While scoliosis usually starts to develop during puberty, it is not unheard of for the condition to arise far later in life. We frequently treat elderly scoliosis sufferers here at the Scoliosis SOS Clinic, and whereas our younger patients usually have what’s known as idiopathic scoliosis (a progressive spinal curvature with no apparent cause), scoliosis in older people almost always occurs as the result of another, underlying condition.
Very often, that underlying condition is osteoporosis.
 
Osteoporosis vs. Normal Bone Density

What is osteoporosis?

Osteoporosis is a weakening of the bones that commonly occurs in later life. As we age, our bones naturally lose mass and become more fragile, although this process happens more quickly in some people than others. You are particularly at risk of osteoporosis if:
  • You are going through, or have already experienced, the menopause (reduced oestrogen levels often lead to a rapid decrease in bone mass, particularly when the menopause occurs before the age of 45)
  • You have a very low BMI
  • You drink and/or smoke heavily
  • You don’t get enough calcium and vitamin D in your diet
  • Osteoporosis runs in your family
  • You don’t get enough exercise
  • You have had your ovaries removed (e.g. due to ovarian cancer)
  • You have been taking certain medications (such as corticosteroids) for an extended period of time

Symptoms of osteoporosis

Osteoporosis doesn’t have any symptoms in and of itself, but it is problematic because weak bones are far easier to break. Reduced bone mass can easily be identified via an X-ray or DEXA bone mineral density scan; however, many osteoporosis sufferers remain unaware of their condition until they break a bone (usually a hip, wrist, rib or vertebra).
 
Increased risk of fracture isn’t the only issue that can arise due to osteoporosis. When the bones in the spine lose their strength and density, the spine can begin to slip into a curved position as it becomes too weak to support the weight of your upper body. This is how many osteoporosis sufferers end up suffering from hyperkyphosis (a forward curvature of the spine) or scoliosis (a sideways curvature of the spine).
 
Osteoporosis & Curvature of the Spine

Treating osteoporosis and osteoporosis-related scoliosis

Once osteoporosis has been diagnosed – and again, this often doesn’t happen until after the patient has suffered a fracture – the condition can sometimes be managed using medication that helps to strengthen the patient’s bones. Doctors may also recommend dietary/lifestyle changes to help slow the deterioration of the bones, and certain measures can be taken to reduce the risk of a fracture (e.g. removing household hazards that may result in a fall).
 
When scoliosis arises as the result of osteoporosis, it can be treated in a number of different ways. Some patients will undergo surgery to correct their spinal curvature, but it is usually possible to manage the condition with physical therapy – eliminating the need for surgical intervention.
 
Located in the City of London, the Scoliosis SOS Clinic treats scoliosis and hyperkyphosis sufferers using the ScolioGold method (a combination of specially selected non-surgical treatment techniques). Click here to see the results that this approach can achieve for elderly patients, or contact Scoliosis SOS now to arrange a consultation.
Bad Posture
Scoliosis (a sideways curvature of the spine) can be caused by all sorts of different factors. For example, if your muscles are weakened by a condition such as cerebral palsy or Guillain-Barré syndrome, this can lead to a curvature of the spine that progresses over time. Some children are born with scoliosis because their spines didn’t develop properly in the womb; on the other hand, scoliosis sometimes develops much later in life due to the deterioration of the spine’s intervertebral discs with age. Of course, the vast majority of scoliosis sufferers have idiopathic scoliosis, which usually arrives with puberty and has no known cause.
But now that we’ve covered some of the things that do cause scoliosis, let’s talk about something that definitely doesn’t.

Bad posture doesn’t cause scoliosis…

Bad posture can have a very detrimental effect on your general health, but there is no evidence that slouching in a chair or hunching over your laptop can cause scoliosis. As we recently clarified in our Scoliosis Myths blog post, the same goes for:
  • Wearing a rucksack on just one shoulder
  • Playing a heavy guitar
  • Carrying weighty loads on your back
The causes of scoliosis are many and varied, but generally speaking, the condition only ever arises as a result of genetic factors or neuromuscular / skeletal deterioration. Poor posture is not a recognised cause of scoliosis.

…but bad posture is still bad for you!

Of course, just because something doesn’t cause scoliosis doesn’t mean that it can’t affect your health in other ways. We’ve discussed the effects of bad posture in previous blog posts, but we’d like to briefly revisit the potential consequences of postural health now, just to make sure you understand them.
Bad posture CAN cause:
  • Back pain
  • Neck pain
  • Shoulder pain
  • Arm pain
  • Hyperkyphosis (another curvature of the spine – hyperkyphosis is a forward curve, whereas scoliosis goes sideways)
Our ScolioGold treatment courses can help hyperkyphosis sufferers as well as scoliosis patients – in fact, one of our most famous patients came to us for help combating his hyperkyphosis. Nick “Topper” Headon, who was the drummer for British punk band The Clash (of ‘London Caling’ and ‘Rock the Casbah’ fame) from 1977-1982, developed a kyphotic spinal curve after years spent hunching over a drum kit; he completed a two-week course at the Scoliosis SOS Clinic, and this enabled him to come off the medication he had been taking to help him cope with his back pain.
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Living with neurofibromatosis can be challenging enough in itself, but unfortunately, this is one of the many conditions that can lead to the onset of scoliosis.
In this post, we’ll take a look at neurofibromatosis, how it is linked to scoliosis, and what can be done to treat a spinal curvature when it develops.

What is neurofibromatosis?

N.B. Strictly speaking, there are two different forms of neurofibromatosis: type 1 (NF1) and type 2 (NF2). NF1 is by far the more common of the two, and from here on out, we will be using the word ‘neurofibromatosis’ to refer specifically to NF1.
Neurofibromatosis (sometimes known as Von Recklinghausen’s disease) is a genetic condition that causes tumours to grow on the coverings of the body’s nervous system. The tumours are almost always benign, but as the patient reaches adolescence and approaches adulthood, they tend to manifest themselves in the form of visible lumps and bumps on the skin.
Neurofibromatosis
These bumps – which vary greatly in size and visibility from one patient to the next – are the most characteristic and recognisable symptom of neurofibromatosis, but the condition is also associated with a range of other problems as well, including:
  • Learning disabilities
  • ADHD and other behavioural conditions
  • High blood pressure
  • Impaired vision
  • Scoliosis (curvature of the spine)

What causes neurofibromatosis?

Neurofibromatosis is caused by the mutation of a specific gene that is responsible for controlling cell division in the human body. This can happen spontaneously, although the mutated gene can also be passed from parent to child (meaning that some – but not all – cases of neurofibromatosis are hereditary).
Neurofibromatosis affects roughly 1 out of every 3,000 babies born each year. The condition can be found in people of all races and sexes; interestingly, the condition can be detected in the womb via genetic screening tests, although the majority of NF1 sufferers aren’t diagnosed until the classic symptoms (bumps and coffee-coloured patches on the skin) begin to develop further down the line.

Scoliosis in NF1 patients

Whereas a person with idiopathic scoliosis (that is, scoliosis with no apparent underlying cause) usually won’t develop a spinal curve until they reach adolescence, a neurofibromatosis sufferer may well develop scoliosis during their childhood. In fact, roughly 10% of children with NF1 are also affected by scoliosis.
When neurofibromatosis does result the onset of scoliosis, it seems to happen because of benign tumours growing on the spinal cord. This leads to an overall weakening of the spine, which in turn can lead to the growth of a scoliotic curve.

Treating scoliosis in neurofibromatosis sufferers

Scoliosis that arises as a result of NF1 can generally be treated using the same methods as idiopathic scoliosis. Surgery may be recommended, as may the use of a back brace to halt the progress of the spinal curve. Since the spine tends to start curving at an early age when neurofibromatosis is the underlying cause, medical practitioners may even recommend simply waiting and monitoring the condition to see if it improves or deteriorates with growth.
The ScolioGold treatment courses that we deliver here at the Scoliosis SOS Clinic represent another effective treatment option and a far more appealing alternative to surgery in many cases. We have treated numerous patients with NF1 (including several children), and the results have been consistently impressive.
ScolioGold therapy uses a combination of proven techniques to combat the symptoms of scoliosis without the need for surgery or bracing. This exercise-based treatment programme can relieve pain, improve mobility, and reduce the angle of the patient’s spinal curve – click here to view upcoming course dates, or contact us now to arrange an initial consultation.
As we’ve seen time and time again on this blog, scoliosis can occur as a result of numerous other conditions – from congenital heart defects to Ehlers-Danlos syndrome, there are all kinds of different reasons why a person might have a curved spine.
Today, we’d like to talk about yet another condition that can lead to scoliosis: a rare genetic disorder called Rett syndrome.

What is Rett syndrome?

Rett syndrome (sometimes called RTT for short) is a neurological condition that affects approximately 1 out of every 12,000 girls born each year. Rett syndrome can affect boys as well, but male cases are exceedingly rare. The condition is named after Andres Rett, the Austrian doctor who first described it.
Most cases of RTT occur because of a spontaneous genetic mutation that affects the development of the brain. Rett syndrome is a postnatal disorder that usually doesn’t develop until the patient is 6 to 18 months old; after that, the condition progresses in stages as time goes by.

Symptoms of Rett syndrome

A person with Rett syndrome will exhibit different symptoms depending on what stage their condition has reached. Here’s a rough breakdown of how the condition progresses:
  • Stage 1: As mentioned above, the first stage tends to begin when the patient is 6 to 18 months old. Early symptoms include unusual or erratic hand/limb movements, difficulty feeding, and mobility problems that make it difficult for the child to crawl or walk. Babies with RTT may also take longer than average to start speaking.
  • Stage 2: Stage 2 can begin at any point between 1 and 4 years of age. At this point, the patient will often become unable to use their hands at all as the involuntary, repetitive movements (e.g. hand-wringing, clapping) become increasingly difficult to control. Additionally, the child will begin to display behaviours that are more commonly associated with autism, including periods of distress/irritability, refusal to maintain eye contact, and extreme social withdrawal. They may also have trouble sleeping and eating.
  • Stage 3: Stage 3 can start at any time between 2 and 10 years of age. At this point, most RTT patients begin to experience seizures and irregular breathing patterns; some may also be affected by arrhythmia (an irregular heartbeat) and find it difficult to put on weight. However, some symptoms do improve at this stage: patients may find it easier to walk and/or engage in social interactions with others.
  • Stage 4: Some RTT patients never get to stage 4, but those that do tend to experience stiffness and muscle weakness, which can greatly impair their ability to get around. Many patients also develop scoliosis (a sideways curvature of the spine) as the condition continues to worsen.

Treating scoliosis in Rett syndrome patients

Since there is no cure for Rett syndrome, patients tend to be treated on a symptom-by-symptom basis. Anti-epileptic medication can help RTT sufferers to manage their seizures, while beta-blockers are sometimes used to combat the arrythmia that can arise in stage 3 (see above). Hand splints can help with the hand movements that are characteristic of this condition, and speech and language therapists often work to help RTT patients with their communication difficulties.
As for scoliosis, there are a number of different approaches to this. A Rett syndrome sufferer may attend physiotherapy sessions in order to prevent their spine from becoming curved; if scoliosis does occur, a doctor may recommend that the patient wears a brace or undergoes surgery to correct the curve.
However, physiotherapy and other exercise-based treatments needn’t be seen as solely a preventative measure. Here at the Scoliosis SOS Clinic, we have helped numerous RTT sufferers to overcome the effects of scoliosis after it has begun to develop. Our ScolioGold treatment programme has proven very effective when it comes to:
  • Cobb angle reduction
  • Improving mobility
  • Reducing pain
Click here to find out more about our ScolioGold courses, or get in touch to arrange an initial consultation with our scoliosis specialists (consultations can be carried out via Skype or over the phone if necessary).
Congenital Scoliosis
 
The most common form of scoliosis is idiopathic scoliosis, which usually develops during adolescence and has no known cause (although science is gradually getting closer to solving that mystery). The vast majority of idiopathic scoliosis patients are diagnosed between the ages of 10 and 18; as a general rule, the characteristic spinal curve does not develop until the onset of puberty, when the body goes through a rapid growth spurt.
 
However, some people have a type of scoliosis that sets in far earlier – from birth, in fact. This is called congenital scoliosis.

What is congenital scoliosis?

Congenital scoliosis is a type of scoliosis that is present from birth. If a baby is born with a spine that curves to one side, they are said to have congenital scoliosis.
 
Congenital scoliosis is caused by irregular development of the bones in the spine while the baby is in the womb. In some cases, congenital scoliosis occurs because one or more vertebrae did not form properly, although a spinal curve can also arise because multiple vertebrae are joined together.

How to spot congenital scoliosis

The symptoms of congenital scoliosis are similar to the symptoms of idiopathic or any other type of scoliosis (although they may be somewhat harder to spot in an infant or small child):
  • Uneven hips and/or shoulders
  • Rib cage more prominent on one side than the other
  • The patient appears to lean to one side
  • Clothes do not fit properly
  • Numbness, loss of coordination or weakness

Is congenital scoliosis painful?

Every congenital scoliosis patient has a different experience of the condition, and that applies to children born with scoliosis just as much as it applies to those who develop the condition later on. Some scoliosis patients do experience pain, reduced mobility, and/or compromised breathing, but these symptoms are relatively uncommon, especially in their more severe forms.
 
In cases where congenital scoliosis is linked to a problem with the spinal cord / nervous system, the patient may experience reduced coordination, reduced strength, and/or a feeling of numbness. Again, though, such cases are quite rare.

Treating congenital scoliosis

Scoliosis can be treated in a number of different ways, and congenital scoliosis is no exception. If the patient is still very young, some doctors may recommend simply waiting and monitoring their condition to see whether or not the spinal curve corrects itself as the child grows. This is usually the recommended treatment for congenital scoliosis curves less than 25°.
 
If congenital scoliosis worsens over time, some doctors may recommend bracing to prevent further deterioration. The brace puts pressure on the patient’s lower back, helping to straighten the spine. This can often be uncomfortable and inconvenient, especially for children who want to be able to run around and play restriction-free. 
 
In especially severe cases of congenital scoliosis may be referred for spinal fusion surgery, but this is a major operation and surgery is not usually the preferred treatment route when the patient is a child.
 
As with other forms of the condition, congenital scoliosis can be effectively managed via exercise-based physiotherapy. We have treated many young children here at the Scoliosis SOS Clinic, and we have seen some real transformations – just visit our Results (4-14 Years Old) page to see how effective our treatment courses are when it comes to reducing spinal curves.
 
If you would like to find out more about our treatment courses and how they can benefit congenital scoliosis patients, please call Scoliosis SOS on 0207 488 4428 or click here to book an initial consultation.