Chiropractic for Scoliosis

Chiropractic for Scoliosis

         Scoliosis is the most common spinal deformity, and according to the American Association of Neurological Surgeons, scoliosis affects an estimated 6–9 million people in the United States. Many of those people are looking for healing without surgery if possible, and that is where chiropractic treatment becomes a beneficial option.

What is Scoliosis?

            Scoliosis is an irregular sideways curvature of the spine, and as the degree of curvature increases, this curvature, known as the Cobb angle, can cause other health issues such as difficulty breathing and decreased lung capacity. Scoliosis comes in many forms each with its own age of onset and cause. All forms of scoliosis do involve spinal curvature. However, some are less severe than others and harder to detect, which is why early intervention is critical. In general, scoliosis is broken into two categories, and then the types of scoliosis with specific diagnostic criteria fall under these two categories to determine the best treatment and severity.

Two Main Scoliosis Categories:

  • Nonstructural Scoliosis – also known as functional scoliosis, it is fairly uncommon and includes only a side-to-side curve of the spine without spinal rotation, comes from a temporary cause, and is considered less severe.

    • Common causes:

      • Inflammation – when an area near the spine becomes inflamed, a Cobb angle can result.

      • Muscle Spasms – when a large muscle in the back spasms, this can cause the spine to be pulled in one direction causing a Cobb angle.

      • Different Leg Length – the Cobb angle can present itself if one leg is longer than the other by a significant amount.

  • Structural Scoliosis – this is the most common scoliosis category, and unlike nonstructural scoliosis, structural scoliosis involves side-to-side spine curvature in addition to spinal rotation. It affects the structure of the spine, is permanent without treatment, and is considered more severe.

    • Types of Structural Scoliosis:

      • Idiopathic Scoliosis – this type is the most common, makes up about 8 out of 10 cases of scoliosis, and means that there is no single factor which contributes to the development of it. This type also is inclusive of all age groups, but usually appears in adolescence and can start in early childhood or even infancy. Some research indicates that genetics plays a role in idiopathic scoliosis, but research is continuing on the subject.

      • Degenerative Scoliosis – this type is late onset scoliosis also known as De Novo scoliosis or adult onset scoliosis which presents later in life as the joints in the spine degenerate, and is directly caused by age-related degeneration. It most commonly develops in the lumbar spine forming a slight C-shape, and it the curve exceeds 10 degrees, scoliosis is diagnosed.  This type also occurs in patients who have no prior history of scoliosis, and complain of low back pain, muscle fatigue, stiffness, and weakness or numbness in the legs.

      • Congenital Scoliosis – this type develops from spinal abnormalities in the womb, present in infancy, and very rare affecting only 1 in 10,000 newborns. It can result in a sideways curvature of the spine but can additionally develop other curves in the opposite direction which is the body’s way of compensating for the abnormality in the spine. Symptoms include uneven waistline, more prominently visible ribs on one side, head and shoulder tilt, and the body overall leaning to one side.

      • Neuromuscular Scoliosis – this type, also known as myopathic scoliosis, and develops secondary to other disorders of the spinal cord, muscular system, and brain. It becomes more sever in patients who can’t walk due to a neuromuscular condition such as cerebral palsy, muscular dystrophy, myelodysplasia, and spinal muscular atrophy.

In rare cases, scoliosis is caused by a tumor or spinal lesion. It is essential as healthcare providers that we understand the various types of scoliosis classifications so that we may have a foundation of comprehension of scoliosis as a whole, and perform spinal manipulations and exercises on those afflicted with scoliosis in our practice.

Chiropractic Benefits for Scoliosis

            Chiropractic is not to be misunderstood as a “quick fix” for scoliosis, but if patients affected by scoliosis get routine adjustments, it can help with overall spinal posture and alignment, improve quality of life, and decrease pain. Chiropractic works for scoliosis by decreasing strain on the muscles of the spine allowing better blood flow to those muscles that are damaged and decrease inflammation and pain.

Chiropractic Benefits for Scoliosis:

  • Non-invasive – especially in the case of scoliosis, many are searching for an alternative to surgery as this is usually a last resort if they’re experiencing pain.

  • Treat other conditions/issues at the same time – there are many other issues that often coexist with scoliosis such as hip, neck, and shoulder pain, headaches, and numbness in the limbs. Chiropractic can correct these subluxations to provide relief from other pain to help the patient feel better and improve quality of life.

In addition to these benefits, and going along with being non-invasive, it is also drug free. Many people in the United States manage their pain with over-the-counter medications which carry their own set of side effects and risks just like surgery. It is important to note that as providers when it comes to more severe conditions such as scoliosis that we make every effort to be integrative with the patient’s care and work with the other providers that are treating them.

Scoliosis Chiropractic Protocol

            One of the first things to do as a chiropractic provider even before a patient is involved is to be sure and get specialized training for scoliosis. It is a serious condition, and it is important that if you are a practice that is going to focus on conditions like scoliosis to do right by your patients and make sure you’re a specialist. There are multiple ways to further your education in scoliosis chiropractic, but there are two practice implementations that are the most popular.

Scoliosis Specific Certifications:

  • CLEAR Scoliosis Certification – This certification provides a comprehensive, evidence-based, and effective approach to achieving real results.

  • Schroth Method Certification – if you also have experience in physical therapy, or have a physical therapist on your staff, this method is beneficial to implement. The goal of the Schroth method is to use exercises customized for each patient’s unique spine curvature to de-rotate, stabilize, and elongate the spine as well as prevent scoliosis from advancing. These exercises include three components, muscular symmetry, awareness of posture, and rotational angular breathing. However, with this certification, you will either need to be a physical therapist yourself or have one on staff.

When the patient comes into the office, there are a few things you will want to look for.

Symptoms that indicate Scoliosis:

  • Clothes hang unevenly

  • Uneven hips

  • Chronic back pain or muscle spasms

  • One shoulder blade higher or protrudes out more than the other

  • Difficulty breathing because of decreased area in the chest for the lungs to expand

In general, a good protocol to follow for a scoliosis patient is as follows:

  • Physical evaluation – a comprehensive assessment should be conducted at the initial visit well as at regular intervals to refine the treatment plan and monitor progress.

  • Warm-Up – before adjusting, be sure the patient warms up their spine with things like a wobble chair (sits on a ball-and-socket joint and flexes in every direction), Eckard Flexion table (motorized table with belts that pull the curves out of the spine), or traction (a technique by the patient which relax ligaments and soft tissues of the spine).

  • Adjust the spine – use adjustments only based on the assessment of the patient at their initial visit. Adjusting instruments such as the activator enhance results while decreasing the force needed to correct the spine.

  • Hold in Spinal Corrections – after the adjustment, it is important to instruct the patient on at-home scoliosis exercises for neuromuscular re-education in order to “set” the spine in its corrected position.

Should I Specialize in Scoliosis Chiropractic Care?

So many patients dealing with scoliosis are funneled toward spinal surgery, and not offered other treatment options such as chiropractic, which could be helpful. A study from 2011, Outcomes for Scoliosis Patients Receiving Chiropractic Rehabilitation, found sustained radiographic, self-rated, and physiologic benefits at the conclusion of chiropractic treatment and 24 months after.

Specializing in chiropractic care for scoliosis can be a great way to help patients relieve many of the symptoms and discomfort associated with this condition.