or injuries lead to scoliosis, but this isn’t supported by research.
- To help stop scoliosis from progressing, I recommend making lifestyle changes and seeking help from a chiropractic physician who’s trained in structural correction and targeted spinal exercises, such as the type taught and offered by the CLEAR Institute.