back pain related with scoliosis

          We often feel back pain, however, we either don’t know or didn't realize the real contributing factor or causes that lead to the back pain. One of the causes for back pain associated with the scoliosis. Lets take around for the information of the scoliosis….

Meaning:

The abnormality of the spinal curvature, defined by a lateral (side by side) curvature of more than 10 degrees.

Degree of spinal curvature may vary for each person, however curvature more than 90 degrees associated with an increased risk of mortality and morbidity.

Sign and symptoms:

•     Uneven musculature on one side of the spine
•     Uneven level of shoulder, hip, knee
•     A rib prominence or a prominent shoulder blade

Types of spinal curvature:

Scoliosis curves are often described based on the direction and location of the curve.

Spinal curvature divided into 2 types: C-shape or S-shape

                       

Dextroscoliosis describes a spinal curve to the right ("dextro" = right). 

Levoscoliosis describes a spinal curve to the left ("levo" = left)

Terms that describes the location of the curve:

Thoracic scoliosis is curvature in the middle (thoracic) part of the spine. This is the most common location for spinal curvature.

Lumbar scoliosis is curvature in the lower (lumbar) portion of the spine.

Thoracolumbar scoliosis is curvature that includes vertebrae in both the lower thoracic portion and the upper lumbar portion of the spine.

1

     C-shaped curve described as thorocolumbar dextroscoliosis refers to a single curve that spans the lower thoracic and upper lumbar vertebrae.

2 

     S-shaped curve described as thoracic dextroscoliosis and lumbar levoscoliosis indicates that there are two curves of which the upper curve is located in the thoracic spine and leans to the right, and the bottom curve is in the lumbar spine and leans to the left.

                              

Types of scoliosis:

      1)    Congenital curves

These are classified into failure of formation, failure of segmentation and mixed groups. Generally, the worst curves occur with unilateral defects in segmentation. Other factors include the type of anomaly, site of anomaly and age of onset. Congenital scoliosis ranges from the trivial to catastrophic depending on the capacity to progress.

      2)    Infantile and juvenile idiopathic curves

Infantile and juvenile are terms used describe curves that develop from ages 0-3 years and 4-10 years respectively. Arborization of the bronchial tree and alveolar development continues to age 8 and at age 10 the thoracic volume is 50% of the adult expected. This division helps to identify those children at higher risk of developing cardiopulmonary complications. Children with early onset scoliosis can have a profound effect on lung development that in turn has an impact on life expectancy.

     3)    Adolescent idiopathic curves

The adolescent idiopathic type is the commonest seen in clinical practice. They will often present the deformity as progressed to a point where a family member notices shoulder, waist or back asymmetry.

     4)    Neuromuscular curves

Now the most common neuromuscular cause of scoliosis is cerebral palsy (CP). The more severe the CP, the greater the likelihood of scoliosis appearing in childhood. Muscular dystrophies are included within this group along with Duchenne, Beckers, spinal muscular atrophy and other rarer varieties.

Treatment for scoliosis:

1.       Surgery: usually recommended by orthopedists for curves with a high likelihood of progression (greater than 45 - 50° of magnitude), curves that would be cosmetically unacceptable as an adult, curves in patients with spina bifida and cerebral palsy that interfere with sitting and care, and curves that affect physiological functions such as breathing. It is usually impossible to completely straighten a scoliotic spine, but in most cases, significant corrections are achieved.
2.       Postural correction: by changing the strategies of carrying load using both hands instead of 1 hand at the curvature side, by using cushion support during sitting, avoid handling object at only one dominant side only, and try to avoid prolonged static position of lateral lean position. Gait training may require if gait affected after prolonged scoliosis posture.
3.       Exercise: imbalance muscle corrected through the principles of strengthening and stretching exercise with combination of core stabilization. This is because the muscles at the back are essential when it comes for supporting the spinal column and maintaining proper shape of spines
4.       Scoliosis braces: Bracing is normally done when the patient has bone growth remaining and is, in general, implemented to hold the curve and prevent it from progressing to the point where surgery is recommended. Braces are sometimes prescribed for adults to relieve pain related to scoliosis

scoliosis surgery

scoliosis braces

                              

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further reading:

Daniel, R., Colin, N., & Jeremy, F. (2013). Scoliosis: A review. Symposium surgery and orthopaedics, 24(5), 197-203.