One of the worst things about scoliosis
(sideways curvature of the spine) is the fact that, very often, the condition becomes more and more pronounced as time goes by. A curve that is barely noticeable to begin with can become seriously problematic and disfiguring if left untreated for long enough.
But how long does it take for a spinal curve to reach that point? How quickly does scoliosis progress, and how long can you safely go without treatment?
As usual, every case is different.
Unfortunately, there is no hard and fast answer to either of the above questions. Some spinal curves don't progress at all after a certain point, while others progress very rapidly and continue to do so until action is taken.
Let's take a look at the most common form of scoliosis - idiopathic scoliosis
. In most cases of idiopathic scoliosis, the curve develops around the time the patient hits puberty, then continues to progress throughout their adolescence until their spine has finished growing (usually at age 16-18). However, the rate of progression can vary greatly from one person to the next, and there's no guarantee that the progression will cease as soon as the patient stops growing. No two cases are alike!
Things get even more complicated when you take into account all the other different forms of scoliosis. While most cases of scoliosis are idiopathic (i.e. lacking a clear underlying cause), the condition can also be triggered by any number of other factors, from neuromuscular diseases to the human body's natural ageing process. The type of scoliosis you have makes a huge difference to the speed at which your condition progresses (if indeed it progresses at all).
How to stop a spinal curve from progressing
Once scoliosis has been diagnosed, there are a number of different ways to prevent it from progressing any further. For some patients - particularly young children with very mild scoliosis - medical practitioners may simply recommend observation (closely monitoring the spinal curve and watching for changes) as the best way forward. However, in most cases, one or more of the following treatment methods will be used:
- Bracing - The patient wears a rigid plastic back brace to effectively hold their spine in place and prevent it from becoming any more curved than it already is.
- Spinal Fusion Surgery - A surgical procedure where metal rods are used to anchor the spine in place.
- Physical Therapy - A non-invasive approach that uses stretches and exercises to correct the curvature and prevent further progression.
ScolioGold therapy, which we use to treat curved spines here at the Scoliosis SOS Clinic, is an example of the third treatment method. To read more about ScolioGold and the use of physical therapy to treat scoliosis, please click here
Some scoliosis sufferers undergo spinal fusion surgery to correct their spinal curve. As with any surgical procedure, there are many risks involved - risks that put many people off the idea of scoliosis surgery altogether.
For some people, however, surgery is the only treatment available. If you are preparing for a spinal fusion procedure, you should bear in mind that surgery is not an instant miracle cure - after scoliosis surgery there is a long recovery period, and the exact results of the operation can vary.
What happens after the operation?
After scoliosis surgery, you will be required to stay in hospital for a certain amount of time, with the exact duration differing from one case to the next. The discomfort that immediately follows spinal fusion surgery is generally greater than for other spinal surgeries, and patients usually stay in hospital for three or four days after the operation, but a longer stay after a more extensive surgery is not uncommon. If you have undergone extensive surgery, or if you're an elderly patient, it is recommended that you stay in a rehabilitation unit after release from hospital.
How long will it take to fully recover and return to a normal lifestyle?
After surgery, it usually takes a while before the patient can return to a normal active lifestyle. This is because the surgeon will need to see evidence of the bone healing first; the speed of the fusion process varies greatly because all bodies heal (and incorporate the bone graft fusing the vertebrae together) at different rates. In some cases, you won't see any evidence of the bone healing until at least 6 weeks after the surgery.
During this period, the patient's activity is restricted. Large-scale bone healing doesn't take place until three or four months after surgery. After this period, the patient's activity can be increased.
Some spinal fusion patients are required to wear a back brace for a period of time after the operation. The decision to use a brace and the degree of restrictiveness depends upon your surgeon’s preference and other factors related to your surgery.
How long will I need off work?
Time off work also varies depending on how extensive your surgery was and also what type of job you do. Downtime can vary from 4-6 weeks (common for a single-level fusion in a young, healthy patient with a desk job) to as much as 4-6 months (which may be necessary after more extensive surgery on an older patient with a more physically demanding occupation).
How can Scoliosis SOS help?
It is difficult to predict the length of your recovery period and the amount of pain and discomfort you will feel after undergoing spinal surgery - these things vary greatly from one patient to the next. However, if you wish to speed up the recovery process and reduce any pain you're still experiencing, we at the Scoliosis SOS Clinic can help! Our ScolioGold method
can help to reduce back pain, improve mobility, speed up the correction of a spinal curve, and correct any secondary curves that may have developed above or below the fusion site.
Our ScolioGold programme is largely based around the Schroth method
- however, unlike many other clinics, we don't solely use Schroth exercises to treat scoliosis. Instead, we compliment it with a range of non-surgical spinal treatment techniques, resulting in a more well-rounded treatment regime.
If you wish to find out more about our ScolioGold method and how it can help you recover from scoliosis surgery, please contact Scoliosis SOS
and book an initial consultation today.
Although it is estimated that over 4% of individuals have some degree of scoliosis
, many people have never heard of (or know very little about) this condition.
Whether you have just been diagnosed or are simply looking to find out a little bit more about scoliosis, we thought that it would be a good idea to provide a short history of scoliosis so as to allow our patients and other visitors to find out more about mankind's understanding of scoliosis and how this has progressed over the years.
Scoliosis in Ancient Greece
Although our sophisticated understanding of scoliosis, what causes it, and how to treat it is a rather modern development, knowledge of the condition can be traced back to ancient civilisations, and is well-documented by ancient Greek scholars. Hippocrates wrote about spinal curvature throughout his medical literature, although there was no clear distinction between different types of curve at this time. He even developed treatment methods and devices for spinal correction, the most well-known being his 'Hippocratic ladder' and 'Hippocratic board'.
This research was furthered by Galen in the 2nd century AD, who is considered to be an early pioneer of spinal research, and who is said to have first coined the term σκολίωσις/sκoliosis (from which the modern term derives).
Ambroise Paré's Scoliosis Brace
The modern Boston bace (designed circa 1972 in Massachusetts) is widely used to treat idiopathic scoliosis, particularly in children, by halting curve progression. The concept of bracing for scoliosis, however, has been around far longer than the 1970s, with Ambroise Paré suggesting the use of a metallic brace for spinal correction during the Renaissance era. Known as the 'Father of Modern Surgery', Paré was the first to use continuous bracing as a form of treatment for scoliosis, and was also the first to recognise that this was not useful once the patient had reached maturity. Despite his insistence on the bracing method, Paré never rejected traction therapy, continuing to use this in his treatments, and also insisting on the importance of exercise for healthy spinal development and curve correction.
The Development of Cobb Angle Measurement
The system used nowadays to measure scoliosis and post-traumatic kyphosis is known as the Cobb angle
, which acts as a guide for assessing the severity of a patient's curve. This method was devised by and named after John Robert Cobb, an American orthopaedic surgeon who worked at what was then known as the 'Hospital for the Ruptured and Crippled' from 1934 onwards. It was here that Cobb experimented with and developed his scoliosis assessment method as a way of better understanding the condition and avoiding unnecessary surgery.
Scoliosis that develops during adulthood is known as adult degenerative scoliosis (ADS). There are two forms of ADS:
- Degenerative scoliosis, which affects adults who have already had problems with scoliosis in the past. Degenerative scoliosis is caused by the degeneration of the facet joints and intervertebral discs (the moving parts of your spine).
- De novo scoliosis, a curve in the spine that first appears in adulthood. Again, this is caused by wear and tear of the discs and facet joints; the key difference is that the patient never had a curved spine before.
Both types of ADS are typically diagnosed after the age of 50.
Curvature of the spine due to degeneration can occur slowly over time. Someone with adult degenerative scoliosis may experience a variety of pains, ranging from a dull back ache to sciatica; it may also make walking difficult or, in extreme cases, impossible.
How does ADS develop?
Everyone experiences natural degeneration of the facet joints and the intervertebral discs as they grow older. However, for some people, the degeneration process is accelerated. If degeneration takes place on only one side of the spine, the resulting imbalance can cause the spine to curve sideways.
Interestingly, most cases of ADS show no significant symptoms, and so adult degenerative scoliosis can often go undetected.
Common ADS symptoms include:
- Back Pain - This pain will not start suddenly; instead, it will slowly worsen as the degeneration gradually progresses. The initial pain can begin as just a dull ache or a slight stiffness; this is usually located in the lower back, but in some cases it may occur a little higher up. ADS-related back pain tends to be at its worst first thing in the morning, improving once the patient gets out of bed and starts moving around. The pain can return towards the end of the day, or after any vigorous or strenuous physical activities. Sitting reduces some of the pain, as the facet joints are under less pressure when seated.
- Nerve Root Impingement - This can occur when a bone overgrows or when there's a spur in the bony hole where the nerve root exits the spine. If your nerve root becomes impinged, you may suffer from severe pain, numbness, tingling, and in some cases a weakness in the lower back and/or leg. These symptoms are usually felt on just one side of the body.
- Neurogenic Claudication - This occurs when the patient's lumbar spinal canal narrows, resulting in the nerves becoming compressed and causing leg pain and muscle cramps when the patient begins to walk. This type of pain affects both legs, and begins after the patient has walked a short distance; in more severe cases, it is even felt when the person is sat down or flexing forward.
- Postural Changes - As with any other form of scoliosis, an ADS patient's shoulders and hips may start to become uneven as a result of their spinal curvature. If the angle of the curve becomes too severe, the patient may experience balance problems, and it may even push the rib cage against the heart or other internal organs.
How can degenerative scoliosis be treated?
Most cases of adult degenerative scoliosis can be treated non-surgically using physical therapy. Here at the Scoliosis SOS Clinic, we treat our patients using a non-surgical method that we call the ScolioGold method. This treatment regime is based around the Schroth method, but it also incorporates a range of well-established non-surgical spinal techniques that ensure all aspects of the patients's condition are fully treated.
We're constantly monitoring and developing our treatment techniques to reflect the latest advancements in the non-surgical field.
If you suffer from adult degenerative scoliosis and you would like to find out more about our non-surgical treatment methods, please do not hesitate to contact us.
Exercise is important for scoliosis sufferers - in addition to being good for your overall health, the right kind of physical activity helps to strengthen the muscles that may have been weakened by the curvature of your spine. However, some exercises can have a negative, even dangerous impact on a scoliotic spine, and if you have scoliosis, it's good to know which stretches and exercises might do you more harm than good.
We at Scoliosis SOS have a lot of experience when it comes to treating scoliosis
and other spinal conditions, and our physiotherapists
understand exactly how a curved spine can be affected by different movements and extensions. Today, we'd like to highlight some exercises that scoliosis patients are better off avoiding.
Positions and exercises to avoid if you have scoliosis
It's important to avoid any position which will exert excessive force to the lower back through extension. This will encourage compression of the lumbar spine, and is especially dangerous if you have an underlying spinal problem such as spondylolisthesis
Uncontrolled Thoracic Rotation
You should avoid any prolonged positions where your upper trunk is rotated above your lower trunk as in the images above. This will apply inadvertent torsion and twisting forces to your spine - especially critical when looking at scoliotic rotation.
Hyperflexion of Neck
Positions such as the one shown above apply excessive strain to the small vertebrae in your neck; if you have scoliosis, this will also place increased weight and strain through the weaker parts of your spine, potentially causing your spinal curve to increase.
Similar to hyperextension of the lower back (see above), this position will put undue stress and strain on your spine, and may cause your spinal curve to become even more severe.
If you want to learn more about which scoliosis exercises to avoid, or if you're interested in receiving treatment here at the Scoliosis SOS Clinic, please do not hesitate to contact us.