As a progressive condition, scoliosis is incurable, but it can be highly treatable, especially with early detection and a proactive treatment response. As scoliosis gets worse, it gets more complex to treat, so the sooner treatment is started in a condition’s progressive line, the better.
All types of scoliosis need treatment, especially as the condition’s nature is to get worse over time. Idiopathic scoliosis is not associated with a single-known cause and is the most common condition type to affect all ages. The best time to start idiopathic scoliosis treatment is always now.
Let’s start with what sets idiopathic scoliosis apart from the other condition types, before focusing on why it’s always best to start treatment as close to the time of diagnosis as possible.
Diagnosing Idiopathic Scoliosis
Diagnosing idiopathic scoliosis means an unnatural spinal curve that also rotates, and has no known cause, has developed.
When scoliosis is diagnosed, it’s comprehensively assessed so it can be further classified based on key patient/condition variables.
Patient age, curvature location, cognition severity, and condition type are the classification-points that treatment plans are customized around.
When it comes to patient age, this is important in terms of progression and pain; growth is what triggers scoliosis to progress, so young patients are more at risk for rapid progression than adults.
In addition, scoliosis doesn’t become a compressive condition until skeletal maturity has been reached, so patient age also indicates whether or not pain management is going to need to be a focus of treatment.
The spine has three main sections, and scoliosis can develop in any of them, or in more than one as a combined scoliosis: cervical spine (neck), thoracic spine (middle/upper back), and the lumbar spine (lower back).
Curvature location is important not only because it tells me where to concentrate my treatment efforts, but also because it indicates the area of the body most likely to feel the condition’s direct effects.
Condition severity is determined by a measurement known as Cobb angle, and the higher a patient’s Cobb angle measurement, the larger the scoliotic curve, the further out of alignment the spine is, and the more severe the condition:
- Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
- Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
- Severe scoliosis: Cobb angle measurement of 40+ degrees
- Very-severe scoliosis: Cobb angle measurement of 80+ degrees
When it comes to determining condition type, this involves causation.
What is Idiopathic Scoliosis?
In approximately 80 percent of known diagnosed scoliosis cases, they are classified as idiopathic, meaning not clearly associated with a single-known cause; this isn’t the same as saying there is a complete absence of a cause.
Instead, idiopathic scoliosis is thought to be multifactorial: caused by a number of factors that can vary from person to person.
It can be difficult to explain to patients that we don’t fully understand why their scoliosis has developed, but I do point out that knowing the cause wouldn’t necessarily change the course of treatment, or its outcome; what’s more important is how a diagnosis of scoliosis is responded to with treatment.
The remaining 20 percent of known scoliosis cases are associated with known causes: neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.
Neuromuscular scoliosis is caused by the presence or a larger neuromuscular condition such as spina bifida, muscular dystrophy, and cerebral palsy, to name a few.
Degenerative scoliosis is caused by natural age-related spinal degeneration, and congenital scoliosis is a rare form affecting approximately 1 in 10,000 and is caused by a malformed spine that develops in utero.
Idiopathic scoliosis is the most common type to affect both children and adults, and the most prevalent form of scoliosis overall is adolescent idiopathic scoliosis, diagnosed between the ages of 10 and 18.
As the trigger for progression is growth, this age group is the most at risk for rapid-phase progression due to the rapid and unpredictable growth spurts of puberty: the main reason treatment should be started sooner, rather than later.
In addition, as a progressive condition, scoliosis only gets more complex to treat as it increases in severity.
Idiopathic Scoliosis Treatment
So as adolescent idiopathic scoliosis is the most common condition type, we’ll focus on the topic of adolescent idiopathic scoliosis treatment.
While there are never treatment guarantees, particularly when detected early and responded to with proactive treatment, adolescent idiopathic scoliosis can be highly treatable.
There are two main approaches to treating scoliosis: surgically or non-surgically.
Traditional treatment tends to funnel patients towards spinal fusion surgery, which is a costly, invasive, and risky procedure that can negatively impact the spine’s long-term spinal health and function, and the reality is that many cases of scoliosis don’t require surgical treatment.
Here at the Scoliosis Reduction Center®, my patients benefit from a modern conservative chiropractic-centered treatment approach that has the goal of preventing progression, achieving a significant curvature reduction, holding the reduction despite growth, and avoiding the need for invasive surgical treatment in the future.
Through an integrative approach that combines multiple scoliosis-specific treatment disciplines, conditions can be impacted on every level.
Chiropractic care works towards achieving a curvature reduction through a series of techniques and manual adjustments; physical therapy and scoliosis-specific exercises can work towards increasing core strength so the spine is surrounded by strong supportive muscles, addressing any related muscle imbalance, improving posture, and stimulating specific areas of the brain for enhanced brain-body communication.
Corrective bracing can be particularly effective on growing spines so is a regular facet of treatment for adolescent idiopathic scoliosis; it can help augment corrective treatment results pushing the spine into a corrective position.
Further stabilizing and healing the spine through a home-rehabilitation program involves a series of custom-prescribed home exercises.
The Benefit of Early Detection and Being Proactive with Treatment
Early detection of adolescent idiopathic scoliosis isn’t always easy, particularly in mild cases and in light of the fact that scoliosis is not commonly painful for adolescents.
Early detection is, however, associated with increased treatment success.
As scoliosis progresses and the size of a scoliotic curve increases, the spine gets increasingly rigid, and this makes it less responsive to treatment, and in addition, increasing spinal rigidity can make it challenging for some patients to perform key therapeutic exercises as part of treatment.
In addition, condition effects become more overt and difficult to reverse the longer they’re established; it’s far more effective to proactively work towards preventing progression, than attempting to reverse its effects once they’re established.
The main effect of scoliosis in children is postural deviation caused by the condition’s uneven forces disrupting the body’s overall symmetry, and as scoliosis becomes compressive in adulthood, the main effect in adult scoliosis is pain: back pain and pain that radiates into the extremities due to nerve compression.
Even with a diagnosis of mild idiopathic scoliosis, as a progressive condition, it can easily progress to become moderate, severe, or very severe; only proactive treatment can work towards counteracting the condition’s progressive nature.
Conclusion
So when does idiopathic scoliosis need treatment: as soon as it’s diagnosed.
Even when mild, improvement can be worked towards, and in fact, scoliosis is more likely to respond to treatment the milder it is; small scoliotic curves are simpler to treat.
Here at the Center, I start treatment as close to the time of diagnosis as possible because I want to spare patients the hardships associated with progression, increasing condition effects, and the need for invasive surgical treatment.
The most important decision patients are faced with is how best to treat a condition moving forward as the way a diagnosis is responded to can affect long-term spinal health and function.
By combining multiple scoliosis-specific forms of treatment, I can impact conditions on every level for the best potential results, and while I can never guarantee treatment results, when idiopathic scoliosis is diagnosed while mild and treatment is started, the outcome can be very positive.
While there is still a place for traditional scoliosis treatment and spinal fusion surgery, the procedure does come with some serious potential risks, side effects, and complications so should be considered carefully.
The main complaint that patients have post-scoliosis surgery is that they have experienced a noticeable loss in spinal flexibility and range of motion, and this is a result that can greatly impact a person’s quality of life.
When it comes to conservative non-surgical treatment for idiopathic scoliosis, the goal is to address the scoliosis on a structural level so as much of the spine’s natural strength and function can be preserved throughout treatment and beyond.
So for idiopathic scoliosis patients wanting to forgo a surgical recommendation, or for those wanting to try a less-invasive treatment option first, don’t hesitate to reach out for guidance and support.
