As scoliosis is diagnosed, the process involves further classifying conditions based on important patient and condition variables, one of which is condition type, and this
The main four types of scoliosis are idiopathic scoliosis, neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis. The main cause of scoliosis is unknown, and this accounts for 80 percent of known diagnosed cases, while the remaining 20 percent are associated with known causes.
As determining type is part of the classification process, let’s start with how conditions are diagnosed and further classified.
How is Scoliosis First Diagnosed?
Scoliosis affects all ages, and while it’s more often diagnosed in children, it does also affect adults.
Scoliosis requires a medical professional to diagnose the structural spinal condition through a combined physical examination and X-ray results.
A physical examination looks for signs of an unnatural sideways spinal curve that also rotates; this is scoliosis, and as a progressive condition, scoliosis gets worse over time.
So where a scoliosis is at the time of diagnosis doesn’t mean that’s where it will stay, particularly if left untreated, or not treated proactively.
To diagnose scoliosis, there has to be an unhealthy sideways-bending and rotating spinal curve, and it has to have a minimum Cobb angle measurement of at least 10 degrees, and this is part of classifying scoliosis.
No two cases of scoliosis are the same, and the treatment process has to be streamlined, so conditions are classified based on key patient and condition variables: condition type, patient age, condition severity, and curvature location.
Condition type is determined by causation.
Condition Type
A condition’s underlying cause is what shapes its treatment, and when it comes to scoliosis, the main type of scoliosis diagnosed is idiopathic scoliosis, and this means not clearly associated with a single known cause.
Idiopathic scoliosis is the most common type of scoliosis to affect both children and adults, and the most prevalent type overall is adolescent idiopathic scoliosis, diagnosed between the ages of 10 and 18.
Idiopathic doesn’t mean a complete absence of cause; it means scoliosis isn’t clearly associated with a single-known cause, but is instead considered to be multifactorial, so it’s thought that idiopathic scoliosis is caused by a number of variables that can vary from person to person.
Neuromuscular scoliosis is caused by the development of an underlying neuromuscular condition such as spina bifida, cerebral palsy, or muscular dystrophy.
Congenital scoliosis is caused by a malformed spine that develops in utero, and degenerative scoliosis affects older adults facing spinal degeneration.
Types of Idiopathic Scoliosis
The main type of scoliosis, and Idiopathic scoliosis overall, is adolescent idiopathic scoliosis, diagnosed between the ages of 10 and 18.
We don’t fully understand why idiopathic scoliosis initially develops, but we do know that it’s growth triggering it to progress, and that means the size of the unnatural spinal curve is increasing, as are the condition’s uneven forces and their effects.
The most common type of scoliosis to affect adults is idiopathic scoliosis, followed by degenerative scoliosis, and degenerative scoliosis affects older adults and has a known cause: natural age-related spinal degeneration.
Adult Idiopathic Scoliosis
Cases of adult idiopathic scoliosis are cases of adolescent scoliosis that were undiagnosed and untreated during adolescence, and conditions progress with time and maturity into adulthood, when scoliosis becomes compressive and painful.
A challenge to the early detection of childhood scoliosis is the lack of pain; scoliosis isn’t commonly painful in children because as a child grows, their spines are experiencing a constant lengthening motion that counteracts the compressive force of the unnatural spinal curve.
It’s compression of the spine and its surrounding muscles and nerves that causes the majority of condition-related pain.
For adults, pain is the main symptom of scoliosis that brings them in for a diagnosis and treatment, and that can include muscle pain, back pain, and most often, pain that radiates into the extremities due to nerve compression.
By the time I see an adult’s spine who has had scoliosis since adolescence, they have generally progressed a significant amount and didn’t notice the condition until it became painful.
Is Idiopathic Scoliosis Genetic?
Idiopathic scoliosis is highly prevalent, and as it mainly affects children and its progression is triggered by growth, childhood scoliosis should always be taken seriously.
Idiopathic scoliosis has been researched and studied, and despite the effort made trying to identify a scoliosis gene, or genetic combination, that accounts for the development of idiopathic scoliosis, one has yet to be identified.
However, it can seem contradictory then that having a family history of scoliosis is considered a risk factor, but remember, families share a lot more than just their genes, which fulfills the suggested multifactorial nature of scoliosis.
Families share body types, diet, lifestyle, socioeconomic factors, geography, responses to stress, and more, so any one of those factors, or more than one, could cause the onset of idiopathic scoliosis.
Twin studies also support the argument that scoliosis isn’t genetic because of cases where one twin has scoliosis and the other doesn’t, despite sharing genetics, or cases where one twin has one type of scoliosis and the other has a completely different type.
The general consensus is that while there might be certain genetic factors at play that have yet to be determined, scoliosis is considered a familial spinal condition.
Symptoms of Idiopathic Scoliosis
In childhood scoliosis, the main scoliosis symptoms involve postural changes caused by how the condition disrupts the body’s overall symmetry:
- Uneven shoulders
- Uneven shoulder blades
- Uneven hips
- The development of a rib cage arch
- Arms and legs that appear to hang at different lengths
As scoliosis progresses, these postural changes become more noticeable, along with changes to balance, coordination, and gait.
And in adult scoliosis, while adults also experience postural changes that can include a prominent lean to one side, the main symptoms of scoliosis that brings adults in to see me for a diagnosis and treatment are back pain and radiating pain due to nerve compression.
It’s important to remember that most cases of scoliosis are going to progress at some point, hence the benefit of being proactive with treatment.
Treatment For Idiopathic Scoliosis
How a patient decides to address their idiopathic scoliosis with treatment will shape the spine’s long-term spinal health and function, so it’s an important decision, and I want patients to fully understand all treatment options available to them.
There are two main ways to treat scoliosis, and that’s with surgical or nonsurgical treatment.
Surgical treatment is offered as part of traditional treatment, but the reality is that many cases of scoliosis don’t require surgery, and all surgeries, particularly spinal surgeries, come with their share of risks.
Spinal fusion involves fusing the curve’s most-tilted vertebrae into one solid bone and attaching rods with pedicle screws to the spine to hold it in place, and while this can straighten a bent spine, the way it does so is contrary to the spine’s movement-based design.
Conservative nonsurgical treatment has proven results and is modern, proactive, and integrative; here at the Scoliosis Reduction Center, our results speak for themselves.
I combine condition-specific chiropractic care, physical therapy, corrective bracing and rehabilitation.
When it comes to treating idiopathic scoliosis in children, a focus is to achieve a significant curvature reduction and hold it there despite the constant trigger of growth, and a focus of adult scoliosis treatment is to reduce curves back to where they were prior to becoming painful, increasing spinal stability, and pain management.
Chiropractic adjustments can work to reposition the curve’s most-tilted vertebrae back into alignment with the rest of the spine, and physical therapy can help increase core strength so the spine’s surrounding muscles can optimally support and stabilize it.
Corrective bracing can help by pushing the spine into a corrective position, and rehabilitation can be ongoing and involve continued chiropractic care and the prescription of scoliosis-specific exercises that can be performed from home to further heal and stabilize the spine.
Conclusion
So symptoms of idiopathic scoliosis include postural changes such as uneven shoulders and uneven hips, and pain in the back and/or radiating pain due to nerve compression.
Symptoms of all types of scoliosis will get worse alongside progression, and that means more noticeable postural changes, more pain, and more potential complications such as digestive issues and migraines.
Idiopathic means not clearly associated with a single-known cause, and while we don’t fully understand what triggers the initial onset of scoliosis, we do know that it’s growth that triggers it to progress.
When it comes to treatment for idiopathic scoliosis, determining the type is important, and once conditions are fully classified based on key variables, the streamline process can be streamlined and treatment plans can be customized.
Regardless of type or severity, the best time to start treatment, as a progressive condition, is always now.
