Scoliosis: what causes it and how to recognize it?

Scoliosis is a curvature of the spine in the lateral plane, clearly visible when viewed from behind. It can be congenital or acquired. If scoliosis is relatively stable and does not cause displacement of the vertebrae, the pathology will be limited to pinching of the segments. If the spine not only deviates to the side, but also twists, problems with the facet joints may arise. Specialists distinguish several types of scoliosis: C-shaped, when the spine has one bend to the side, S-shaped, if the spine has two bends in and Z-shaped, which is the rarest and has three or more bends in different directions.

If you come across a mention of scoliosis, it is worth remembering that in the post-Soviet space, the concepts of "scoliosis", which means any deviation of the spine from the norm, and "scoliotic disease", which is an age-related disease of adolescents aged 12 to 15, were not distinguished. Therefore, if you are interested in an exact diagnosis, check with your doctor what exactly was meant.

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What causes scoliosis?

There are several most common causes that cause scoliosis. One of them is incorrect posture, which was not given due attention since childhood. Physical activity can also cause scoliosis: both a lack of daily exercise and too difficult loads can cause curvature of the spine.

Among the more complex causes of scoliosis, we can highlight such diseases of the musculoskeletal system as rickets or paralysis, congenital defects, radiculitis or serious damage to the central nervous system. If we talk about rickets, the spine begins to deform as the disease progresses and continues to curve even when rickets is at the stage of recovery. Due to the incorrect position of the child while sitting at the table, the spine is subjected to an unbearable load for the growing body and, accordingly, is deformed, which causes scoliosis.

If the causes of scoliosis cannot be identified, then the term "idiopathic scoliosis" or "rapidly progressive scoliosis" is used. A distinctive feature of this type of scoliosis is that its appearance is typical for girls aged 10-12 years (before puberty).

How does scoliosis manifest itself?

The segments pinched in the center of the curve hurt especially badly. There may be several of them, depending on the number of curves. It is these places that cause various symptoms of scoliosis. This may be pain in the neck (and sometimes a headache), pain in the shoulder blade area (sometimes radiating to the arm), pain in the lower back (sometimes radiating to the groin), pain in the coccyx area (sometimes radiating to the buttocks or leg). For some unknown reason, the complaints of patients with mild scoliosis are rarely taken seriously and they are unfairly considered malingerers, although they really are in a lot of pain.

The painful symptoms of scoliosis, caused by an excessive increase in the normal physiological curves of the spine, usually appear around the age of 30, when the structure of the tissues changes. Pain from a disease such as scoliosis can appear as early as age ten and remain for life, gradually increasing until you seriously address this problem.

How to recognize scoliosis?

Scoliosis is easy to diagnose. The main method used by specialists is called the "tilt test." The patient is asked to lean forward and relax the upper limbs. If asymmetry is visible to the naked eye, the doctor can diagnose scoliosis. The main signs of scoliosis are a strong and noticeable curvature of the spine, a protruding hip or shoulder blade. X-rays are used to determine the percentage of curvature of the spine, the presence of congenital deformities. Based on the information received, the type of scoliosis is determined: congenital or idiopathic, the degree of scoliosis, the presence of changes in bone tissue. Having received detailed information, doctors can prescribe appropriate treatment.

Scoliosis typically occurs first at the lower spine, and then a secondary curve forms at a higher level to compensate for the lower one. As a result, the spine is tilted twice from its central axis to allow the head to sit squarely on the shoulders and the eyes to focus.

When one leg is shorter than the other, the spine, compensating for this deficiency, usually bends predominantly in one direction. For example, if the right leg is shorter and the pelvis tilts to the right, the spine curves to the right, forming a lateral bend with a convexity to the right. In this case, another bend will appear higher, smaller, with a convexity to the left, tilting the spine in the other direction.

Scoliosis is fraught with great troubles, since in the anterior-posterior direction the ligamentous attachments on the sides of the spinal column are not strong enough. Unlike movements, which are supported by a variety of structures, only the walls of the discs prevent the segments from sliding to the side.

The vertebrae below the apex of the curve tend to slide to one side, and those above it to the other. Unfortunately, the vertebra at the very apex of the curve gets pinched in the middle, compressing the intervertebral disc below. The vertebrae shift off the center of their discs, and the discs shift to the side. The disc at the center of the curve flattens, and the discs next to it stretch in opposite directions. In either case, the walls of the discs become deformed, and the discs themselves become denser. Several adjacent discs become thinner, and their vertebrae become clumsier.

Modern medicine distinguishes four degrees of gradual development of scoliosis: The first degree is a slight curvature of the spine, which can be very noticeable only in a standing position. In a lying or sitting position, the curvature disappears and is not determined by X-ray. The second degree is if the angle of curvature does not exceed 25 degrees. The third degree is already fixed scoliosis, in which the angle of curvature tends to 50 degrees. The fourth and most severe degree is if the angle of curvature of the spine is higher than 50 degrees. The so-called rib hump is visible to the naked eye.

How to prevent scoliosis?

Scoliosis is a disease that develops mainly in childhood and requires mandatory prevention. Posture control while sitting at a school table or desk, active games, morning exercises - these simple rules, along with mandatory medical check-ups, can ensure the prevention of scoliosis at an early age.

With a noticeable curvature of the spine, special attention should be paid to daily physical exercises: in the initial stages of the disease, the benefits of breathing exercises and exercises to strengthen the back muscles have been proven. In conservative (non-surgical) treatment of scoliosis, swimming or simple exercises in water (aqua aerobics, as an option), therapeutic massages and corset therapy are mandatory.

In particularly difficult cases, when scoliosis reaches the third or fourth stage of development, surgical intervention will be inevitable.