The spine is one long complex structure with three main sections, and each spinal section has unique roles to play in preserving the spine's overall health and function. The health of the lumbar spine, in particular, is important for lower body movement.
Scoliosis can disrupt the biomechanics of the entire spine, even if the unnatural spinal curve develops in a single section. Lumbar scoliosis develops in the lower back, and treatment options include conservative modalities such as chiropractic care and physical therapy, or invasive spinal surgery.
As scoliosis isn't always simple to diagnose, let's start with why.
Scoliosis causes the spine to bend unnaturally to the side and rotate, and it's a prevalent condition with close to seven million people diagnosed in the United States alone.
Diagnosing scoliosis involves a physical examination, commonly including an Adams forward bend test, and the results of a scoliosis X-ray are needed to confirm the spine's rotation and the size of the unnatural spinal curve.
Curve size determines condition severity, reflected by a patient's Cobb angle measurement; a minimum curve size of 10 degrees is needed to be considered a true scoliosis.
So if the spine bends to the side and twists in the lower back, and the curve is at least 10 degrees, this is diagnosed as lumbar scoliosis.
As the spine also contains 31 pairs of spinal nerves, it works right the brain to form the central nervous system: a complex communication network that facilitates brain-body cohesion.
In addition, the spine is key in determining the body's center of gravity, although it changes constantly with movement.
So with these important spinal roles in mind, it seems difficult to imagine that an unnatural spinal curve that bends and twists could go unnoticed, but his is a common scenario, particularly in children.
Although children have the most to gain from early detection and intervention, they can be the most difficult to diagnose.
Postural changes are the main effect of childhood scoliosis, and while we don't know what triggers scoliosis onset in most cases, we do understand the condition's progressive nature.
As a progressive spinal condition, the nature of scoliosis is to become more severe over time, and it's growth that triggers progression.
Scoliosis progression means the size and rotation of the unhealthy spinal curve is getting more severe.
When the spine's curves are healthy, the spine is aligned in a neutral/straight position, but when a scoliotic curve develops, some vertebral bodies are unnaturally tilted, shifting them out of alignment with the rest of the spine and disrupting the spine's ability to function optimally.
Scoliosis is an asymmetrical condition whose uneven forces disrupt the body's symmetry, but the condition can be mild and cause subtle changes.
In addition, as scoliosis doesn't become compressive until skeletal maturity is reached, childhood scoliosis isn't commonly associated with pain: a significant challenge to early detection.
When diagnosing adult scoliosis, it's pain that brings adults in for a diagnosis, and in many cases, these adults had scoliosis since adolescence but were unaware, until enough progression occurred to make the condition's effects noticeable.
The goal is to diagnose childhood scoliosis while still mild, when the spine is still flexible and most likely to respond to treatment, and condition effects aren't yet well established.
A diagnosis of lumbar scoliosis means scoliosis has developed in the lumbar spine.
The lumbar spine's unique roles include supporting the weight of the spinal sections above (the cervical spine and the thoracic spine), the trunk, and its vertebrae feel the effects of lower body movements (lifting, bending, twisting).
The effects of lumbar scoliosis include postural changes such as uneven shoulders, shoulder blades, a rib cage arch, uneven hips, and changes to balance, coordination, and gait are common.
It's also not uncommon for lumbar scoliosis to cause a compensatory curve in the middle/upper back as the spine attempts to counteract the uneven forces of the first unnatural spinal curve.
For adults, along with postural changes including a prominent lean to one side, back pain is a common symptom, along with muscle pain, and most commonly, nerve pain caused by compression.
Sciatic nerve pain is an additional common complication of adult lumbar scoliosis as the sciatic nerve starts in the lower back and can become compressed and/or impinged.
The most common type of scoliosis to affect adults is adult idiopathic scoliosis, and as mentioned, these cases are extensions of adolescent idiopathic scoliosis cases that were neither diagnosed nor treated during adolescence, and the second most common type to affect adults is degenerative scoliosis.
Adult degenerative scoliosis can be particularly painful because of the degenerative changes occurring in the spine.
Scoliosis can be a complex condition to treat; not only does it range widely from mild scoliosis to severe scoliosis, there are also different condition and curvature types.
A spine that's unbalanced due to scoliosis is one that can unbalance the entire body from the head to the feet, and a goal of conservative non surgical treatment is to improve the spine's balance and stability by reducing the size of the unnatural spinal curvature.
While there is also surgical intervention to consider, a scoliotic spine surgical treated is one that can be weaker, more vulnerable to injury, and less flexible, and nerve damage is always a potential risk of spinal surgery.
Many cases of scoliosis respond well to non surgical treatment, and with progressive conditions like scoliosis, the best way to manage symptoms and provide pain relief is to treat the condition proactively with the goal of preventing increasing symptoms.
Improving the spine's structural alignment is addressing the condition's underlying structural nature, and a conservative approach is integrative so applies other therapies and modalities to help sustain structural improvements.
A healthy spine is supported and stabilized by healthy and strong surrounding muscles, so physical therapy and the power of scoliosis-specific exercises can help improve the spine's surrounding muscle balance and strength; scoliosis is also associated with a muscular imbalance.
Corrective bracing can also help push the spine into a straighter alignment, and as a child's spine is more flexible and responsive to bracing, the ScoliBrace can be an integral facet of childhood scoliosis treatment.
Rehabilitation is important for holding treatment results as scoliosis is an ongoing condition; this commonly involves custom-designed corrective scoliosis exercises that patients are taught so they can be performed from home.
Corrective scoliosis exercises can include mirror image exercises that help patients achieve postural awareness and remodeling; healthy posture is important for supporting a healthy aligned spine.
Here at the CLEAR Scoliosis Institute, scoliosis is treated proactively with a conservative non surgical treatment approach.
Treatment plans are fully individualized to impact conditions on every level, and this is possible through an integrative approach that combines powerful complementary scoliosis treatment modalities.
Chiropractic care, a variety of therapies, physical therapy, corrective bracing, and rehabilitation are combined for an all-encompassing treatment response to a complex 3-dimensional condition.
The lumbar spine has to support the weight of the spinal sections above and facilitate the lower body's range of movement; if an unnatural spinal curve develops in the lumbar spine, its effects can also be felt in the spinal sections above.
Symptoms of lumbar scoliosis can include postural changes, lower back pain, leg pain, nerve pain, and mobility issues.
An unhealthy curvature of the spine can always benefit from treatment, and while spinal fusion surgery is a frequently performed surgery, scoliosis surgery is still invasive, and in many cases, unnecessary.
While no treatment results can be guaranteed, when lumbar scoliosis is diagnosed while still mild, and responded to with a proactive conservative treatment plan, the condition can be highly responsive, and curve progression can be prevented.
Developing scoliosis doesn't mean surgical treatment is inevitable, nor does it have to mean a life of limitation, particularly with early detection and intervention.
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