For individuals with severe scoliosis, life can be very difficult indeed. Patients with a pronounced spinal curve may suffer from any number of symptoms, including chronic pain, limited mobility, and a low body image. In especially extreme cases, the curvature of the spine may cause serious problems with the patient's lungs, limiting their ability to breathe - but every spinal curve is different, and the symptoms vary massively from one case to the next.

The phrase 'severe scoliosis' usually refers to a case of scoliosis that has progressed to the point at which spinal fusion surgery is typically recommended. This is usually around 40-50 degrees, depending on your age and where in the world you live. In most cases, spinal curves this severe continue to worsen, and that is why spinal fusion is often recommended.

In the vast majority of cases, severe scoliosis will drastically affect the posture and physical appearance of the patient, and surgery can be effective in reversing these changes to a certain extent. However, spinal fusion surgery is not always successful, and can pose some risks of its own.

What other treatment options are available?

While the procedure is relatively safe and successful in the majority of cases, many people are put off spinal surgery due to the risks involved. If you'd rather not undergo spinal fusion surgery to correct your severe scoliosis, your options are somewhat limited; bracing can be effective way to stop scoliosis progressing further, but a back brace cannot reverse the curvature that has already developed and is only used in patients who are still growing.

But it's not all bad news! We at Scoliosis SOS are able to treat severe scoliosis in patients of all ages without surgery and without the use of a brace. Our therapists treat scoliosis patients using a unique combination of non-surgical spinal techniques that we collectively call the ScolioGold method. Our treatment programme can help reduce your Cobb angle, provide pain relief, and help improve body image, boosting your sense of self-esteem.

We have frequently treated patients with Cobb angles of 50 degrees or more - in fact, we have even helped patients with curves of up to 120 degrees!

Severe Scoliosis Treatment

A patient with severe scoliosis before (left) and after (right) ScolioGold treatment.

If you'd like to find out more about our ScolioGold method, click here. If you'd like to arrange an initial consultation, please contact us today.

Hyperlordosis vs. Healthy Spine
 

As you'll know if you've read our blog post on the subject, hyperlordosis is an excessive curvature of the lumbar spine (that is, the lower portion of the backbone). Whereas the spine of a scoliosis patient curves sideways, the spine of somebody with hyperlordosis curves inward, resulting in an unusually arched posture among a number of other symptoms.

Symptoms of hyperlordosis

While no two cases of hyperlordosis are precisely alike, the following symptoms are common among hyperlordosis sufferers:
  • Back pain and stiffness
  • Muscular imbalance
  • Reduced flexibility
  • Visibly arched posture (inward curve of the lower back, causing the buttocks and stomach to stick out)
One telltale sign of hyperlordosis can be seen when the patient lies on their back. A lower back curve will mean that the person's lower back will be raised up off the floor.

Hyperlordosis treatment methods

Hyperlordosis treatment usually aims to halt and reverse the progression of the curvature and alleviate symptoms such as back pain and muscular imbalance. These goals can be achieved in a number of different ways - common hyperlordosis treatment methods include:
  • Bracing. If the patient is young and still growing, they may be told to wear a back brace. This is usually a rigid plastic shell that effectively holds the back's shape and prevents the curve from becoming more pronounced as the wearer's body grows.

  • Surgery. In extreme cases, spinal surgery may be recommended to reduce the degree of the patient's lordotic curve and ease some of the symptoms. This will usually not be considered as an option for mild to moderate cases of hyperlordosis.

  • Medication. If the patient's excessively curved spine is causing chronic pain and perpetual discomfort, pain relief medications of various strengths may be prescribed in order to battle this symptom.

  • Exercise / physical therapy. As with scoliosis and hyperkyphosis, exercise-based physical therapy can be an effective option for hyperlordosis patients, particularly when it comes to improving flexibility, restoring muscle balance, and improving overall quality of life.
Here at the Scoliosis SOS Clinic in London, we specialise in the fourth and final treatment method: exercise-based physical therapy. We have treated numerous hyperlordosis patients with mild to moderate to severe spinal curves, and if you or a loved one suffer from a curvature of the lower spine, we would be more than happy to hear from you.
 
Contact Scoliosis SOS today to discuss your condition and your treatment requirements.

Further reading

Pregnant woman having an epidural
 
Previously on this blog, we've examined the impact that pregnancy can have on scoliosis and discussed the ways in which we at Scoliosis SOS can help. However, there's one fairly common question that we failed to cover last time around: if you have a curved spine, can you have an epidural to help with the pain of giving birth?

What is an epidural?

An epidural is a type of steroid injection administered into the 'epidural space', which lies between the covering of the spinal cord and inside the bony spinal canal. The medication reduces pain by coating the nerve roots and the outside lining of the facet joints in the areas near the injection.
 
An epidural is administered by an anaesthetist, who will first insert a drip into your arm to administer fluids whilst you are having the epidural. You will then be asked to sit leaning forwards - or to lie on your side with your knees drawn up - in order to allow the anaesthetist to begin the procedure of inserting the epidural. First, an injection of local anaesthetic will be used to numb the skin where the epidural will be inserted; then, a needle will be used to insert a fine plastic tube between the bones of your back.
 
The needle is then removed, leaving the tube to be used for administering the pain relief drugs. While this will usually make it difficult to walk around and cause unsteadiness on your feet, some hospitals are able to offer mobile epidurals that allow you to walk around.

Scoliosis and epidurals

Cases of scoliosis vary hugely in their severity, and every spinal curve impacts the patient in different ways; the same is also true of undergoing an epidural. It is quite rare for back problems to prevent the use of an epidural during labour, but it may not be an option for some scoliosis patients, particularly those who have undergone surgery or have a curve in the lower (lumbar) spine.
 
Due to the fact that the epidural is placed in the lower spine, a spinal curve in this region may present difficulties for the anaesthetist, who may not be able to safely inject the epidural catheter in order to administer the pain relief medication.  If the scoliosis impacts the patient's middle to upper spine, this should not present a problem, although it is still important for the patient to make the doctor/nurse aware of their condition beforehand.
 
If you have undergone spinal fusion surgery to correct a progressive curve, your doctor may not wish to risk disrupting the implant and/or giving you an infection, both of which can occur when administering an epidural. This may cause them to advise you against receiving an epidural.
 
If you are a pregnant scoliosis sufferer and you would like to have an epidural when you go into labour, the most important thing for you to do is to speak with your doctor and anaesthetist, who will be able to give you professional advice and guidance based on your individual circumstances. Not only will this provide you with a truly informed understanding of the possible risks involved (and the likelihood of success), it will also enable you to discuss alternative methods of pain relief in the event that an epidural is not possible or presents too much of a risk.
 
Would you like to find out more about treating your scoliosis before becoming pregnant or after giving birth? Get in touch with the Scoliosis SOS team today! 
Scoliosis through life
 
While scoliosis is typically diagnosed during adolescence, the condition can also lead to complications later in life, particularly when left untreated. Most cases of spinal curvature are treated before any major complications occur; if left untreated, however, there is a chance that scoliosis may lead to more serious problems for the patient in question. Some people who undergo spinal fusion surgery for scoliosis also experience complications later in life.
 

What complications can occur later in life if scoliosis is left untreated?

If scoliosis is left untreated for long periods of time, it can lead to chronic pain and a variety of other complications. Most of the symptoms listed below will only occur after the patient's scoliosis has reached an advanced degree of curvature, and can usually be avoided as long as the condition is treated in a timely manner:
  • Breathing problems
If scoliosis is left untreated for many years, the increasing curvature of the spine can cause the ribs to restrict lung capacity. This can lead to shortness of breath.
  • Leg pain
Advanced cases of scoliosis can cause one leg to appear shorter than the other due to misalignment of the hips. This can change the patient's posture and gait (how they walk), which in turn causes the muscles to tire sooner due to over-compensation to maintain balance.
  • Cardiovascular problems
If the curvature of the spine reaches a particularly severe point, the restriction of the rib cage can lead to heart problems. In the most severe cases, this may even lead to heart failure; however, this only occurs in a tiny minority of cases.
  • Lumbar stenosis
While scoliosis is unlikely to cause any severe neurological problems no matter how old you are, it is associated with lumbar stenosis. Lumbar stenosis is the narrowing of the spinal canal, which can ultimately lead to nerve complications, weakness or leg pain.
 

Post-surgery complications

When surgery is conducted on (or near) the spine, there is always a possibility of short-term or long-term complications. In the case of scoliosis, spinal fusion surgery can sometimes lead to the following complications in later life:
  • Flat-back deformity
After surgery to rectify scoliosis, the natural 'C'-shaped sagittal curve of the lower back may be lost. This is due to the vertebrae in the lumbar spine fusing together, thus eliminating the natural curvature. This deformity typically appears later in life, sometime between the ages of 30 and 50.
  • Transitional syndrome
When the spine is working correctly, each segment shares the weight and stress of everyday movement and activities. However, when one or more segments are not working correctly, the others have to take on more stress to account for this. This means that, if your vertebrae are fused together, the closest vertebrae to the fusion site will begin to take on more stress and may ultimately become damaged over time.
 
 
Scoliosis can cause many complications later in life, but if you seek treatment before your spine deteriorates too far, many of these issues can be nipped in the bud and avoided altogether. Surgery is not your only option when it comes to improving the curvature of your spine - here at Scoliosis SOS, we provide non-surgical treatment courses that have shown to be very effective indeed.
 
To discuss scoliosis treatment options, please book a consultation - this can be conducted over the phone, via Skype, or in person at our clinic in London.
Thoracic hyperkyphosis

Thoracic hyperkyphosis is a condition where the thoracic (upper) spine curves forward, resulting in a slouched or hunched appearance. It can affect people of all ages for a variety of different reasons.

While most people have some level of curvature in the upper spine, a person is said to have hyperkyphosis if the angle of their curve exceeds 45 degrees. Common symptoms of thoracic hyperkyphosis include:
  • Back pain
  • Stiffness
  • Top part of the back looking curved or hunched over
Every case is different, but many thoracic hyperkyphosis patients also report feeling fatigued as a result of their condition. Furthermore, the visible effects of hyperkyphosis sometimes contribute to low self-esteem, a negative body image, and emotional and social issues.

What causes thoracic hyperkyphosis?

As mentioned above, thoracic hyperkyphosis can arise for a number of different reasons. The most common causes include:
  • Bad posture - If you frequently slouch or otherwise fail to sit properly in chairs, your poor posture may end up causing hyperkyphosis over time.

  • Scheuermann's disease - Scheuermann's is a condition (mostly affecting young people) that occurs when the vertebrae don't grow evenly. This can result in a hyperkyphotic spinal curve. Read more about Scheuermann's disease here.

  • Congenital issues - Sometimes, a baby's spine will develop incorrectly in the womb. This may result in the child being born with hyperkyphosis, with the condition progressing (getting worse) as they grow up.
Thoracic hyperkyphosis may also be caused by nutritional deficiencies, vertebral trauma, and a number of other problems.

How to treat thoracic hyperkyphosis

Just as hyperkyphosis has many different causes, it can also be treated in many different ways, including:
  • Bracing
  • Physical therapy
  • Spinal surgery
Here at the Scoliosis SOS Clinic, we frequently treat thoracic hyperkyphosis patients who wish to reduce the angle and visibility of their curve and alleviate symptoms such as pain and stiffness. We do this using our ScolioGold method, an exercise-based alternative to surgical intervention that has repeatedly shown itself to be effective in cases of spinal curvature.

Click here to learn more about ScolioGold therapy, or get in touch to arrange a consultation with Scoliosis SOS.