15 September 2021
Although it sounds scary, a scoliosis is simply a curvature in the spine. More specifically, it's a lateral curve, meaning you can see it when looking at someone from behind. It's not the same as a "hunch back", which would be seen from the side. There is usually some degree of rotation through the spine alongside the curves, which may be more obvious when a person bends over and one side appears higher.
More severe scoliosis cases are identified in childhood or adolescence. Although a clinical diagnosis can be made without imaging, an X-ray is required to determine the severity. This in turn will help your doctor work out what needs to be done next.
- mild cases are referred for conservative treatments, like manual therapies
- moderate cases may be good candidates for a brace
- severe cases might warrant surgery
These curves are caused by changes to the shape of the spinal bones (a structural scoliosis). Most of the time, this is for unknown reasons. However, it is possible to have a functional scoliosis. This looks similar to a structural one, but is not dictated by the vertebral shape. As a result, the curves are not present all the time. Often they are visible when standing, and caused by an asymmetry in the legs. A difference in leg length can be the root cause. In this case, when the person sits down and the asymmetry is removed, the curves disappear. Conversely, curves can be introduced when sitting if you keep a wallet or phone in your back pocket.
Your osteopath can differentiate between a structural or functional scoliosis.
Effects on the Rest of the Body
The lateral curves directly impact the movements the spine is capable of. They also cause altered movement through the ribs. Combined with potential diaphragm tension, there may be changes in breathing. Extra work for the shoulder muscles that help with breathing can lead to neck pain and headaches.
A functional scoliosis requires less compensation from the rest of the body. You might find that your symptoms are only really present in the position that causes the curves. Management will likely be quicker, although you may still benefit from continuing with your exercises or regular treatments in the long term.
Osteopathy and Scoliosis
Your osteopath may be able to help manage mild cases. Where the bones have developed a wedge shape, we can work with the compensating muscles and joints to adapt more comfortably. We cannot influence the shape of bones. However, we can help to relax tight muscles, and give you advice for strengthening weak ones. Preventative management may also be useful- if a joint is working ineffectively, the load is passed on to another area. By spreading the load between as many joints as possible, we reduce the risk of overworking any one area.
Adults can be diagnosed with a scoliosis too, and cases are usually mild (or functional) if undetected in childhood. Your osteopath can support your diagnosis beyond the treatment room if necessary.