The effects of scoliosis can be widespread, but they don't have to be with a proactive customized treatment plan. Although scoliosis is progressive, many cases are highly treatable, and while there are no treatment guarantees, the sooner treatment is started, the better.
Rib flare is closely associated with thoracic scoliosis as the thoracic spine attaches to the rib cage. If the thoracic spine has an unnatural curve and rotates, it can disrupt the rib cage's natural position, causing one side to protrude more than the other and forming a rib flare.
The earliest signs of scoliosis in children are postural changes, and as an asymmetrical condition, the rib cage can also be affected.
The spine has three main sections: the cervical spine (neck), the thoracic spine (middle/upper back), and the lumbar spine (lower back).
Containing 12 vertebrae (bones), the thoracic spine is the largest spinal section and the most commonly affected by scoliosis.
It is important to note, however, that scoliosis can also develop in more than one section (thoracolumbar scoliosis), and the spine can also develop a compensatory curve in an attempt to restore balance lost by the first unnatural spinal curve.
Each spinal section has unique roles to play in the spine's overall health, biomechanics, and function.
The thoracic spine attaches to the rib cage, so it anchors the rib cage and protects important organs within by forming the thoracic cage; it also provides stability for the trunk and supports upper body movement.
As scoliosis doesn't just cause the spine to bend unnaturally to the side, but also rotate, if it develops in the thoracic spine, ribcage position can be affected.
The spine's rotation can put uneven pressure on the rib cage and cause it to twist with the spine.
A rib flare is most noticeable when in a forward bend position, which is why the Adams forward bend test remains the most commonly-used scoliosis screening examination.
When bending forward, the spine and any related trunk asymmetries are the most visible.
Because of the disruption to the rib cage, signs can also be seen in the shoulders as one shoulder will sit higher than the other, and one shoulder blade will protrude more; in addition, uneven hips are also common with one hip sitting higher and an uneven waist line.
As a progressive condition, the longer scoliosis is left untreated, the more potential there is more increasing effects, and if a rib flare is left untreated and scoliosis continues to progress, it can become more pronounced, and related complications can involve the organs being compressed inside the thoracic cavity.
The effects of scoliosis can be widespread, and primary symptoms include postural changes, mobility changes, and pain.
While organ involvement isn't considered a common symptom of scoliosis, when severe, thoracic scoliosis can impact the cardiopulmonary and digestive system.
Part of the role of the thoracic spine is attaching to the rib cage to form the thoracic cage, which protects the heart, lungs, and a number of digestive organs within.
The rib cage is involved in the breathing process; through its expansion and contraction, it changes the chest cavity's volume, so if the rib cage has an unnatural asymmetry, its role can be disrupted.
If the space within the thoracic cavity is reduced due to the rib flare, it can affect the lungs through compression. If the lungs don't have the space needed to function optimally, breathing problems can develop; it can be difficult to fully inhale and exhale.
The heart can also be affected if the lungs are being pressed against the heart due to compression; it can disrupt the heart's ability to pump blood effectively, potentially contributing to mitral valve prolapse, hypertension, and although rare, heart failure.
Again, cardiac issues aren't considered a primary effect of typical mild and moderate cases, but are more closely associated with severe and/or atypical types of scoliosis.
The same can happen to several digestive organs facing compression and disruptions to their function, including the stomach and intestines.
Digestive issues caused by scoliosis can include acid reflux, nausea, bloating, constipation, and can lead to issues with nutrient absorption.
Scoliosis also can disrupt the function of the central nervous system as the brain and spine work together to facilitate brain-body communication, and nerve function is involved in the digestive process.
Compression can also slow digestive motility, making it difficult to move food through the system effectively and efficiently, and in adults for whom scoliosis is compressive, the torso is shortened, further limiting space available for several digestive organs.
The best way to minimize the potential effects and complications of scoliosis is to approach each case with a customized and proactive treatment plan.
Here at the CLEAR Scoliosis Institute, customized treatment plans start with a comprehensive initial assessment.
Treatment is nonsurgical, chiropractic-centered, and integrative; it combines the power of multiple scoliosis-specific treatment disciplines such as chiropractic care, physical therapy, and corrective bracing.
Scoliosis-specific chiropractic care can work towards impacting scoliosis on a structural level through repositioning the curve's most unnaturally-tilted vertebrae, and scoliosis-specific physical therapy harnesses the power of scoliosis-specific rehabilitative exercise to increase spinal support/stability through improving the strength and balance of the spine's surrounding muscles.
Corrective bracing can be particularly effective on growing spines and works towards improving the spine's position and alignment, along with body posture; posture and spinal health are closely linked, so improvements to posture will impact the spine positively and vice versa.
Through combining multiple different treatment modalities, there is more potential to impact scoliosis on every level, and as a complex 3-dimensional progressive spinal condition, scoliosis plans need to be shaped around a number of key patient and scoliosis variables.
Scoliosis doesn't just affect the spine, but also its surrounding nerves, muscles, and the symmetry of the entire body.
The earliest sign of scoliosis in children is the development of asymmetrical posture, and this often involves uneven shoulders, hips, and an asymmetrical rib cage.
A rib flare occurs when the spine's unnatural curve and rotation disrupts the position of the rib cage, pulling excessively on one side and causing it to flare out (protrude excessively), and this type of asymmetry can also affect organs within the thoracic cavity.
While not everyone with scoliosis will experience a rib flare, cases of thoracic scoliosis are most closely associated with rib cage asymmetry, and the more severe, the more potential there is for related complications; for adults, compression increases due to skeletal maturity, so adults with severe thoracic scoliosis are the most likely to experience complications such as organ involvement.
What's most important to understand about scoliosis effects is that even cases diagnosed as mild can experience increasing symptoms as progression occurs, so while a rib fare might not be part of the initial onset of scoliosis, if left untreated and allowed to progress unimpeded, it can develop over time.
When it comes to progressive conditions like scoliosis, the best time to start treatment is always now, regardless of how mild; in fact, there is the most potential for a positive treatment outcome when scoliosis is detected and treated while still mild.
Mild scoliosis curves are more flexible and responsive to treatment, and related effects are milder and easier to improve and/or correct.
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