Unlike functional scoliosis, structural scoliosis is not a simple lateral curve of the spine. It involves a more complex three-dimensional deformity of vertebrae. Thus, the side to side curvature we see is normally a product of two abnormalities.
- Increased lordosis (like the bend in your lower back)
- Abnormal rotation of individual vertebrae with respect to one another
Structural scoliosis is actually very common. Normal” children have neither straight nor symmetrical spines. Fifteen per cent of children show evidence of a lateral curvature on a visual examination and as many as 30 per cent with a more accurate measurement. Anatomists two centuries ago clearly demonstrated that everyone had a scoliosis, albeit of small magnitude (Dickson 1984). Structural scoliosis is also 7 times more common in women.
It can be classified by the type of curve that is seen or by the age it develops i.e.
- Infantile,
- juvenile,
- adolescent
By far the majority of cases are adolescent onset and screening of children allows early intervention to minimise progression.
Doctors measure the size of the curve from X-rays using the Cobb technique. A curvature of 20 degrees or more is considered significant, but this is rare. For example, only 2-5 people per 1000 with structural scoliosis of thoracic spine have a curve of 20 degrees or more.
Most structural scoliosis cases (80%) are of a type called ‘idiopathic scoliosis’. Idiopathic just means that no one knows why it occurred. For the rest these is a laundry list of conditions that lead to scoliosis, but some include:
- Congenital (bone abnormalities present at birth)
- Neuromuscular conditions such as
- Cerebral palsy
- Muscular dystrophy
- Connective tissue disorders
- Marfan’s syndrome
- Rheumatoid arthritis
- Certain dwarves
- Trauma
- Fractures
- Irradiation
- Surgery
You may need to consult an orthopaedic or neurosurgeon, and treatments in severe cases may include a ‘Harrington’ metal rod, and / or bone grafts to stabilize the spine.
People with structural scoliosis are often afflicted with great back pain. They have tremendous muscle fatigue, because day-in & day-out for years, the muscles around the spine have to stabilise the body around a bent spine. This is very hard work indeed. Fatigued muscles cells sustain damage & release chemicals of inflammation. These cause fluid accumulation & muscle swelling, and pain.
Physical therapy can help relieve pain for people with structural scoliosis, however the treatment needs to be regular and ongoing to be beneficial because the back muscles are continually over worked. If you have structural scoliosis and would like some advice, please come see us at the clinic.
Article Written + Submitted by:
Andreas Klein Nutritionist + Remedial Therapist from Beautiful Health + Wellness
P: 0418 166 269