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Scoliosis: what causes and how to recognize?

 
, medical expert
Last reviewed: 18.10.2021
 
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Scoliosis is the curvature of the vertebral column in the lateral plane, clearly visible when viewed from behind. He can be innate or acquired. If the scoliosis is relatively stable and does not cause displacement of the vertebrae, the pathology will be limited to the pinching of the segments. If the spine not only deviates to the side, but also twists, there may be problems with arcuate joints. 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 most rare and has three or more bends in different directions.

If you meet the 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 years, were not discerned. Therefore, if you are interested in an accurate diagnosis, ask your doctor what exactly it meant.

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What causes scoliosis?

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

Of the more complex causes of scoliosis, we can distinguish such diseases of the musculoskeletal system as rickets or paralysis, birth defects, radiculitis, or severe lesions of the central nervous system. If we talk about rickets, the spine begins to deform with the development of the disease and continues to bend even when rickets is at the cure stage. Because of the incorrect position of the child while sitting at the table, the spine is subjected to a load that is prohibitive for the growing organism and, accordingly, deforms, this causes scoliosis.

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

How does scoliosis manifest?

Braced in the center of the bend, segments hurt especially strongly. There may be several, depending on the number of bends. It is these places that cause a variety of scoliosis symptoms. It can be a pain in the neck (and sometimes a headache), pain in the shoulder area (sometimes giving up in the arm), pain in the lower back (sometimes giving in the groin), pain in the coccyx region (sometimes giving to the buttocks or leg). For some reason, complaints of patients with mild scoliosis are rarely taken seriously and they are considered unfairly as simulators, although they are really very painful.

The painful symptoms of scoliosis caused by an excessive increase in normal physiological curves of the spine usually appear at the age of about 30 years, when the tissue structure changes. The pain from such a disease as scoliosis can appear at the age of ten and stay for life, gradually increasing, until you come to grips with 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 his upper limbs. If the asymmetry is noticeable with the naked eye, the doctor can diagnose scoliosis. The main signs of scoliosis - a strong and noticeable curvature of the spine, protruding toward the hip or scapula. With the help of X-ray images determine the percentage of curvature of the spine, the presence of congenital deformities. Based on the information received, determine the type of scoliosis: congenital or idiopathic, the degree of scoliosis, the presence of changes in bone tissues. Having received detailed information, physicians can prescribe suitable treatment.

Usually scoliosis first occurs in the lower part of the spine, and then at a higher level a secondary bend is formed, which compensates for the lower one. As a result, the spine deviates twice from its central axis, so that the head is directly seated on the shoulders, and the eyes can be focused.

When one leg is shorter than the other, the spine, compensating for this deficiency, usually curves mainly in the same direction. For example, if the right leg and pelvis are shorter to the right, the spine is curved to the right, forming a lateral bend to the right. In this case, above appears another bend, smaller, convex to the left, inclines the spine in the opposite direction.

Scoliosis is fraught with big troubles, because in the anteroposterior direction the ligamentous fastenings on the sides of the spine are not strong enough. In contrast to movements that are supported by a variety of structures, slipping of segments to the side is hampered only by the walls of the disks.

The vertebrae, located below the bend vertex, tend to slip to one side, and above it to the other. Unfortunately, the vertebra at the very top of the bend is jammed in the middle, squeezing the intervertebral disc located below. The vertebrae are displaced from the center of their disks, and the disks are shifted to the side. The disc in the center of the bend is flattened, and the adjacent ones are stretched in opposite directions. In any case, the walls of the disks are deformed, and the discs themselves are compacted. Several adjacent discs become thinner, and their vertebrae are more sluggish.

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

How to prevent scoliosis?

Scoliosis is a disease that develops primarily in childhood and requires mandatory prevention. Control of posture while sitting at a school desk or school desk, mobile games, morning exercises - these simple rules, along with mandatory examinations of doctors, can provide a warning of scoliosis at an early age.

With a noticeable curvature of the spine, special attention should be given to daily physical exercises: at the initial stages of the disease the use of respiratory gymnastics, exercises for strengthening the muscles of the back is proved. With conservative (non-operative) treatment of scoliosis, swimming or simple exercises in water (aquaerobic, as an option), therapeutic massages and corsetotherapy are mandatory.

In particularly difficult cases, when scoliosis acquires a third or fourth degree of development, surgical intervention is inevitable.

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