Alternative Scoliosis Treatment - The Law of Conservation

The law of conservation tells us that matter cannot be created, nor destroyed. It's a law. No exceptions and, honestly, I don't think anyone is in dispute about it. So why, then, isn't being applied to the concept of idiopathic scoliosis treatment which is a 3 dimensional (front to back....Aka: sagital dimension, side to side....Aka: coronal dimension, head to toe....Aka: vertical height) spinal deformity? Think about it. The spine is straight on day and crooked the next. The bones haven't changed, the discs haven't changed, the ligaments and muscles don't change that quickly. In fact, there isn't anything wrong with the idiopathic scoliosis patient's spine, except for the fact that is crooked.

Everyone knows the shortest distance between 2 points is a straight line and that is exactly what the non-scoliotic spine does when it connects the head to the pelvis. However, the scoliosis spine twists and curves a crooked path when connecting the head and hips, which requires more spinal matter to travel the longer distance demanded by taking the crooked path. This begs the question, "where does the extra spine to travel the longer distance demanded by taking the crooked path come from?" It is almost as if the patient has "gained" more spine in the front to back dimension that it can hold and it is buckling off to the sides.

Most people assume that it comes from the vertical dimension (height), but we don't see any correlation between adolescent idiopathic scoliosis patient's curve progression and a loss of height. Some people think it is just a matter of rapid, uneven bone growth, but the time frame in which the curve progression advances is much too fast to be attributed to rapid, uneven bone growth and even then we don't see a large amount of vertebral body wedging during the early stages of rapid idiopathic scoliosis progression.

So where does this "extra" scoliosis spine in the side to side dimension come from? Well, it appears that it's being "lost" from the front to back dimension. The normal side view (called the "sagital" dimension) of the human spine should have forward curves in the neck and lower back, with a backwards curve in the mid back. This normal side view profile is distorted and diminished in 100% of all idiopathic scoliosis patients. This critical piece of information dramatically affects how one goes about treating the scoliosis spine, because its self-evident that one must create space in the normal side view of the spine BEFORE attempting to push the crooked spine out of the side to side crooked dimension. Essentially, all scoliosis treatment including alternative scoliosis treatment needs to focus on re-storing the sagital spine back to normal, before it can start transferring the spinal gains out of the coronal dimension.

Otherwise, it would be like (metaphorically) trying to fit 7 cars into a 3 car garage.....Not going to work out very well.

3-D effects of idiopathic scoliosis on the spinal cord

No other part of the human body comes under more stress due to scoliosis than the spinal cord. This is primarily, because the 3 dimensional spinal deformity caused by scoliosis stretches, pushes, pulls, and compresses the spinal cord in all 3 dimensions.
The spinal cord is really just an extension of the brain stem which houses all of the automatic postural control centers and is ultimately anchored to the pelvis at the bottom of the spine. This means the cord and brain stem are functionally linked and tied down pretty tight.

Dr. Alf Breig studied the relative lengths of spinal canal and cord CAN lead to pathologic axial tension of the spinal cord by back in 1978.

In 1981 another researcher (Roth) added to Breig's work when he speculated that idiopathic scoliosis is a disproportion of vertebral and neurological growth due to either a short spinal cord or overly rapid growth spurt of the spine.

The spring/string model. (think of a slinky with a string running though it)
Roth found that shortening of a string running though a spring model hindered elongation of the spring resulting in a scoliotic deformity.

The uncoupled neuro-osseous growth concept presented by Porter supported the notion of idiopathic scoliosis as a physical manifestation of the mal-adaption of the growing immature spine to the tether created by the short spinal cord.This evidence for this was the finding that the conus medullaris (the end of the spinal cord) position is NOT significantly different from that of a normal spine.

In 2007, Dr. Chu (comparing AIS patients with severe curvatures vs. normal subjects) re-examined the Roth-Porter theory via an MRI study. They found the vertebral column in the idiopathic scoliosis population was much longer, yet the there was no detectable change in spinal cord length. Chu speculated that the initiation and progression of idiopathic scoliosis is the result of vertebral column over-growth through a subclinical tethering of a relatively short spinal cord.

Despite the Hype, There Are Still Only Three Approaches to Scoliosis Treatment

I happened upon a page on the American Chiropractic Association (ACA) Web site that explained scoliosis and its treatment options. Interestingly, the ACA lists three options for scoliosis treatment: careful observation, bracing, and surgery. Missing from this list are several commonly advertised methods of treatment for scoliosis. Most notably omitted is chiropractic. Despite a plethora of aggressively promoted options that are available to patients and their families, we think the ACA actually got this right.

To simplify this article, let us assume that the ACA included surgery as an approach for severe scoliosis cases only. Orthopedic surgeons cannot prescribe surgery for curves less than 45°. These cases would transcend an observation-only approach and push the limits of brace effectiveness. Therefore, let's continue without surgery as one of the three approach options. Agreed? Good.

Next, let's ponder the observation approach, which is commonly known as the "wait and see" approach. Although an important practice, technically there is no scoliosis treatment inherent in taking scoliosis curvature measurements every few months. Patients should consider the observing specialist's scoliosis specialty. Orthopedic surgeons do surgery and might prescribe a rigid brace if the curve is below the surgical threshold, yet is progressing. Surgeons have their eye on patients reaching the threshold for surgery. There is also a specially trained group of chiropractors who offer a flexible brace that can be worn to correct and stop progression of curves ranging from 15°-45° degrees. This is called the SpineCor Brace. So, as the orthopedic surgeons' specialty is surgery, the SpineCor chiropractors' specialty is maintaining healthy spines. So, while surgeons focus on the progressed condition, chiropractors know their chances of treating scoliosis successfully are greater if detected and treated early.

There are a group of chiropractors, physical therapists and others who offer alternative treatment to manipulate scoliotic spines. On its Web site the ACA states that "Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis... " Despite the ACA's omission spinal manipulation (chiropractic) and therapies from its list of viable approaches plus the lack of clinical studies showing effective treatment, several providers are still leveraging popular exercises and therapies with catchy titles to lure patients. One such method uses the allure of a speedy fix, which entails a two-week "boot camp" - a trendy phrase that denotes focused exercises - which is coupled with an exercise regimen to be completed at home. Sounds simple, right? Unfortunately, this method has no randomized clinical study results to support the claims of the providers. Secondly, common sense tells you that scoliosis, which took months and perhaps years to progress, cannot be corrected in a matter of a couple or few weeks, no matter how many high-force gadgets and equipment the providers use to pull or push your spine in one direction or another.

We are all aware of the benefits of exercise such as yoga and pilates. However, for scoliosis sufferers these activities are likely to have little to no effect and can actually destabilize the spine if they are not in a flexible brace like SpineCor while exercising.

Schroth exercises have some enthusiastic support. However, the problem with these exercise regimen is that they are not administered to match the specific scoliosis curve of the sufferer. SpineCor, a company that offers a dynamic (flexible) scoliosis brace, developed a physiotherapy a regimen that specifies an exercise regimen that addresses many specific scoliosis curve types and is complemented the SpineCor Brace configuration.

When it comes to the bracing approach, there are two general types: rigid braces, i.e. the Boston, Rigo Cheneau, and Milwaukee braces; and the aforementioned SpineCor brace, which is the only clinically proven dynamic brace. The differences are huge. First of all, although Orthopedic Surgeons tend to recommend rigid bracing, clinical studies for these braces is dismal, causing many to wonder why they are so commonly prescribed. A big cause of failure with rigid braces, which are used only for pediatric cases, is lack of compliance due to discomfort and embarrassment. Rigid braces also make exercise almost impossible and are known to cause muscle atrophy when worn for prescribed periods.

Conversely, the SpineCor Flexible Scoliosis Brace allows patients a full range of motion and has a much lower profile, allowing it to be worn underneath clothing and while playing sports and completing exercise such as yoga and pilates. Both of these features increase the chances of full compliance. Furthermore, clinical studies comparing rigid braces to SpineCor show SpineCor achieved a much higher degree of success.

Choosing An Alternative Scoliosis Treatment Provider

Alternative scoliosis treatment options vary greatly and can offer promising results but buyers beware. Websites that offer exciting new methods of treating scoliosis demonstrating results that seem too good to be true are often scams. The best way to discover whether or not a website offering alternative scoliosis treatment which is defined as treatment other than a medical standard of care such as rigid bracing or surgery is to conduct further research. A great place to start is to determine who is selling the treatment. If the treatment is not provided by a licensed healthcare professional such as a medical doctor, chiropractor, or physical therapist then quickly move on your child's health is not worth the risk. The next step is to do a personal Google search of the provider of these scoliosis treatment methods to see what their background is and what kind of training or education is involved. In addition search any articles or publications by the provider and read their material which is an excellent way to familiarize yourself with their approach. The last step is to forward your clinical information directly to the provider and ask for a phone consultation to determine whether or not you feel confident in choosing this person to care for you or your child. In some instances you may even request to speak with others who have received scoliosis treatment and see if they had a good experience and outcome.

The interesting thing about healthcare is that when it comes to procedures and not just prescribing a medication, there is a significant difference in results based on skill level and knowledge of the clinician. This couldn't be more true when choosing an alternative scoliosis treatment provider for your child. The majority of alternative therapies are performed outside the medical profession by chiropractors and physical therapists. So digging pretty deep and trying to find the most experienced leader of the pack is worth the extra time rather than just settling for the clinic next door that may provide that treatment method. Practitioners who have leadership and teaching roles are more likely to be up to speed on the latest advances in procedures and have more experience in general.

When choosing an alternative technique check to see if case studies are available, some methods may not have published research based on many obstacles like funding and length of time data has been collected. The fact that they are not published in a journal doesn't necessarily mean the program of care is not valid. Look for doctors and therapists that have innovated new procedures or equipment relative to scoliosis, again this sets them above the general pack that may have just gotten the certificate for completing the required courses and aren't as invested in their name remaining reputable, especially nationally. Clinics that have clients from outside their region are also a good indicator that they may know more than other centers closer to you and may be well worth the drive or flight.

When it comes to choosing an alternative scoliosis treatment provider make sure to do your research. The person you decide to hire may the successful step that prevents more invasive treatment options from being recommended or avoided.

The Unique Method of Scoliosis Treatment

The main law of osteopathy says: "When all parts of the human body are in line we have health. When they are not the effect is disease.

Disease is the result of anatomical abnormalities. The dysfunction of one part of the body may frequently lead to discomfort in another part, because the human body doesn't function in separate units but only as a harmonious whole. When the parts are readjusted disease gives place to health.

Osteopathic treatment is UNIQUE in the way that it provides a holistic approach. It is based on treating the whole body. Osteopath works with all body system and internal organs. The first and necessary task of the treatment is to adjust the body from abnormal to normal and put the organs in the right anatomical position.

In our clinic, osteopath diagnoses scoliosis. Specialist, using both visual and computer-based diagnostics determines the state of the spine, posture, position of the shoulders and shoulder blades, the patient's muscle tone. Changes in the internal organs because of deformation of the spine show a "visceral syndrome", which requires specialized treatment.

Scoliosis affects the functioning of the whole body. Scoliosis resulrts in rib deformity, digestive problems, shortness of breath, chronis fatigue, acute or dull back pain, dysfunction of internal organs.

I developed the method of scoliosis treatment with osteopathic techniques. This scoliosis treatment consists of consecutive manipulation techniques that can be described as follows:

1. The elimination of thoracic blocking
2. Putting structural, visceral and cranial organs in their anatomical position
3. Putting shoulder blades in their anatomical position

The standard medical approach to the treatment of scoliosis has not changed for years. Our method of scoliosis treatment is unique because I treat scoliosis with gentle osteopathic techniques. Treatment plan is individually developed for each patient depending on the patient's age and curvature.

The treatment includes a special set of exercises, as well as nutrition program and dietary supplements.

One of the laws of osteopathy says "function affects the structure." In a well-balanced and optimally functioning body fluids move in a certain direction. Scoliosis affects the body fluids flow. Osteopathic treatment eliminates the tension of membranes that improves the flow of tissue fluid, lymph and blood. It also helps the proper distribution of body weight. Fluid technologies is widely used in osteopathy. This fluid flow factor has a powerful effect in the scoliosis treatment and posture disorders.

Osteopathy gives very good results even if patients come with severe scoliosis It helps to improve not only posture but the overall condition of a patient. Good posture improves immune system and increases the tone of the central nervous system.

Everyone knows that most of elderly people start to slouch. People who regularly visit an osteopath have a good posture. Among them even elderly people have good posture and health.

In conclusion I would like to quote the words of Dr. Still: "The human body is a masterpiece created by the greatest architect by the name God, and who is never wrong." Yes, all of us is affected by gravity and atmospheric pressure, but if the person is well balanced, he stays healthy. Osteopath is a mechanic who repairs and balances the biological "machine" - the human body. Everobody should take care of posture and osteopathy is another choice in the scoliosis treatment and posture defects.

Scoliosis Treatment 101 - The Successful Management of Adolescent Idiopathic Scoliosis

Understanding your child's diagnosis of idiopathic scoliosis can be difficult to say the least. Approximately 4 out of every 100 children in your community will have scoliosis. The most common form of idiopathic scoliosis (no known cause) is adolescent scoliosis which makes up about 80% of those diagnosed or 3.2 of the 4. Adolescent idiopathic scoliosis is defined as a scoliosis of the spine that is diagnosed between the ages of 10 and 16 or before the bodies bones are done growing referred to as skeletal maturity.

Skeletal maturity is determined by a RISSER score which measures the growth plate of the hip bone. A Risser I means there is only 25% bone closure, Risser II is 50%, Risser III is 75%, and Risser IV is 100% closure and growth is slowing way down. A Risser V means complete cessation of growth. This will become more relevant in later discussions.

As a parent you have to quickly understand a few terms and concepts when dealing with a diagnosis of scoliosis. The first key concept is the progressive nature of this condition. Severe progression is likely to occur in 25% of children diagnosed with AIS (adolescent idiopathic scoliosis) so 75% of kids will likely not have a curve in their spine that worsens to a surgical level of more than 40 degrees. Of the 25% with increased risk of progression only 1% of the children in this group will be at a high risk considered 99% chance for developing a surgical level scoliosis of greater than 40 degrees.

A brief recap of the discussion so far, nobody knows what causes scoliosis, it is generally diagnosed between ages 10 and 16. 75% of the time it won't reach 40 degrees, 24% of the time it is likely it will reach 40 degrees and 1% of the time it will definitely reach 40 degrees. These statistics are referring to the natural course of the condition so in order to affect the outcome you need to do something that will alter the natural course.

The next term to familiarize yourself with is the Cobb angle which is the accepted standard measurement for a spine that is crooked or bent more than 9 degrees. The Cobb angle is measured in degrees and is a very simplistic way to get a feel for the severity of curvature. There are much more sophisticated ways of measuring scoliosis but most doctors still use this method. The number is given to you at diagnosis which can range from 10 degrees to upwards of 100 degrees depending on what satge the scoliosis is discovered. The Cobb angle will be categorized into three main groups, according to the AMA, 10-25 is early stage or mild scoliosis, 25-40 is moderate scoliosis, and a spinal curvature above 40 degrees is considered advanced progressive scoliosis. A severe scoliosis is considered by most authorities to be 60 degrees or higher. The term severe is used in reference to the potential influence of scoliosis on the pulmonary system causing a decrease in breathing capacity.

The current medical model for scoliosis treatment consists of three categories which are essentially all determined by the Cobb angle measurement. Spinal curves between 10-25 degrees are observed generally for a 6 month period before another measurement is taken via x-ray. If the scoliosis remains under the 25 degree barrier they will continue on the 6 month schedule until your child reaches skeletal maturity. Spinal curves between 25-40 degrees are prescribed a spinal orthosis for scoliosis brace treatment.

Scoliosis brace treatment involves a fitting session with an orthotist, who is a specialist in making spinal braces. The goal of this session is to create a brace that forces the spine straighter in an attempt to halt progression. The doctor will then recommend a timeframe that your child wears the brace generally everyday for 20+ hours is recommended. After a period of again 6 months an x-ray is performed to see if the scoliosis is not getting worse. If it is not getting worse the same recommendations are given regarding scoliosis brace treatment until either your child reaches skeletal maturity or the curvature gets worse. If the scoliosis continues to get worse even with scoliosis brace treatment the doctor will still recommend wearing the brace until the measurement reaches the 40 degree surgical threshold at which time a consultation occurs between you and the surgeon to explain the fusion procedure and schedule a time to ultimately perform the procedure.

Let's again recap the information so far. We don't know what causes scoliosis, it is a progressive condition and 25% children have increased risk of reaching 40 degrees. If a scoliosis curvature approaches the 25 degree barrier, scoliosis brace treatment is recommended. If the scoliosis brace doesn't work and it approaches the 40 degree level a spinal fusion surgery is performed to halt progression and make the spine straighter. The management of scoliosis is done by the orthopedic community and has been done the same way for decades. The only changes to this medical model are some different styles of braces and different surgical techniques.

Successful management of adolescent idiopathic scoliosis is more about making informed decisions versus following scoliosis treatment dogma. Burying your head in the sand and essentially allowing the medical industry to manage your child's scoliosis is the equivalent of letting a surgeon remove your leg without giving you a reason why. Scoliosis treatment and scoliosis prognostication has changed immensely in the past 5 years. The medical community's scoliosis treatment model has not caught up with the current understanding of what makes this condition tick. So in a sense the scoliosis treatment model continues to do the same old thing even though there are several breakthroughs in understanding its cause and cure. Not unlike a medication that remains on the market for a year even though it is known to cause kidney damage until eventually it is pulled from the shelf with little apology to all the people that now have kidney damage from using it. In this example if you were to dig a little before taking the medication you may have learned about its well known side effects and decided not to take it rather than just following doctors orders.

Understanding the statistics is the first step in proper management of scoliosis treatment. The second step is having a proper game plan that moves from least invasive to most invasive and avoids doing nothing. As a parent you have the right to make decisions and ask questions this is your child we are talking about. The first step to proper scoliosis management, understanding the statistics, is achieved by getting a scoliscore. The genetic test should be performed upon initial diagnosis to determine your child's genetic risk factor. It is a simple saliva test that is covered by insurance. The reason this is extremely important is it will allow you to quickly categorize your child into one of three risk levels, low risk, intermediate risk, or high risk of developing severe scoliosis. Once you have this test performed the second step regarding your game plan is to take a proactive position rather than a reactive position.

A proactive approach simply means start scoliosis treatment immediately. The watching and waiting mentality is not a treatment strategy it is a gambling strategy. This overwhelming complacency within the medical model regarding mild early stage scoliosis is foolish. For instance even if your child has a 15 degree scoliosis and is in the 75% low risk genetic category they still are at risk for their curvature to get worse. It most likely won't reach surgical levels of 40+ degrees but the genetic test only predicts progression to this level of curvature so a 15 degree scoliosis can with a low genetic score still progress to let say 35 degrees. A 35 degree scoliosis is at further risk of progression in adulthood and may place your child at a significant risk for developing pain and a decreased quality of life. On its way to reaching 35 degrees you will enter the 25-40 treatment zone which will unfortunately put you in the orthotist's fitting room for scoliosis brace treatment. My point here is that LOW risk doesn't mean that you can go home and forget about it because the doctor said it essentially won't progress to 40.

A truly proactive approach means that you will have to take the initiative to search for available scoliosis treatment methods for mild scoliosis. There will be a couple of different options. Scoliosis is broken down, like all diseases, into two primary factors that ultimately control the magnitude or expression of the disease, one being genetics, and the other being our environment. Since you can not change your child's DNA you have to look for the best ways to alter and reduce the environmental factors influencing the progressive nature of the condition. So for mild scoliosis where observation is generally recommended you need to have a better understanding of environmental influences on scoliosis. Most experts agree that scoliosis is not a condition involving bones, or muscles but mainly involving the nervous system with some other biochemical factors as well.

New information regarding scoliosis etiology and prognostic testing such as scoliscore and the soon to be available scoliosis blood test reveal very specific control factors that are thought to heavily influence progression. Things that have been tried but have shown not to influence these factors and therefore not alter the natural course of scoliosis are physical therapy, chiropractic adjustments, electrical stimulation, and spinal bracing. Scoliosis treatment options that are thought to influence scoliosis expression involve neuromuscular reeducation techniques designed to alter the brain's control over body posture. This rehabilitation treatment affects neurological control of spinal alignment using balance boards, vibration therapy, and body weights. By altering the postural control methods early on your child has the best chance of changing imbalances from the environment that are involved in the progression of scoliosis. The other factor that may play a significant role in biochemistry of scoliosis expression is selenium deficiency. Selenium is a mineral which has been found in low levels with children with scoliosis. Selenium influences osteopontin a chemical that affects spinal growth plate activity.

To summarize this discussion and help you take control of your child's scoliosis treatment plan I would recommend the following steps be taken. Your child receives a radiographic measurement of the scoliosis curvature and a scoliscore genetic test. You then enter your child in a proactive scoliosis treatment program using neuromuscular training of posture. Your child should be tested for selenium deficiency and be place on an appropriate supplementation program if deficiency is present. In addition you need to gain a better understanding of potential biomechanical risk factors like backbends and heavy backpacks.

The key to successful scoliosis treatment management lies with avoiding status quo thinking and gaining a current understanding of what scoliosis statistical analysis using genetic predisposition is all about and those environmental factors that are most influential on the progressive nature of the scoliosis condition. Following doctors orders when it comes to scoliosis treatment recommendations will most often lead to frustration, anxiety, and poor outcomes.