Content
Scoliosis, popularly known as "crooked column", is a lateral deviation in which the column changes to a C or S shape. This change most of the time has no known cause, however in other cases it may be related to lack of physical activity, poor posture or the fact of sitting or lying too long with a crooked spine, for example.
Due to the deviation, it is possible that the person develops some signs and symptoms such as one leg shorter than the other, muscle pain and feeling of fatigue in the back.Although scoliosis is more common in young people and adolescents, children can also be affected, especially when other neurological changes are present, such as cerebral palsy, and the elderly can develop scoliosis due to osteoporosis, for example.
It is important that scoliosis is identified and treated according to the orthopedist's guidance to avoid the development of symptoms or complications, and physical therapy, the use of vests or surgery may be indicated in the most severe cases.
Scoliosis symptoms
Scoliosis symptoms are related to the deviation of the spine, which leads to the appearance of some signs and symptoms that can be perceived over time and according to the severity of the deviation, the main ones being:
- One shoulder higher than the other;
- Scapulae, which are the bones of the back, sloping;
- One side of the hip is tilted upward;
- One leg is shorter than the other;
- Muscle pain, the intensity of which may vary according to the degree of scoliosis;
- Feeling of fatigue in the back, especially after spending a lot of time standing or sitting.
If a sign or symptom related to scoliosis is found, it is important to consult the orthopedist so that it is possible to make the diagnosis and start the most appropriate treatment, if necessary.
How the diagnosis is made
The diagnosis of scoliosis is made by the orthopedist based on the evaluation of the signs and symptoms presented by the person, in addition to performing some imaging exams to check the degree of deviation of the spine. The doctor initially performs a physical exam that consists of the following test:
- Stand with your legs hip-width apart and lean your body forward to touch the hands with your hands, keeping your legs straight. If the person is unable to get their hands on the floor, there is no need to strain too much;
- In this position, the professional can observe if a higher region of the spine appears on one side;
- If it is possible to observe this 'high', called gibosity, this indicates that there is scoliosis on the same side.
When the person has scoliosis symptoms, but does not have gibosity, scoliosis is mild and can be treated only with physical therapy.
In addition, the x-ray of the spine must be ordered by the doctor and must show the spine vertebrae and also the hip, important for assessing the Cobb angle, which indicates the degree of scoliosis the person has, which helps to define the most suitable treatment. In some cases, an MRI may also be indicated.
Types of scoliosis
Scoliosis can be classified into some types according to the cause and the region of the affected spine. Thus, according to the cause, scoliosis can be classified into:
- Idiopathic, when the cause is not known, it happens in 65-80% of cases;
- Congenital, in which the baby is born with scoliosis due to malformation of the vertebrae;
- Degenerative, which appears in adulthood due to injuries, such as fractures or osteoporosis, for example;
- Neuromuscular, which happens as a result of neurological conditions, such as cerebral palsy, for example.
Regarding the affected region, scoliosis can be classified as:
- Cervical, when it reaches the vertebrae C1 to C6;
- Cervico-thoracic, when it reaches the C7 to T1 vertebrae
- Thoracic or dorsal, when it reaches vertebrae T2 to T12
- Thoracolumbar, when it reaches the vertebrae T12 to L1
- Lumbar, when it reaches the vertebraeL2 to L4
- Lumbosacral, when it reaches the L5 to S1 vertebrae
In addition, one must know if the curvature is left or right, and if it is C-shaped, which indicates that it has only one curvature, or S-shaped, when there are 2 curvatures.
Scoliosis Treatment
The treatment for scoliosis can vary according to the severity of the deviation curvature and the type of scoliosis, and physiotherapy, the use of a vest or surgery in the most severe cases may be indicated.
1. Physiotherapy
Physiotherapy is indicated to treat scoliosis that has a curvature of up to 30 degrees and can be done through therapeutic exercises, clinical pilates exercises, spinal manipulation techniques, osteopathy and corrective exercises such as the postural reeducation method.
2. Collect
When the person has between 31 and 50 degrees of curvature, in addition to physiotherapy it is also recommended to wear a special vest called Charleston that should be worn at night while sleeping, and the Boston vest, which is to be worn during the day to study , work and do all activities, and should only be taken for the bath. The vest should be recommended by the orthopedist and in order to have the expected effect, it must be worn for 23 hours a day.
3. Surgery
When the spine has more than 50 degrees of curvature, surgery is indicated to reposition the spine's vertebrae on the central axis. Surgery is usually indicated for children or adolescents, which is when the results are best and the treatment is most effective. Surgery can be done to place plates or screws to centralize the spine. See more details about scoliosis treatment.
Check out in the video below some exercises that can be indicated in scoliosis: