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What is it?
When viewed from the side, the spine should have a natural curve. When viewed from behind the spine should be completely straight. Scoliosis a condition in which an abnormal sideways twisting and curvature of the spine causes deviation from the normally straight vertical line.
Signs and Symptoms
Scoliosis can be seen as a visible asymmetry of the spine, asymmetry of the shoulders or hips, or a prominent rib cage. This asymmetry can stress the joints and muscles of the back, neck and shoulders often resulting in pain and discomfort. In severe cases, with very large curves, the lungs and heart can be compressed affecting their function.
Who does it effect?
Scoliosis most commonly affects school-aged children, with around 1-2% of under 16 year olds being diagnosed with the condition. It is more common in girls than boys.
There are many potential causes of scoliosis:
- Congenital. Present in infants.
- Neuromuscular. Caused by an abnormality of the muscles or nerves.
- Degenerative. Occurs later in life, often as a result of osteoporosis or previous trauma.
- Idiopathic (no identifiable cause). This is the most common category with 80% of scoliotis cases defined as idiopathic.
Scoliosis can be detected by physical examination. The “Adam’s Forward Bend Test” is a commonly used screening procedure. By having the patient bend forward from the waist towards the floor, any asymmetry through the spine, ribs, pelvis or shoulders can be seen more readily. Neurological testing to rule out neuromuscular causes of scoliosis should also be performed. For more detailed assessment and to accurately measure the degree of curvature an X-ray is required.
Treatment will depend on the degree of spinal curve, skeletal maturity and the underlying cause (if known). Manual treatment, including chiropractic, can help relieve scoliotic pain and in some cases can improve the scoliosis itself, depending on the underlying cause. Bracing is often the recommended treatment for adolescents with curves between 25-40 degrees. Surgery is considered in severe cases with curves greater than 40 degrees.
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