Scoliosis is a classic Chiropractic subject because many cases of scoliosis respond excellently to Chiropractic adjustments. I have treated many cases over the years. Some of these cases resolved nicely while others didn't change at all yet the symptoms improved. So today I am going to look at several causes of scoliosis and discuss which ones are changeable and which ones are
not.
First off, just what is scoliosis? Scoliosis is when your spine has a side-to-side curve to it. Side to side your spine should be perfectly straight and in alignment with gravity. When you look at your spine from the side, it is supposed to have curves in it – forward in the lower back, backward in the mid back, and forward in the neck. These forward/backward curves should all balance each other so that your
head is centered over your shoulders and both are then centered over your hips and ankles. In other words, you don't want side-to-side curves, but rather balanced front-to-back curves.
Why are front-to-back curves okay but side-to-side curves not okay? This is because of the shape of the joints between the vertebrae. They are designed for much more forward and backward movement and minimal side-to-side movement to protect the nerves that exit the spine from side outlets between the vertebrae. If there is too much of a side bend, the nerves will get pinched. This is why we don't want scoliosis
– nerve pinching. However, this also means that a little bit of scoliosis is not usually a problem for most people since the spine is designed for some side-to-side motion. A curve of 10 degrees or less generally isn't even diagnosed as scoliosis. A mild case is when the tilt back and forth is 10 to 24 degrees, and a moderate case is 25 to 39 degrees.
What causes scoliosis? There are many possible causes. Let's start with the worst-case and least frequent scenario and work our way to the most common and most easily resolved. Some folks end up with severe osteoporosis of the spine due to aging and poor diet, lack of exercise, or overuse of steroid drugs for other conditions. Sometimes the vertebrae in the spine get so weak that they collapse. Usually, this
happens fairly evenly or more in the front or back of the vertebra because of the greater pressure caused by the flexion of the spine forward and backward. But sometimes the vertebra collapses on just the right or left side. Now the vertebra is wedge-shaped and tilting the spine above that point off in one direction or another. To not hit your head going through a doorway, your muscles will try to pull the body back to center which creates the spinal curve or scoliosis.
Another rare circumstance is one-sided joint degeneration in the lower back caused by asymmetric joint surfaces. Sometimes a person can have one joint on one side of a vertebra shaped for movement in one direction and the other joint on the other side going a different direction. Both sides are supposed to work together, but sometimes they don't. This produces abnormal motion at that level of the spine and
results in inflammation and degeneration on just one side. The muscles on that side lock up and pull the spine to one side creating scoliosis.
Another similar condition I have seen many times is when a person has a stroke that paralyzes the muscles on one side. If it makes the muscles weak then the spine will tilt away from that side. If the stroke produces spastic muscles on one side then the spine will pull to the same side. This situation is pretty obvious when there is a full-body stroke and in those cases, scoliosis is usually the least of their
problems. However, I have seen several cases where there has been a mini-stroke that only affected the muscles in just a part of the spine. In both cases, I have seen the tilt of the spine to one side gradually recover over the course of a couple of months. I would adjust their spine and make it better for a few hours, but without proper muscle balance guided by proper brain function, the adjustment simply could not hold things together.
Sometimes scoliosis is genetic. Usually, there is a strong pattern of scoliosis in the family. This type of scoliosis typically shows up in children as they go through rapid growth spurts. I have never heard a good explanation of why it gradually appears as they grow. Most genetic structural abnormalities are present at birth. These cases are treated with various exercises to try to
keep the muscles balanced as well as the use of orthopedic spinal braces. For some reason, this pattern is more prevalent in women. There are cases in which a baby is born with one or more vertebrae malformed so that the vertebra looks much like those vertebrae that have had one-sided osteoporosis collapses. In these types of cases, orthopedic surgery is used to place metal rods along the spine to hold things up in place. A similar surgery is used with folks that have progressive scoliosis
getting worse to the point that breathing is becoming compromised or heart function is being inhibited.
Okay, let's move on to the most common cause of scoliosis – asymmetric pelvic rotation or short leg syndrome. Due to an injury to the stabilizing ligaments of the sacroiliac joint just below the lowest vertebra in your spine (the 5th lumbar vertebra), the sacrum bone can drop on one side and the pelvic bones can counter-rotate making one side higher than the other. When this happens, the hip joint ends up
being higher on one side thus causing the leg to be pulled up on that side. This makes that leg look shorter on that side. This pattern makes the whole pelvis lower on one side. The sacrum/pelvis is the foundation that the entire spine rests on. If it is tilted off to one side, the entire spine tilts with it. The muscles try to compensate for this tilt by pulling the spine back into place in a snake-like fashion in order to try to get the eyes to be level for balance reasons.
This same pattern will also happen if a person has an actual short leg like in a post-polio situation or due to some leg injury in which the healed leg ends up shorter on one side. In my almost 43 years in practice, I have only seen a few cases of an actual short leg (although many patients claim to have been diagnosed with a short leg.) In contrast, I have seen thousands of people with an apparent short leg caused by
a rotated pelvis which is fairly easily corrected. If their scoliosis is of recent formation, as an adaptation to their pelvic rotation, then it corrects on its own when I balance the pelvis. However, if their scoliosis has been present for many years, the rib bones will actually change shape to accommodate the twist in the spine. The deformed ribs will now hold the scoliosis in its twisted shape, making resolution very difficult. In these cases fixing the rotated pelvis generally takes care of
the leg and hip pain and adjustments help relieve the midback discomfort, but the twist to the spine remains.
Back to the 99% of patients I see that have a recent pelvic rotation that has produced a short leg of only a ¼ to a ¾ of an inch. These cases only produce mild scoliosis and the ribs do not change shape. It takes many years to remodel the shape of a rib. These cases are generally easy for me to take care of. In general, only two or three adjustments are usually required over a two week period. I advise my patients to
stop doing any one-sided activities like raking leaves, vacuuming, working down on one knee, yoga postures with one leg forward, and the like while the ligaments heal. I adjust the entire spine to assist the shift to new compensations while the body realigns with gravity once again. Most of the time this is all it takes. What will slow this down is when there is a significant degenerative joint disease or disc disease in the lumbar spine. I can't reverse a degenerated spine. Getting the
foundation of the pelvis back into balance helps with the pain and dysfunction, but the total resolution is not available due to the destruction of the joint surfaces. Fortunately, this is not the case 90% of the time.
This hopefully paints a better picture of scoliosis for you. Most of the time it is very addressable and help is available for the discomfort. We can't always straighten out the spine, but we can make it work better.
Take care,
David
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Ellen has started getting ready for Christmas, which means wrapping presents. This is a little tricky wrapping with one hand, but she is persistent. I took a picture of her doing this, but we are having trouble with loading our pictures right now.
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"Learn and let go. Our life experiences are for us to learn from and then let go. To identify with them stops our growth. This is the real reason for forgiveness."
~ David DeLapp
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Too much standing causes heart disease?
Remember when the big buzz was how too much sitting would cause you to die earlier. Well now a Finnish study has determined that too much standing will increase heart disease. The standing causes pooling of blood in the legs requiring the body to raise blood pressure to push that blood back up to the heart. Walking around relieves this issue.
"The more you give, the more you get. Life is a flow of energy from spirit down through us to the world. If we don't outflow there is no room for inflow."
~ David DeLapp
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Vaccines can now be delivered by mosquito
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