Scoliosis Facts

A normal spine is straight when viewed from the front or the back. Normally, when viewed from the side, the spine curves backwards in the chest area (kyphosis) and forward in the waist area (Lordosis). When viewed from the top down, all of the vertebrae should be facing forward. However, with scoliosis the spine curves to one side or the other in the thoracic and/or lumbar areas. From the top looking down through the center of the spine, some of the vertebrae are twisted which causes the ribs attached to the vertebrae to protrude, usually on the right side.

Scoliosis is a condition that may appear in more than one member of a family in the same or different generations. It does not develop as a result of anything that a child or her parents did or failed to do. Poor posture or carrying a heavy book bag does not cause scoliosis. Scoliosis is a spinal deformity that usually appears during adolescence, although it may appear in younger children as well.

HOW IS IT NOTICED?

One of the most common signs of scoliosis is a prominent shoulder blade, frequently the right one. One shoulder may also be higher and the child tends to “list” to one side. The hips may be uneven and one seems to be higher than the other. Scoliosis should not be confused with poor posture. Very often the first indication of scoliosis is that there is something wrong with the fitting of clothes. This is very apparent in girls when observing the hemline of a skirt or dress. When a child with scoliosis bends forward, the appearance of a rib prominence is one of the most striking signs.

IS SCOLIOSIS VERY COMMON?

According to the Scoliosis Research Society, about 10% of the adolescent population has some degree of scoliosis. This means that about 1,000,000 children just in the United States have scoliosis. About on fourth of these children, or 2%-3%, will require medical attention which may consist of observation for further progression of the curve, bracing or surgery, depending upon the degree of the curvature at the time of its detection. Some scoliosis may be so mild that treatment may never be necessary.

Mild scoliosis occurs nearly as often in boys as in girls. More serious curves are five to eight times greater in girls than in boys.

Studies conducted throughout the world show there is a very even occurrence of scoliosis. There is virtually no variation of racial or ethnic incidence.

ARE THERE DIFFERENT TYPES OF SCOLIOSIS?

There are many causes for scoliosis. About 80%-85% of the patients have a type called IDIOPATHIC scoliosis. This means “no known cause”. Idiopathic scoliosis often runs in families and appears to be due to genetic or hereditary factors. It is not known what “triggers” the development of the curve, or why some curves progress more than others. Scoliosis may occur in children who are otherwise perfectly healthy.

Also, scoliosis may be caused by NERVE and MUSCLE DISORDERS, such as cerebral palsy, muscular dystrophy and polio. Other known causes of scoliosis include: CONGENITAL which is caused by abnormalities in the formation of the vertebrae present at birth, CONNECTIVE TISSUE DISORDERS such as Marfan’s Syndrome, and CHROMOSOMAL ABNORMALITIES, such as Down’s Syndrome. Early diagnosis of the cause of scoliosis can aid in the proper treatment.

During adolescence scoliosis usually produces no pain and may be difficult to detect. Mild scoliosis may be present for several years before it is seen. One of the easiest ways to detect it is by using the forward bending examination. Most importantly, a medical professional should check the child’s spine regularly until growth is complete since scoliosis may appear at any time during adolescence. The curvature may progress considerably during the last major growth spurt.

SIMPLE HOME TEST FOR THE EARLY DETECTION OF SCOLIOSIS

• Is one shoulder higher than the other?
• Is one scapula (shoulder blade) more prominent than the other?
• Does one hip seem higher or more prominent than the other?
• Is there a greater distance between the arm and the body on one side than on the other when the arms are hanging down loosely at the sides?
• Does the child have excessive "swayback" (lordosis)?
• Does the child have excessive "round shoulder" or "round back" (Kyphosis)?
• Is there a larger "crease" at one side of the waist than the other side?
• Does the child seem to "list" or lean to one side?
• When you examine the child, have them bend forward with their arms hanging down loosely with the hands even and the palms touching each other at about the level of the knees. When in this position:
• Is there a prominence or hump in the rib area?
• Is there asymmetry in the hips or waist? 

 If you have any "yes" answers or if the child has a brother, sister, parent or other close relative with scoliosis, consult your medical professional. Schubbe Resch Chiropractic and Physical Therapy – Appleton is also available to answer your questions, and a more through follow up screening can be arranged if parents find any areas of concern.

The McKenzie Method

What is the McKenzie Method for back pain and neck pain?

The McKenzie Method involves more than just exercise

Many people know about the McKenzie Method of physical therapy and exercise for back pain or neck pain, but aren’t sure exactly what the goals of the program are and what the exercises entail.

A common perception is that the McKenzie approach comprises a set of exercises that people can do on their own. While this is true, the McKenzie Method is really an overall program of assessment, treatment and prevention strategies (including exercise) that are usually best learned with a physical therapist who is trained in the method.

Overall goals for healing from back problems that cause pain

The McKenzie Method was developed in the 1960’s by Robin McKenzie, a physical therapist in New Zealand. In his practice, he noted that extending the spine could provide significant pain relief to certain patients and allow them to return to their normal daily activities.

With the McKenzie approach, physical therapy and exercise used to extend the spine can help "centralize" the patient’s pain by moving it away from the extremities (leg or arm) to the back. Back pain is usually better tolerated than leg pain or arm pain, and the theory of the approach is that centralizing the pain allows the source of the pain to be treated rather than the symptoms.

A central tenet of the McKenzie Method is that self-healing and self-treatment are important for the patient’s pain relief and rehabilitation. No passive modalities—such as heat, cold, ultrasound, medicine or needles—are used in the treatment.

The long-term goal of the McKenzie Method is to teach patients suffering from neck pain and/or back pain how to treat themselves and manage their own pain for life using exercise and other strategies. Other goals include:

• Reduce pain quickly
• Return to normal functioning in daily activities
• Minimize the risk of recurring pain (avoid painful postures and movements)
• Minimize the number of return visits to the spine specialist

The movement of pain from the extremities to the back will not occur with all patients. The McKenzie Method is designed to help patients where the pain does "centralize." Also, for some patients, such as those with lumbar spinal stenosis or facet joint osteoarthritis, extending the spine may actually increase their pain.