Definitions: lateral curvature of the spine
A curve is identified by the side of the convexity (the side it sticks out to) and the area that it affects (cervical, thoracic, lumbar)
Types:
- congenital scoliosis
- idiopathic (unknown cause) infantile (birth-3 years), juvenile(3-9years old), adolescent (10-19 years old) scoliosis. Most common is adolescent girls. A young girl that has not reached menarche is at much higher risk for scoliosis progression than a girl 2 years after onset of menses (skeletally mature).
- neuromuscular conditions such as poliomyelitis, cerebral palsy , muscular dystrophy ,amyotonia congenita , Friedreich’s ataxia, spina bifida
- mesenchymal disorders : Marfan’s syndrome ,Morquio’s syndrome ,rheumatoid arthritis
- postural (functional) scoliosis – postural misalignment due to habitual patterns of use
- Hysterical scoliosis- a non-structural deformity of the spine that develops as a manifestation of a psychological disorder.
Classification of severity of curvature:
- Mild – curves of less than 20 degrees. Normal is often considered to be curves of 10 degrees or less
- Moderate -20 – 50 degrees with early structural changes in the vertebrae and rib cage
- Severe- 40 -50 degrees or more with significant rotational deformity of the vertebrae and rib cage, pain and degenerative joint disease are often present. Curves of more than 60-70 degrees are associated with cardiopulmonary changes.
Causes: Idiopathic scoliosis means that there is no known cause. Some possible causes are scar tissue, spasm or proprioception problem, sensory-motor amnesia, abnormal postural control because of vestibular system dysfunction, imbalanced posture due to trauma, food allergies, side dominance
Signs/Symptoms:
- rotation and lateral flexion of the spine often with fixed rotation of the vertebrae
- uneven leg length
- uneven muscle development in legs and back
- muscle pain from spasm, atrophy and overuse
- arthritis
- stenosis of the spinal column
- nerve compression
- Scoliosis may be related to or cause the following: TMJ, thoracic outlet syndrome, carpal tunnel syndrome, quadratus lumborum dysfunction, shoulder/forearm tendinitis, plantar fascitis, achilles tendinitis, sacro-iliac strain or dysfunction, headaches, digestive problems, dizziness
Measurements:
- asymmetric shoulder level
- prominence of the scapula on the side of the convexity
- protrusion of the hip to one side
- asymmetrical ASIS
- increased lumbar lordosis
- leg turn out (laterally rotated leg)
- foot problems such a flat feet on one foot more than the other.
Treatments: structural integration,
lengthen structures on the concave side, lengthen hip flexors and erector spinae: strengthen the muscles on the chronically weakened side, decompress joints
Other helpful therapies include acupuncture, physical therapy, pilates, movement therapies, eliminate food allergens
Resources:
Getting it Straight Scoliosis and Structural Integration By Lana Lensman : Massage and Bodywork Magazine
Straight Talk Symptomatic Scoliosis By Erik Dalton : Massage and Bodywork Magazine
CASE REPORT (pdf Massage therapy foundation.)Impact of massage therapy in the treatment of linked pathologies: Scoliosis, costovertebral dysfunction, and thoracic outlet syndrome Michael Hamm, LMP
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