Scoliosis: Causes, Symptoms, and Treatment Options

Scoliosis

Hello doctor, my physical examination report from my vocational school indicated that I have scoliosis, but since I didn't know the angle, I have been undergoing posture correction (due to poor sitting habits) without visiting a hospital for two years.
However, the physical examination report from my technical school no longer showed any issues.
Recently, when I visited a traditional Chinese medicine doctor, he mentioned that my spine still has curvature and that I have flat feet, which is causing pelvic tilt.
I suspect this might have recurred or worsened due to frequently lifting heavy objects during the second semester of my first year in technical school.

Yesterday, I went to a regional hospital for chest discomfort, and when I saw the chest X-ray, I was shocked to finally see the area of scoliosis again (the angle is unknown, but it appears to be leaning to the right).
Being anxious, I wondered if the discomfort could be due to nerve compression.
I also had an ultrasound done and will check the report next week to see if there is mitral valve prolapse.
A relative who accompanied me suggested that I should exercise more and do stretching, as they teach yoga.
I am considering whether yoga could help improve my condition.

Additionally, due to soreness, I plan to get a massage tomorrow, which should provide some relief.
I have been frequently visiting traditional Chinese medicine for body conditioning and also the dentist (I have a cavity that is severe and has been delayed for too long, and I fear infection, so extraction is necessary, but I need to wait for the ultrasound report before proceeding).
Over time, this has become overwhelming, and I prefer not to visit hospitals frequently (as they are far and inconvenient), and I am even less inclined to wear a brace or undergo surgery.

P.S.
Both my brother and I have scoliosis, and we are both going for a massage tomorrow.

Niming, 20~29 year old female. Ask Date: 2017/01/13

Dr. Shi Guozheng reply Orthopedics

You are already 26 years old, and if you have scoliosis, it is unlikely to worsen significantly.
Typically, scoliosis tends to progress during puberty when growth spurts occur.
After reaching adulthood, the curvature rarely increases.
Treatment is generally required only for scoliosis with a curvature of 20 degrees or more.
During puberty, the focus is on preventing further progression; usually, mild curvatures do not cause back pain, but they may affect appearance.
In the thoracic region, this may result in uneven shoulders, while in the thoracolumbar region, there may be differences in pelvic height.
Sometimes, individuals may perceive a leg length discrepancy.
Surgical intervention is indicated when the thoracic curvature exceeds 40 degrees or the lumbar curvature exceeds 60 degrees, especially if there are symptoms of thoracic compression.
Therefore, it is essential to determine the degree of curvature and consult a physician to assess the necessity of surgical treatment.
Chiropractic manipulation is unlikely to provide significant help for scoliosis.

Reply Date: 2017/01/13

More Info

Scoliosis is a condition characterized by an abnormal lateral curvature of the spine. It can manifest in various forms and degrees, and understanding its causes, symptoms, and treatment options is crucial for effective management.

Causes of Scoliosis
Scoliosis can be classified into several categories based on its origin:
1. Idiopathic Scoliosis: This is the most common type, accounting for about 80% of cases. The exact cause is unknown, but it typically develops during adolescence.

2. Congenital Scoliosis: This type occurs due to malformations of the spine that are present at birth.

3. Neuromuscular Scoliosis: This type is associated with conditions that affect the nerves and muscles, such as cerebral palsy or muscular dystrophy.

4. Degenerative Scoliosis: This type can develop in adults due to degeneration of the spine, often related to aging or conditions like arthritis.

In your case, it seems that the scoliosis may have been exacerbated by physical activities, such as lifting heavy objects, which can strain the muscles and ligaments supporting the spine. This could potentially lead to a worsening of the curvature or discomfort.

Symptoms of Scoliosis
Symptoms can vary widely depending on the severity of the curvature. Common symptoms include:
- Uneven shoulders or hips
- A prominent shoulder blade
- A noticeable curve in the spine
- Back pain or discomfort
- In severe cases, it can lead to respiratory issues due to reduced space in the chest cavity.

Given your report of chest discomfort, it is essential to consider that significant spinal curvature could potentially affect lung function or lead to other complications. However, it is also important to note that chest discomfort can arise from various causes, including anxiety, musculoskeletal issues, or cardiac concerns, especially if you have a history of mitral valve prolapse.

Treatment Options
1. Observation: For mild cases, especially in adolescents, regular monitoring may be sufficient. This involves periodic check-ups to assess any changes in the curvature.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the spine and improve posture. Exercises that focus on stretching and strengthening can be beneficial. Yoga, as suggested by your relative, can also enhance flexibility and core strength, which may help alleviate some discomfort associated with scoliosis.

3. Bracing: In growing children and adolescents with moderate scoliosis, a brace may be recommended to prevent further curvature. However, it seems you are not inclined towards this option.

4. Surgery: In severe cases, surgical intervention may be necessary to correct the curvature and prevent further complications. This is typically considered when the curvature exceeds 45-50 degrees or if the patient experiences significant pain or respiratory issues.

5. Chiropractic Care: While some individuals find relief through chiropractic adjustments, it is essential to consult with a healthcare provider to ensure that this approach is safe and appropriate for your specific condition.

6. Pain Management: If you experience pain, over-the-counter pain relievers or prescribed medications may help manage discomfort. However, it is crucial to consult with a healthcare provider before starting any medication.

Conclusion
It is understandable to feel anxious about your condition, especially after seeing the X-ray results. While it is essential to address your scoliosis, it is equally important to manage your overall health and well-being. Engaging in regular physical activity, such as yoga or stretching exercises, can be beneficial. However, it is advisable to consult with a healthcare professional before starting any new exercise regimen or treatment plan, especially considering your history of mitral valve prolapse and other health concerns.

If your chest discomfort persists or worsens, it is crucial to follow up with your healthcare provider to rule out any serious underlying conditions. Regular check-ups and open communication with your healthcare team will help you manage your scoliosis effectively and maintain your overall health.

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