To coincide with Scoliosis Awareness Week this week, we at Hands On Osteopathy wanted to offer some insight into the intricacies of scoliosis—often depicted as being a mysterious condition of the spine. ‘Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty’ (Mayo Clinic, 2018). It is thought to be a multigene dominant condition with variable phenotypic expression (meaning multiple genes are involved to produce it as a dominant trait, and it can be expressed in multiple differing ways) (Reamy & Slakey, 2001). This condition develops as a result of incomplete union of the vertebrae (the ‘block’ component of the vertebrae structure), where asymmetrical formation results in curvature of the spine during periods of growth spurts, predominantly from 10–15 years of age (WebMD, 2019). ‘High rates of scoliosis are observed amongst dancers and gymnasts. Research has shown adolescent dancers are at significantly higher risk of developing scoliosis than non-dancers of the same age’ (Longworth et al., 2014). The prevalence of the condition in the at-risk population (10–15 years of age)is 2-3 per cent (Gutknecht et al., 2009), however the condition’s prevalence increases between 11–14 years of age (Sabirin et al., 2010). Full assessment and diagnosis are typically assisted through clinical testing by a practitioner and the use of diagnostic imaging (namely X-ray). Together with the radiologist performing the imaging, manual practitioners (osteopaths, chiropractors and physiotherapists), treating the patient determine the particular different angles to investigate. The general practitioner involved in the patient’s case will be aware of these specific angles and orthopaedic tests used to determine the presence of scoliosis.
Once the patient’s specific angles in certain regions of the spine are determined, they are compared with normal parameters and a subsequent ‘grading’ of severity of scoliosis can be provided. Depending on the severity, an adolescent patient may or may not require surgery. The more severe the scoliotic curve and its progression, the higher the necessity of surgical intervention (WebMD, 2019).
A dear patient of mine at Hands On suffers from scoliosis at the age of seventeen. She has been receiving osteopathic treatment for twelve months for the compensation patterns associated with her thoracolumbar scoliosis (meaning the scoliosis spans between both the thoracic and lumbar regions of the spine). Treatment through clinical matwork pilates not only provided relief for my patient but also the conditioning necessary in preparation for the spinal surgery she underwent. Regular osteopathic treatment, pain relief and sheer willpower have been the only elements my patient has been able to implement to eliminate the pain she experienced daily. Following spinal surgery and up to nine weeks of recovery, my patient will be able to participate in normal activities of daily living and complete her Year 11 and 12 schooling, pain free. A key factor I want to highlight in the case of this patient is that she was a dancer up until a few years ago, before pain stopped her from doing what she loved most. Recent clinical studies have discovered that, of scoliotic patient demographics, female dancers in their adolescent years tend to show a prevalence towards this condition (Spinal Research, 2019). As an osteopath passionate about scoliosis, the question I want to pose is: Despite signs or symptoms, should all medical professionals implement early scoliotic screening to ensure young individuals with this condition do not remain undiagnosed until it’s too late for intervention—particularly females with a background in dance? The common comment in relation to this condition is ‘…parents often don’t notice the warning signs of this condition until it is too late’ (Spinal Research, 2017). In recognition of Scoliosis Awareness Week, I urge you all to pass this information on to your family, friends, friends of friends and colleagues—anyone who you feel may benefit and could be assisted by greater knowledge about scoliosis and its detection, surveillance and management. Thank you in advance. Look after yourself. Lenore
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