Sunday, May 20, 2012

Scoliosis...how to properly treat it.

Scoliosis... Let's first talk about the DEFINITION of scoliosis.

Scoliosis is the Lateral curvature of the spine with a convexity greater than 20 degrees. (In plain English) It is when you look at someone from behind and see a curve in their back. When measured by Cobb's Angle (manual measurement source used by M.D's and Chiropractor's alike), the angle is greater than 20 degrees.

This is about all the chiropractors and medical doctors agree upon though. Many medical doctors recommend things like swimming, or simply waiting until the curve gets to an uncontrollable  level, that surgery or bracing is the only choice.

In our clinic, we believe in trying to prevent the disease as much as possible.

Okay,...now we explained WHAT scoliosis is,...but HOW does one obtain scoliosis? Approximately 50% of the time it is believed to be inherited (genetic), the other times by trauma. Trauma part is the tricky part. For many times when the initial injury occurs, there is no sign of injury. (On radiographs (Ronson's), there is no sign of fracture or movement of bone). But, I want you to think of a wave.

There is a WAVE effect. This sine wave effect happens immediately, but the visual and painful effects may take years to take place.  There are clues that a doctor will look at when we try to diagnose the cause of injury.
1) The convexity of the curve is not Right thoracic or Left Lumbar.
            -   There may be only one curve, or it may be an opposite side  of normal convexity. Most of the                                    
                 convexities are Right Cervicothoracic and Left Thoracolumbar. (~80%).
2) Patient had a prior trauma during the growth period of their lives (ojek/motorbike...fall off the bike)
            -    Like I said, there may not have been any signs of injury just POST accident, but the sine wave effect is great.
Typical Right Thoracic Convex Scoliosis

There have been many studies done on how to decrease the scoliotic curve, both in the medical profession and in the chiropractic profession, as well. Restriction or confinement by

The best way is to brace. Why is that?...Well, I try to tell patients to think of a "lead pipe". Think of how you would straighten that out? By taking a hammer and hitting it everyday? No,...not really.
But, if you put it in a vice, and then torque it,...and HOLD it in that position for hours or even days,... the curve of that lead pipe will be decreased.

This is how straight your back should look.
If crooked,. what kind of tools would it take
to bring this pipe back to being straight?

But, when we are using this analogy, remember that is a PIPE we are talking about,...not a human being. Remember we are dealing with the psychology of patients. Especially young children. (girls in particular since girls are 10x more likely to get scoliosis than boys). They simply WON'T wear the brace because of ridicule, "it's too tight and makes the back feel really stiff, embarrassment, feeling inadequate, the cost, the bulkiness, or simply lack of discipline (among other reasons). Whatever the reason, the psychology of the human mind plays a big part on why people will NOT wear it.

Therefore, bracing hasn't been as successful as people have hoped it would be,...only due to people not being proactive in their own care.

So, how do we rectify or 'better' that situation... We do A LOT of in clinic work.
a) Proprioceptive exercises.
b) muscle stretching and strengthening to properly activate muscles on the concave side of scoliosis.
c) Torsion exercises to promote behavioral training of muscles and biomechanical structure.
d) advanced chiropractic adjusting. Adjusting specifically for prescoliotic or scoliotic patients.
e) promote an environment that patients feel they can succeed at.


11 yr. old girl pre-scoliotic. Exercises and adjustment


video
Chiropractic-First and Dr. Giovanni (Intro video)

We have been introducing a lot of torsion (torque) exercises, with muscle proprioceptive training. The results have been astounding. Now, granted these patients come in 2-3 x a week and they are extremely proactive in their care. So, don't think these results are typical. Atypical,...only because most patients generally expect the chiropractor to fix everything and they can sit back and do nothing. 

There can always be some type of improvement. We presently have a 60 year old woman with a +50 degree typical Right Convex cervicothoracic curve and a typical Left Convex thoracolumbar curve...and in 3 weeks at 3 x a week, ... she has shown massive improvements. By seeing these improvements, this has given her further motivation to go further. So, her confidence is almost as high as her NEW quality of life. 

Remember to have your daughters (especially daughters) checked for scoliosis by age 10. Especially if you have a family history of scoliosis. Girls get scoliosis 8-10 x more than boys.  So, check them out early and save themselves years of distresses pain. Thank you again.

Dr. G