What is scoliosis and is it the cause of your pain?
Have you ever been told you have scoliosis? Sounds scary right? Whilst some scoliosis is very serious and can be debilitating most scoliosis is perfectly normal and may not really have much to do with your pain. Chiropractors and Osteopaths are notorious for telling people they have scoliosis as though it is a major problem and also that they can fix it. Whilst minor scoliosis can in theory be helped with manual therapy there is no way that cracking your spine will magically straighten it up and it certainly wont help with a genetic structural scoliosis. There is this idea in musculoskeletal health that the spine needs to be straight (within the realms of its natural curves) but in reality does anyone have a straight spine? As a practitioner with over 14 years experience and also a remedial massage teacher of 6 years I have never seen a “straight” spine, including Yoga teachers, pilates instructors and the ones that have seen the Chiro for years who has been trying to fix it.
Scoliosis can often be a symptom and not a cause. If you have bad posture by tilting to one side when you sit or stand all the time, then of course your spine is going to appear to be tilting or curving.
So what is scoliosis?
Scoliosis is a lateral curve of the spine, or when you have an S in the spine when looking at it from behind. Usually a scoliotic spine will contain an element of rotation as well due to the way the facet joints in the spine are formed.
There are 2 types of scoliosis, structural and functional. Structural scoliosis is basically a curve in the spine that is formed genetically by the bones and the way the joints have grown. Functional scoliosis occurs more from your posture or repetitive actions you do such as carrying a heavy bag on one shoulder for years or standing with one hip pushed out to the side. Generally structural scoliosis can't be fixed as it is the bones and joints structure that is causing the curve. Functional scoliosis can be resolved but it can be a lot of work, including soft tissue release to tight areas, strengthening to weakened areas as well as postural awareness.
For those of us who have a mild case of scoliosis (most of us) just changing your posture can make a massive difference. It is really your poor posture that is causing your spine to appear curved. As soon as you straighten up and stand or sit correctly your spine should right itself.
The reality is that just like every other part of our body nothing is perfect. Most faces aren't symmetrical, most legs aren't the same length, most feet aren't the same side, most peoples feet over pronate and yes most people have scoliosis. Are we trying to compare our bodies to an unrealistic perfect normal that will never exist. Over pathologising and also making healthy people worry, known as the worried well.
When scoliosis is severe.
When scoliosis is really bad this is usually discovered in infancy. A child's posture will be noticeably distorted and they may have pain in their back, neck or down the arms and legs from pain on the joints and nerves. The best assessment for scoliosis is an X-ray to effectively check the amount of curvature of the spine. A brace can be worn to attempt to straighten the spine, just like braces on the teeth. The worst case scenario is to have rods surgically inserted into the spine to straighten it as you grow. When you are fully grown it is highly unlikely that a brace will have any effect as the spine is fully developed. The joints will have formed in a manner that is unchangeable. If there is functional scoliosis, from the way you hold yourself, then soft tissue work, specific exercise and postural awareness will be the only things that will help.
Severe scoliosis can lead to problems in the shoulder as the shoulder blades wont sit properly on the ribcage. The thoracic spine connects to ribs so this is why the ribs will often look uneven with someone with scoliosis. The hips can also be affected as the sacrum (lower part of the spine) sits into the pelvis. This could also affect the appearance of the length of the legs.
The point of this blog was to give you some peace of mind that the slight curve in your spine probably isn't the cause of your pain and that most people live perfectly healthy lives with some scoliosis. I am also not saying that scoliosis can't be the cause of your pain, just not always.
If you feel that you have scoliosis and want to have an assessment an treatment then please make an appointment so we can assess and treat you.
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