Scoliosis: What You Need to Know

Scoliosis is not a disease, but rather it is a term used to describe any abnormal, sideways curvature of the spine. Viewed from the back, a typical spine is straight. When scoliosis occurs, the spine can curve in one of three ways:

• The spine curves to the side as a single curve to the left (shaped like the letter C), called levoscoliosis
• The spine curves to the side as a single curve to the right (shaped like a backwards letter C), called dextroscoliosis
• The spine has two curves (shaped like the letter S).

Idiopathic Scoliosis

This article focuses on the most common form of scoliosis, idiopathic scoliosis, which occurs in approximately 2% the population. The term idiopathic means a condition or disease with no known cause.

Idiopathic scoliosis is by far the most common cause of scoliosis in children. (Degenerative scoliosis is the most common form of scoliosis in adults.)

Idiopathic scoliosis rarely causes pain, and in most cases the curve is minor enough to be considered an asymmetry and does not require any treatment. However, once scoliosis is detected it should be closely monitored by a medical professional in the event that the curve progresses and needs treatment.

Article continues below

 

Because the skeletons of children and young adults grow quickly, there is a reasonable chance that if a curve is detected, the degree of the spinal curve may worsen as the spine continues to grow. In those cases, scoliosis treatment may become advisable. Rarely (in 0.2 to 0.5% of all cases), untreated scoliosis can progress to where it restricts space in the ribcage needed for optimal heart and lung function.^1,2

It is important to note that idiopathic scoliosis is not caused by activity such as exercise, sports, or carrying heavy object; nor does it come from sleeping position, posture, or minor differences in leg length.

In This Article:

• Scoliosis: What You Need to Know
• Scoliosis Types
• Scoliosis Symptoms
• Scoliosis Diagnosis
• Scoliosis Treatment
• Scoliosis Surgery
• Scoliosis Surgery: Potential Risks and Postoperative Care
• Scoliosis Video: What is Scoliosis?

Detection, Diagnosis, and Monitoring

Scoliosis most typically occurs in individuals 10 to 18 years old and is often detected by school screenings or regular physician visits. A medical professional will look for:

• Curvature of the spine
• Uneven shoulders, or protrusion of one shoulder blade
• Asymmetry of the waistline
• One hip higher than the other.

Once scoliosis is detected, a physician will continue to monitor the curvature (read more about scoliosis observation). The progression of spinal curvature is very well understood and is measured in degrees.

• Mild curvature that remains at 20 degrees or less will most likely require monitoring and observation, but further treatment is rarely needed.
• Curvature greater than 20 degrees may require non-surgical or surgical intervention, including treatments such as a back brace for scoliosis or scoliosis surgery, both of which prevent further progression of the curve.

Preventing severe curvature is important for the physical appearance and health of the patient. Curves greater than 50 degrees are more likely to progress in adulthood. If a curve is allowed to progress to 70 to 90 degrees, it will produce a disfiguring deformity.

See Bracing Treatment for Idiopathic Scoliosis

A high degree of curvature may also put the patient at risk for cardiopulmonary compromise as the curve in the spine rotates the chest and closes down the space available for the lungs and heart.

Scoliosis Rarely Causes Back Pain

It is important to note that idiopathic scoliosis results in spinal deformity, but is not typically a cause of back pain. Of course, people with scoliosis can develop back pain, just as most of the adult population can develop back pain. However, it has never been found that people with idiopathic scoliosis are any more likely to develop back pain than the rest of the population.

Other Types of Scoliosis

While adolescent scoliosis is the most common, other common types of scoliosis include:

• Congenital scoliosis, which is present in infants
• Neuromuscular scoliosis, which is the results of neuromuscular conditions
• Degenerative scoliosis, which occurs later in life
  

MEET THE BADASS BALLERINA WHO WON'T LET SCOLIOSIS CRUSH HER DREAMS

GIGI CROUCH, 17, IS CONQUERING HER DIAGNOSIS ONE PLIÉ AT A TIME.

Gigi Crouch, 17, wins at Instagram and life. Her account, @scolerina9247, documents her badass dance adventures as a ballet student living with scoliosis -- aka a curved spine.

​

Crouch started ballet dancing when she was 11 and is currently in her sixth year of training. She's currently a student in the Professional Division at Pacific Northwest Ballet.
"I originally started ballet ... to help with my figure skating, to be a more graceful skater," Crouch wrote to MTV News in an email. "I wasn't very serious about ballet in the beginning."
Now she's now pursuing ballet full-time and posting amazing photos for the world to see along the way.

Crouch was diagnosed with scoliosis at 13, and she currently has three major curves in her spine. After her diagnosis, she wore a back brace for 18 to 20 hours per day and started physical therapy, she told us.
"My experience has been very positive; my mother wore a brace for four years when she was in her early teenage years so I had heard all the stories from her experience with a brace, as well as some inside knowledge," Crouch said.

13 THINGS PEOPLE WITH CHRONIC ILLNESS WISH YOU UNDERSTOOD

The insanely talented dancer hopes to be accepted into a professional ballet company after completing her training.

"Scoliosis impacts my training in a very mild way," Crouch explained. "Some sections of my back are tighter than others, which can make some positions hard to achieve. I do not believe that anybody has doubted my abilities because of my scoliosis."
Crouch trained with a brace for three years and is now brace-free. She got into Instagram two years ago and continues to dazzle her followers with amazing pics taken by herself, her friends and even professional photographers -- an interest she's exploring as well.
"When I am not dancing, I love exploring photography. I’ve always been intrigued by the stories pictures can tell," Crouch revealed.
We can understand why. Seriously, this girl's Insta should be displayed in a gallery somewhere. She's posed for photoshoots galore, and the pics are absolutely stunning. Check out some examples below, and visit her page for links to the photographers' Instagrams.

"I have one main piece of advice for others diagnosed with scoliosis: join together with others experiencing the same journey that you are," Crouch told us. She called out the Curvy Girls group, which offers virtual and in-person support, for being "a huge part of [her] scoliosis journey."
Crouch was also recently featured on Instagram's official blog, where she spoke about the motivation behind her goals.
"I dance because it feels natural," she wrote for the blog. "Working hard in class and seeing results gives me a feeling of absolute satisfaction ... I hope that my pictures inspire others, and show them that nothing can stop you if you have passion."

5 Surprising Facts About Adult Scoliosis

You may have more options and control than you think

You may have more power over adult scoliosis than you think. Doctors can offer you various treatment options, and there are things you can do to help yourself. Here are five things you might be surprised to hear about adult scoliosis.

Surprise #1: If you are diagnosed with scoliosis, you probably won’t need surgery

When diagnosed with scoliosis, many people fear the only course of action will be major surgery.

“Only a small portion of people with scoliosis require major reconstructive surgery,” says spine surgeon Douglas Orr, MD. “Many people with scoliosis can manage their symptoms just fine without any type of surgery.”

[Tweet “5 things you didn’t know about #adultscoliosis”]

In many cases, treatment for scoliosis is aimed at relieving symptoms rather than fixing the curve in the spine.

“Adult scoliosis patients are initially treated as we would treat a patient with a straight spine who has back pain,” Dr. Orr says. Treatment might include physical therapy to strengthen and stabilize the spine. It might also include anti-inflammatory medications or epidural injections to relieve pain.

People who can’t get pain relief from medications or physical therapy might need spinal decompression surgery.

“If you’re considering surgery for scoliosis, talk to your surgeon and find out how many spinal deformity procedures he or she performs each year,” Dr. Orr says. “You want to make sure your surgery is done by someone who specializes in these types of procedures.”

Surprise #2: The size or the location of your spine’s curve doesn’t predict whether or not you will have symptoms

As you age, your spine begins to deteriorate. As it weakens, it may also begin to curve. Some people may never have any symptoms. Others might experience leg pain, numbness or tingling when walking and/or back pain.

“If you look at a person from the side, you can see that the spine has three natural curves; one in the lower back, one in the middle of the back, and one at the neck. We tend to lose the curve in the lower back as we age. That’s what creates problems and causes symptoms,” says Dr. Orr.

Surprise #3: Adults can have one of two types of scoliosis

Doctors see two types of scoliosis in adults. One is the type of scoliosis doctors also see in teenagers. This is called idiopathic scoliosis. In some cases, the curve progresses and begins to cause symptoms in adulthood. In other cases, it is not diagnosed until adulthood.

The second common type of scoliosis seen in adults is degenerative scoliosis. In this type, the normal wear and tear on the lower back during the aging process leads to the development of a curve in the spine.

Surprise #4: Smoking causes back and neck problems

In addition to seeking treatment for scoliosis, there are things you can do at home to reduce your symptoms. “The most important thing you can do is not smoke,” says Dr. Orr. “Smoking is the leading preventable cause of back and neck problems.”

Surprise #5: You can still exercise with scoliosis

Although many people who have scoliosis have been told to limit their activities, Dr. Orr disagrees. “The more physically active people with scoliosis are, the less likely they are to be symptomatic,” he says. If you are overweight, weight loss can also help to reduce scoliosis symptoms. It’s also important to monitor your bone density and seek treatment if you have osteoporosis.

After Surgery to Treat Scoliosis, Meagan Blomgren Is Back on Track

Meagan Blomgren is fast. This spring, she qualified for the Iowa state track meet in the 100- and 200-meter dash, posting the fastest time for a freshman in both races.
A year ago, it was hard for Meagan to imagine that she’d ever have that kind of success. She’d been diagnosed with scoliosis and told she would need surgery to correct the curvature in her spine that until then had gone undiscovered. “Her running coach was the first to notice,” says Meagan’s dad, Jason.
After meeting with doctors closer to their home in Waukee, Iowa, the family came to Mayo Clinic‘s Rochester campus for another opinion. “We’d been told she’d need two surgeries,” Jason says. “We were hoping to get a different answer at Mayo and avoid surgery.” The family met with William Shaughnessy, M.D., a pediatric orthopedic surgeon, who confirmed that Meagan would need surgery. But he told the Blomgrens that Meagan’s spine could be straightened with just one procedure.
While he didn’t give them exactly the answer they were hoping for, Jason and his wife, Stacy, were “impressed” by Dr. Shaughnessy. “He spent at least 45 minutes talking to us at that first appointment, answering all of our questions,” Jason tells us. Though other medical centers were closer to their home, the Blomgrens decided to schedule Meagan’s surgery at Mayo Clinic. “We’re three-and-a-half hours away from Mayo,” says Jason says. “I don’t care if it’s 24 hours away. As far as I’m concerned, you go where you need to for the best care.”
Meagan had her surgery in August 2015, and left Mayo Clinic after just four days — two days earlier than most people who have the same procedure. (We told you she was fast.) And three months later, she set another record when Dr. Shaughnessy gave her permission to return to sports a full three months earlier than typically recommended. “Because Meagan is so athletic, her bone density is incredible,” Dr. Shaughnessy tells us. “I don’t recall ever seeing a patient with bones as dense.”
With Dr. Shaughnessy’s blessing, Meagan quickly signed up for basketball, then track and softball. And this fall, she wrote Dr. Shaughnessy a letter to tell him all about it. “When I first did the surgery, I was a little worried that I might not return to the competition level that I wanted to,” she wrote, before going on to tell him about her accomplishments, which also included a state championship in softball. “I led our team in home runs with 7. I also led the state in class 2A state in stolen bases,” she wrote, before concluding, “I could not have achieved this much without you and the rest of your team at Mayo Clinic.”
Dr. Shaughnessy tells us letters like Meagan’s are “priceless” to him. “They make me feel really good about what we do.”
You can make us feel good about what we do by leaving a comment below. Then, you can use the social media tools atop this page to share this story with others.

 

Tags: Dr William Shaughnessy, Scoliosis

Martha Hunt Tweets About Taking Pride in Her Scoliosis Scar

"I wouldn't be who I am without my scars."

When you see a Victoria's Secret Angel on the runway, "imperfection" is maybe the farthest word from your mind. But even when someone is seemingly perfect, that's never actually the case because what is perfect anyway? On Twitter, Martha Hunt served up a much needed reminder that it's the differences between us that make us beautiful.
Martha tweeted about her scars, letting the world know that she's proud of hers because they make her unique and strong. Instead of trying to hide her "imperfections," Martha wrote that she happily displays the long scar down her back and the one on her abdomen.
"Scars are uniquely beautiful and they tell a triumphant story about you. I have a long one down my back and one on my lower right abdomen," Martha tweeted. "I wouldn't be who I am without my scars. What are yours? I urge you to wear them with pride. #imperfectionisbeautiful"

15 Things People With Scoliosis Want You To Understand

Scoliosis – adults have certainly heard the term and know that it refers to a curved spine. They don’t think about it much, though, because it isn’t publicized as a serious condition. And, they don’t really think of it as a handicap or disability either. It’s just one of those things that some people have.

Moderate to severe scoliosis, however, can be really debilitating and really painful, not to mention dangerous to lungs and the heart. While people don’t mean to be critical or mean, their lack of understanding about this condition often causes them to seem to be. So, here are 15 things that Scoliosis sufferers want others to know, so that these non-sufferers can have some empathy for the victims of the condition.

1. We have a real disability

No one really knows the cause, but I‘ve had it since the age of 11, and it got worse as I grew older. It now really impacts my life a lot, and there are lots of things I avoid because of it, not because I am anti-social or lazy.

2. We are in a lot of pain on the bad days

If I am complaining about back pain, it is because it has gotten so bad that I just can’t keep it in any longer. Please don’t make statements like I must have just “slept wrong” the night before. It would be nice to hear you say that you are sorry that I am in such pain and is there anything you can do? Just offering to get me a cold drink so I can down my pain meds would be appreciated.

3. We already feel really self-conscious about our looks

We are trying our best to stand up straight as much as we can. When you make comments like, “Don’t you think it would be good for you if you forced yourself to stand up straight?” you only make us more self-conscious. If I could stand straight more, I would — believe me. I don’t enjoy looking like this either. But it’s something I have to live with.

4. We feel it differently every day

Some days the pain is minimal, other days it is so bad I even have to pull off the road until the spasms subside. So, if you see us doing pretty well one day and very badly the next, please don’t ask if we think some of it might be “mental.” It’s not. The nature of this condition is that there are good and bad days, and no one really knows why. That’s the frustrating part – there just aren’t the answers that all of us who have scoliosis really want and need. Research funding for Scoliosis is pretty minimal, since there are so many other life-threatening diseases that must take precedence.

5. We find desk work particularly hard

We “slouch” in our chairs as it is probably the most comfortable position anyone with scoliosis can get themselves into. Even the newer ergonomic chairs available in most offices don’t help much. Don’t make comments about how I am not using the chair properly — it is because I can’t.

Stand desks can be our best buddies, especially those DIY models you can assemble up to your liking. However, we can’t spend too much time in front of them either. We are not being picky or restless when it comes to our working places. It’s just a tad bit difficult for us to find the optimal position we can comfortably spend the whole day in.

6. We can’t make plans ahead of time

This is because we never know what kind of day we’ll be having. When we have to cancel something at the last minute, please know that we are as upset about the cancellation as you are. But please don’t get angry with us. If we had plans for an after-work Happy Hour, and we cancel, it is because the best we can do right now is get home and try to find some comfortable position that will ease the pain. We really do want a social life, but the scoliosis often gets in the way.

 

7. We don’t just have a crooked spine

That crooked spine causes many other things too. One of my hips is higher than the other, one shoulder blade protrudes more than the other, one of my legs is longer than the other. And my ribs push on my lungs, making it more difficult to breathe. If I am out of breath after walking around a bit, please don’t kid me about being out of shape. It’s my ribs that are out of shape, not me. I get as much exercise as I am able, but my breathing issues do keep me from a lot of the physical activity that you take for granted. Even walking up and down hills is really tough for me.

8. We have to turn down offers to join the office volleyball team and most other group activities

When we turn down offers to be on the office volleyball/baseball/golf/any other team, please don’t think we are being “standoffish” or “unsociable.” We would love for someone to ask us to come and be the scorekeeper or perform some other supportive duty. In fact, we usually volunteer in these circumstances. We really do want to be a part of what others are doing, but often we have to participate in a different way.

9. We experience certain emotional consequences to scoliosis

We don’t just have good and bad days related to the levels of pain. We have emotionally good and bad days too. The lack of being able to lead a normal life, the pain, and the physical appearance just really get to us sometimes. We try to put on a “tough” exterior, but we can’t always keep it together. So if we seem depressed or if you see us getting teary-eyed, please don’t tell us to put a smile on our face and “snap out of it.”

Some days I just don’t want to, and others days I just can’t. If you could put yourself in my position, if only for a day, you would understand, I know. But since you cannot, please just give me a kind empathetic statement, like “I am sorry you are having a bad day. If there is anything I can do, please tell me.” That lets me know you care, and that is important.

10. We have troubles with finding clothes that fit well

Given that one shoulder and one hip are higher than the other, given that my stomach and butt may protrude, given that my ribs are protruding on one side, I have to carefully select the clothing I buy in order to hide as much of my physical deformities as possible.

Most of us actually prefer winter because we can look quite stylish in clothes that are bulky. Spring and summer are the bad months, because the clothing reveals so much more of the body. So, if we seem really out of style with our clothing selections, especially in the warm seasons, please understand that we would love to dress more fashionably, but we just cannot make ourselves expose the “deformities.”

11. We can suddenly experience tremendous pain

Simple things can send our back, legs, and ankles into spasms of pain. I dread colds, because a simple cough or sneeze can “do me in.” If I bump into a desk or chair, or have a little minor fender bender, I can be in pain for hours afterward.

It’s easy to think of us as hypochondriacs, I know, but please understand that we are not exaggerating the pain, and that we are not looking for sympathy. Please just acknowledge that our pain is real. When we see you and someone else rolling your eyes at one another while we are experiencing spasms of pain, it starts hurting even more!

12. We are not lazy

Very basic activities, like cleaning the house, involve some pretty major planning. First, we can only do this on the “good days.” Second, it takes us twice as long as someone else to complete the same cleaning chores. We have to mop, dust, and vacuum very carefully and slowly. We have to avoid bumping into things. We have to watch our stretching, pulling, and pushing.

So, if you should visit me at my house and it is not clean, please do not think I am a bad housekeeper. Understand that I probably have not had a good enough day to get the house cleaned this week. And please don’t go out and comment to others about the condition of my home. It’s hurtful, and giving people the impression that I am lazy is not fair.

13. We don’t usually go to the pool or to the beach

I don’t do this because I would never put on a swimming suit. If I ever do attend an outing of that type, the best I can do is shorts and a good-sized T-shirt. I may dangle my feet into the pool from the side or walk into the shallow part of the lake or ocean, but I will not be swimming.

Please don’t chide us for not bringing a swimsuit – we feel badly enough about it already. Swimming is actually a good exercise for us, and we do go to rehab centers often because they have a pool and we can swim with other Scoliosis patients.

14. We will gladly explain Scoliosis if asked

When people ask us to explain the condition, it makes us feel good. Obviously, the person wants to understand why we have the symptoms and why too many activities are so difficult and/or painful for us. Believe me, I keep up on all of the latest research and treatments because I want to take advantage of anything that might ease my symptoms. How much time have you got?

15. We may not be active participants in all of our kids’ activities

We really want to be. So, if the girl scouts are planning a weekend campout, we do want to go. We will bring our pain meds and we will tell you what we can and cannot do. We may not be able to paddle a canoe, and we may not be able to go along on a nature hike up and down hills, but we will bring the guitar and teach the girls some great fu

n songs around the campfire at night.

We may not be able to participate in the parent-son softball game, but we would love to help out in some other way on game day. We’ll volunteer to pass out drinks. We’ll wash the team uniforms after the game. We’ll be the best vocal cheerleaders ever. Please find a spot for us!

Scoliosis is permanent. And that realization to sufferers is very difficult to deal with. Most who have it started out with a very mild form that developed during a growth spurt period before puberty. Over the years, however, it gradually worsened, and no one really knows why. Some people develop a very mild form that stays very mild all of their lives. Others are severely handicapped by it as adults. If you work or socialize with someone who has moderate-to-severe Scoliosis, it would be really nice to do a bit of research so that you can understand the condition better.

Scoliosis Traced to Problems in Spinal Fluid Flow

by Dr. Francis Collins

Many of us may remember undergoing a simple screening test in school to look for abnormal curvatures of the spine. The condition known as adolescent idiopathic scoliosis (IS) affects 3 percent of children, typically showing up in the tween or early teen years when kids are growing rapidly. While scoliosis can occur due to physical defects in bones or muscles, more often the C- or S-shaped spinal curves develop for unknown reasons. Because the basic biological mechanisms of IS have been poorly understood, treatment to prevent further progression and potentially painful disfigurement has been limited to restrictive braces or corrective surgery.

Now, in work involving zebrafish models of IS, a team of NIH-funded researchers and their colleagues report a surprising discovery that suggests it may be possible to develop more precisely targeted therapeutics to reduce or even prevent scoliosis. The team’s experiments have, for the first time, shown that mutation of a gene associated with spinal curvature in both zebrafish and humans has its effect by altering the function of the tiny hair-like projections, known as cilia, that line the spinal cord. Without the cilia’s normal, beating movements, the fluid that bathes the brain and spinal cord doesn’t flow properly, and zebrafish develop abnormal spinal curves that look much like those seen in kids with scoliosis. However, when the researchers used genetic engineering to correct such mutations and thereby restore normal cilia function and flow of cerebral spinal fluid (CSF), the zebrafish did not develop spinal curvature.

Zebrafish are normally found in tropical freshwater and are a favorite research model to study vertebrate development. They are also an especially good model for studying IS.

The latest study, published recently in the journal Science, involved a research team led by Brian Ciruna of the University of Toronto and The Hospital for Sick Children, Toronto, and Rebecca Burdine of Princeton University, Princeton, NJ. The team was interested in zebrafish with mutations in the ptk7 gene, which encodes the enzyme protein-tyrosine kinase-7 [1].

Ciruna’s lab had earlier shown that mutations in the ptk7 gene could lead to spinal curvature [2]. While ptk7 was already known to play a role in embryonic development, it wasn’t clear how the gene, when altered, might lead to scoliosis in adolescence. In the latest work, the researchers examined the brains and spinal cords of the ptk7-mutant fish in search of clues to their earlier findings. They found something unexpected: the motile cilia normally found at the surface of the brain and lining the spinal cord were unusually sparse. Many of the cilia that were present were also positioned incorrectly.

Those mutant fish developed a curved spine and a brain-swelling condition known as hydrocephalus, which is also associated with defects in motile cilia. While the researchers did not directly measure the movement of those defective cilia, they injected tiny fluorescent beads into the fish and saw had almost no CSF flow. That finding was especially intriguing in light of reports of defective CSF flow in people with scoliosis.

To find out whether those problems in the cilia were responsible for the scoliosis, the researchers restored the normal gene function specifically in the cells that produce cilia. And indeed, with Ptk7 and motile cilia restored, the hydrocephalus and scoliosis no longer developed in the zebrafish, as CSF began to flow normally.

To provide even more evidence of a link between cilia and scoliosis, the researchers introduced other mutations in four genes known to play a role in cilia development and function. They found that zebrafish carrying any of those mutant genes also developed scoliosis.

In a clever series of experiments exploring the timing of scoliosis development, the researchers took advantage of a temperature-sensitive mutation in c21orf59, a gene that the Burdine lab recently showed is essential for cilia function [3]. The mutation allowed them to switch cilia’s movement on and off simply by changing the temperature of the water in the zebrafish tanks. When zebrafish carrying the mutation were kept at 25° Celsius (77° Fahrenheit), the protein product of the gene functioned normally, allowing cilia to work. When those same fish were kept at a temperature of 30° Celsius (86° Fahrenheit), the mutant protein no longer folded correctly, causing cilia to malfunction.

The researchers initially raised zebrafish embryos at 25° Celsius to allow normal development. They then moved the fish to a tank set to 30° Celsius after 19, 24, 29, or 34 days, causing the flow of CSF to slow as the cilia stopped functioning normally. Those studies found that fish were susceptible to developing spinal curvatures when motile cilia stopped working properly at 19 days, a developmental stage corresponding to adolescence in humans.

Fish moved to the warmer tank just a few days later developed only mild curves. Those shifted to the warmer temperature at 34 days showed no scoliosis at all. Taken together, these findings provide evidence that scoliosis might ultimately be treated or prevented with therapeutics designed to encourage normal cilia function and CSF flow.

In the meantime, there is plenty still left to learn. It’s not yet clear precisely how CSF flow influences spinal development in adolescence. The researchers suggest that the rapid growth during adolescence may increase the risk of developing asymmetries, and changes in CSF flow might allow the body to detect and correct them. When CSF doesn’t flow normally, those checks and balances may break down.

Scoliosis is known to be highly prevalent in people with several health conditions associated with obstructed CSF flow. This, together with the new evidence, implies an evolutionarily conserved role for CSF in the development of the spine in fish and humans. They also suggests it would be useful to reexamine CSF flow in children with scoliosis. More broadly, these new findings show once again the value of animal models for learning about human disease.

References:

[1] Zebrafish models of idiopathic scoliosis link cerebrospinal fluid flow defects to spine curvature. Grimes DT, Boswell CW, Morante NF, Henkelman RM, Burdine RD, Ciruna B. Science. 2016 Jun 10;352(6291):1341-1344.

[2] ptk7 mutant zebrafish models of congenital and idiopathic scoliosis implicate dysregulated Wnt signaling in disease. Hayes M, Gao X, Yu LX, Paria N, Henkelman RM, Wise CA, Ciruna B. Nat Commun. 2014 Sep 3;5:4777.

[3] c21orf59/kurly controls both cilia motility and polarization. Jaffe KM, Grimes DT, Schottenfeld-Roames J, Werner ME, Ku TS, Kim SK, Pelliccia JL, Morante NF, Mitchell BJ, Burdine RD. Cell Rep. 2016 Mar 1; 14(8):1831-1839.

Scoliosis Specific Exercises... Seven Main Approaches Explained

By Anne Asher, 

Scoliosis in both children and adults can be painful, unsightly, and perhaps most important, can decrease the optimal functioning of your lungs and heart.
A groundbreaking 2015 study published in the New England Journal of Medicine found that a little over one-third of the 176 children with scoliosis they assessed also had obstructive lung disease (abnormal airway function). The authors say that this type of lung dysfunction cannot be detected with diagnostic imaging (specifically, radiographs such as x-ray, CT scan, MRI, and more).

 

The abnormal airway function persisted in 73 percent of the children—even after bronchodilator therapy was given.

The study found another relationship, this time between scoliosis and low lung volume. Low lung volume, also known as restrictive lung disease, is a different problem than obstructive lung disease. As the name suggests, it is characterized by reduced capacity of the lungs (which means less air volume can come in and go out of the lungs during breathing). It generally results from disease or alteration of the lung structures. What is the solution?

Scoliosis Specific Exercise: Where the Spine Industry Is At

Most of the conventional medical system operates on the model that exercise, generic physical therapy sessions, and in some cases chiropractic can be helpful for pain control and balance in cases of scoliosis. Balance helps restore good physical functioning, which is useful for daily activities, but to actually straighten out the curves, the theory goes, one needs surgery.

 

Not everyone believes this.
Forward thinking physical therapists and others are now, on a case-by-case basis and by growing a body of research, building evidence for PSSE. PSSE is an acronym for "physiotherapy scoliosis specific exercises." It refers to an exercise therapy program given to a patient in physical therapy to treat idiopathic scoliosis.

 

(Idiopathic means the cause of the scoliosis is unknown.)

A 2015 survey found that 22 percent the 263 scoliosis practitioners questioned use PSSE with their patients. Reasons include:

1. As an adjunct to bracing, which is a standard non-surgical scoliosis treatment, for small curves.
2. To help improve aesthetics.
3. To improve outcomes of surgery.

Lack of evidenced-based research at the current time, plus a perception that PSSE isn't valuable in the therapeutic process are the two biggest reasons why the remaining 78 percent choose not to use physiotherapy scoliosis specific exercise with their scoliosis patients, according to the survey. That said, most of the practitioners in the "don't use" group are in favor of more research on PSSE.

The 7 Major Schools of PSSE

There are seven main types of PSSE, and all of them originated in Europe. And while there are exceptions, exercise for scoliosis is not commonly prescribed by physiciansin the U.S. or the U.K.
But in Europe, it thrives. The main schools of physiotherapy scoliosis specific exercise therapy are as follows.

 

Lyon (France)
The Lyon method is the oldest active approach to scoliosis. It started in the early 18th century when Dr. Gabriel Pravaz founded the first orthopedic physiotherapy center in the city of the same name. In Pravaz's day, treatments included auto-adjusted traction, exercise on "extension equipment" that resembled ladders (to allow the patient to do their work in an upright position—as well as to adjust the traction for themselves) and more. Over one hundred years later, casts and braces were added to the protocol, first with the Lyon brace and later with the more modern ARTbrace. The ARTbrace replaced the Lyon, and this effectively retired the use of casts.
The Lyon approach is mainly focused on the use of the brace, although the scoliosis specific exercises are still a part of the plan.
Scientific Exercises Approach to Scoliosis (Italy)
The Scientific Exercise Approach to Scoliosis (acronym SEAS) is as individually tailored as it is evidence based. It follows the Lyon method—although it got its start much later, in the 1960s—when Antonio Negrini and Nevia Verzini founded a center in Vigevano, Italy. In 2002, the center's name was changed to the Italian Scoliosis Spinal Institute.
The SEAS method focuses on active 3D self correction of the scoliosis by means of patient education (first) and then developing the patient's awareness of their deformity. The idea is that with awareness both of the deformity and the way to correct it, the patient is empowered to consciously make adjustments to the curve. These adjustments are done in every plane—horizontal, saggital, and transverse. Exercises are then given to help stabilize the spine and maintain the newly achieved corrected posture. SEAS practitioners are careful to prescribe exercises backed by the most updated medical evidence.
Schroth (Germany)
A family affair, the Schroth method got its start in 1910 when 16-year-old scoliosis patient, Katharina Schroth, took her treatment matters into her own hands. She wore a steel brace, but the properties of balloons caught her attention as a possible model for decreasing the degree of the curve on the concave side.
Schroth's idea was to breathe into the concave side while watching herself in front of a mirror. Eleven years later, Schroth started a scoliosis clinic where she used functional exercises based on her teenage explorations to treat and educate patients. By the late 1930s, the Schroth method was the most widely recognized clinic for conservative treatment of scoliosis.
After World War II, Schroth and her daughter moved to West Germany and started a clinic there, where Schroth's grandson, orthopedic surgeon Hans-Rudolph Weiss, later served as the medical director (until 2008). In 2009, Weiss branched out on his own to offer new bracing and therapy options that are based on the Schroth method. But the clinic in West Germany continues to this day.
As you will see, most of the other PSSE approaches are either based on or borrow from the Schroth method.
Barcelona Scoliosis Physical Therapy School
The Barcelona scoliosis physical therapy school is a modified version of the Schroth method (described above). Prior to around 2009, the Barcelona school was a Schroth center. It was founded in the 1960s by physiotherapist Elena Salva who met Katharina Schroth and her daughter around that time in Germany. who met Katharina Schroth and her daughter around that time in Germany.
The Schroths gave Salva a new perspective on scoliosis which she promptly took back to her native Spain. For 40 years, she practiced the Schroth method; after that, she evolved the work into a mix of cognitive, sensory-motor and kinesthetic training.
At the Barcelona Scoliosis Physical Therapy School, a human approach is taken with patients. They are taught to improve their own 3D scoliosis posture and shape using breathing and muscle activation techniques. The Barcelona school adheres to a "vicious cycle" theory which states that its the scoliosis posture that promotes progression of the curves.
DoboMed method (Poland)
The Dobomed method is a combination of the Schroth method and a mostly defunct method known as Klapp. Developed in 1940, the Klapp method was based on the observation that quadruped animals don't seem to get scoliosis, while humans, who are bipedal, do. The Klapp method worked better for spinal issues than for pelvic issues, but pelvic issues are important for postural support in scoliosis and related conditions.
Along with techniques from the Klapp method, the Dobomed method employs the use of Schroth's active asymmetrical breathing.
The Dobomed method was developed in 1979 by a Polish physician and physiotherapist named Krystyna Dobosiewicz. Within a few years, it became a regular fixture in conservative scoliosis treatment circles in Poland. The method is used both with and without bracing and has been adopted by the Department of Rehabilitation at the Medical University of Katowice, as an in-patient treatment.
Side Shift Method (London)
The Side Shift method was developed in 1984 by Dr. Min Mehta and is practiced at the Royal National Orthopaedic Hospital in London. It's currently under the guidance of Tony Betts, a physiotherapist. At first, the method was used only for treating children, but it's now given to adults as well. This method borrows from the Schroth and Dodomed breathing mechanics work. Emphasis is placed on addressing posture that deviates from the mid-line of the body. The Side Shift method treats both pre- and post-op patients.
In children, a guiding principle of the Side Shift method is that growth can be used as a corrective force in curve management. Lateral trunk shift movements are done repeatedly to oppose the curve; this increases mobility and helps re-align the spine. It also helps to integrate perception of posture. The goal of doing the lateral trunk shift movements is to affect the way the curve develops.
Core stabilization exercises are also done using isometric contractions of the lower abdominals, gluteal muscles and muscles around the shoulder blade (scapula).
In adults, the goal is more about reducing and managing pain that is caused by the posture as it migrates away from the mid-line of the body.
Functional Individual Therapy of Scoliosis (Poland)
Functional Individual Therapy of Scoliosis (FITS) was created in 2004 by Polish physiotherapist Marianna Białek and physiotherapist and osteopath Andrzej M'hango. This approach to PSSE brings together and modifies elements from other scoliosis exercise approaches. It's used in several ways: On its own for curve correction, along with bracing and as pre and post-surgery therapy.  FITS is also given for other posture issues such as Scheuermann's kyphosis.

Understand and Appreciate the Scoliosis Specific Exercise Treatment Spectrum

Although each of the 7 PSSE approaches has the same goals—to correct the 3D scoliosis deformity by re-aligning the spine, ribs, shoulders and pelvis—most put their own stamp on the treatment.
Scoliosis specific exercises are generally given in conjunction with bracing, but as you've seen from the above, this is not a hard and fast rule. It's possible, depending on the patient, the degree of the curve and the doctor, among other things, to use PSSE as the sole treatment.
Either way, scoliosis medicine requires a team approach with observation, physiotherapy, and sometimes psychotherapy and surgery making up the spectrum of potential treatment.
Sources:
F. Bruder Stapleton, MD reviewing McPhail GL et al. J Pediatr. 2015.
Lung Function Can Be Compromised by Severe Scoliosis. NEJM Journal Watch. 2015.
Kotwicki T. et al. Optimal management of idiopathic scoliosis in adolescence. Adolesc Health Med Ther. 2013.
Marti C. et al. Scoliosis Research Society members attitudes towards physical therapy and physiotherapeutic scoliosis specific exercises for adolescent idiopathic scoliosis. Scoliosis. 2015.

BOY WITH SCOLIOSIS GETS BULLIED BUT THIS TATTOO ARTIST HAS HIS BACK – LITERALLY

MIASEPTEMBER 13, 2016

INSPIRATION0 COMMENTS 3

From pesky skin issues to those ever-changing hormonal surges – being a middle schooler can be tough. And when you’re going through that geeky pimply-faced phase, sometimes you can’t help but feel all alone in your awkwardness.
Sometimes it’s hard to find that perfect balance of trying to fit in but not stand out too much. And when you are a little different than other students, sometimes you wish you could fly under the radar without drawing too much attention to yourself.
Being different can sometimes lead to being bullied, a common issue for young people everywhere, like Xavier, a 12-year-old boy from Orlando, Florida.
Recently diagnosed with scoliosis and Pectus, the middle school student was told he had to wear a back brace until his spine straightened out and he was done growing.
Not wanting to draw attention to himself, Xavier tried to wear the cumbersome brace under his clothes at school, but it was uncomfortable. Once he began wearing it on the outside of his clothes, the bullying began.
Out of concern for her son, mom Ashley King put out a message on her Facebook page, asking people if they knew of any place that would airbrush something cool on Xavier’s back brace.

“Okay FB , I just left the Orthopedic Dr. , And Xavier is going to have to wear this back brace longer then expected. He has scoliosis and Pectus, this is suppose to help him straighten out in his growing years. He’s embarrassed to wear this to school. Last year he wore it under his shirt but it’s very noticeable , and got picked on. I’m looking for a place that can possibly do a airbrush design on this in Orlando . Please share this help him out. Thanks !!”

And that’s when Angel appeared.
The legendary tattoo artist, Angel “Evil Tattu” Ruiza, at Anarchy Tattoos & Art Co. offered to airbrush an amazingly cool shark that would make Xavier feel a whole lot better about having to wear a back brace. All at no charge!
No stranger to kind deeds, Angel also gave free tattoos to honor those who died in the Orlando Pulse tragedy earlier this year.
Xavier and his mother were thrilled with the results and now he walks around with his head held high, thanks to his own special guardian “Angel.”

Here’s Xavier

And Here’s Angel

Angel Gives Back To His Community

Angel And Xavier Became Fast Friends

Angel’s Transformation Of Xavier’s Back Brace

 

Angel Is A Well-Known Tattoo Artist In Orlando

And Here Is Another Tattoo Parlor Doing Something Wonderful For Charity

 

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Scoliosis Back Brace Treatment Suitable for Active Kids and Teens

For adolescents who are growing quickly and staying active, back braces are the best non-surgical treatment option for scoliosis.

Scoliosis, or curvature of the spine, affects 3-4% percent of all children in different variations of severity. The goal of an orthotic clinician is to help the patient avoid surgery by providing treatment that’s both effective and non-invasive, to keep the individual active and not hinder their childhood. The key to warding off surgery and the associated recovery period is utilizing a spinal orthosis as recommended by the treating physician and orthotist.

Treating Scoliosis in Kids & Teens without Surgery

Doctors who treat young, rapidly growing scoliotic patients first monitor the patient to see if their spine curvature reaches into the 25 to 40 degree range. If so, a back brace for scoliosis is often prescribed. The patient will be referred to an orthotist who will measure the child for a custom scoliosis brace. It is critical that this be implemented while the child’s spine is still structurally immature.

Keep in mind that braces do not typically correct the existing curvature, but primarily aim to prevent its worsening. A recent study of back braces used in young scoliotic patients found that the longer a patient wore a brace, the less likely they were to experience curve progression. This particularly study cited a 90-93% success rate for stopping curve progression. Only if the spinal curvature continues to develop as the child ages will spinal fusion surgery become recommended, so the best bet is to stop the curve progression via a back brace for scoliosis treatment before surgical intervention is necessary.

One of the biggest obstacles teens must overcome in order to realize successful brace outcomes, and avoid surgery, is getting over the awkward outward appearance of the brace. Brace comfort, how it effects clothing fit, and the logistics associated with wearing a brace all may be attributed to non-compliance issues seen in younger individuals. The orthotist understands these concerns and works hard to make the whole experience as pleasant as possible for the individual.

When assessing a young child or teen, a family orthotist is sensitive to how important self-image and self-confidence are as children grow and develop. As a back brace for scoliosis treatment is prescribed, they will offer the least cumbersome and least visible option possible that can successfully treat the child’s condition. The user can even contribute to their own brace design by selecting custom colors & patterns to use in place of the traditional white plastic style. There are several models and styles available to meet every adolescent’s medical and mobility needs.

Back Brace Solutions for Kids & Teens with Scoliosis

The three braces most commonly used to treat scoliosis are the Boston, the Total Contact TLSO, and the Charleston Bending Brace.

1. The Boston Brace or “underarm” brace is used to treat the most common form of adolescent idiopathic scoliosis (AIS), indicated by a “S” shape or double curve impacting the thoracic and lumbar regions of the spine. The Boston Brace is a custom molded structure made of plastic that incorporates specially placed pads and rotational force couplings to actively and passively straighten the spine. It is generally prescribed to wear 23 hours a day. For active adolescents, it can be removed for activities such as running or swimming.
2. The Total Contact TLSO (Thoracic-Lumbo-Sacral Orthosis), also known as the Wilmington Brace or a body jacket, is an alternative to the Boston Brace that can also be worn up to 23 hours a day, but employs different biomechanical principles for spinal correction. The Total Contact TLSO is arguably easier to fabricate and decreases the “guess work” involved in the Boston’s pressure and pad placement. The total contact brace requires a skillful casting technique where corrective forces are applied manually by the clinician while the fiberglass cast sets. As with the Boston Brace, it can be removed when participating in sports activities.
3. The Charleston Bending Brace is the ultimate in stigma avoidance, as it’s only worn at night. Molded to the patient when they’re bent to the side, the Charleston Bending Brace can apply more pressure than other braces, as the sleeping patient is in a non-weight bearing posture. Most growth in teens happens at night during sleep, making this type of brace just as effective as the back braces worn 23 hours a day.

There is a complex array of decisions confronting parents whose child has scoliosis. Both clinical and psychological factors need to be considered. But the key to a positive outcome is consulting early with an orthotic clinician skilled in diagnosing and treating AIS in active adolescents.

6 WEIRD EPILEPSY, HEADACHE & BRAIN INJURY TRIGGERS

Everyone knows a sinus infection or a major work project can make your head throb, but headaches can also be triggered by seemingly innocuous everyday activities like sleeping in on Saturdays or cleaning your apartment. With so many culprits, it’s no wonder so many people suffer from migraines and nearly half. If you think popping a pill is the only way to ease the symptoms, you’re wrong. We consulted the experts, and they revealed some unexpected causes of headaches, as well as how you can stop the pain for good.

1. Kicking back (too much) on the weekend.

You put in 14-hour days Monday through Friday, only to wake up midmorning on Saturday with pounding pain in your temples. The reason? As tension dissipates, levels of stress hormones,such as cortisol and or adrenaline, decrease. This causes a rapid release of neurotransmitters,the nervous system’s chemical messengers. These send out impulses to blood vessels,making them constrict and then dilate, in addition to releasing other pain causing chemicals.

Head it off

Although it’s tempting to sleep in on weekends, you’re setting yourself up for trouble. In a survey conducted by the National Headache Foundation, 79 percent of headache sufferers reported that they wake up with a headache after snoozing for more than eight hours. Also, if you enjoy an 8 a.m. cup of joe during the week, try to have coffee at the same time on the weekend. Caffeine withdrawal also causes blood vessels to dilate, which can give you a “grande”-size headache. You should try to factor decompression time into your workweek, too. If you don’t have a consistent fitness program, start one now, aiming for at least 30 minutes of exercise three times a week. One study found that this amount of activity reduces headache frequency by 50 percent. Exercise buffers the effects of stress and releases endorphins, the body’s natural painkillers, which help prevent the chemical changes that trigger a migraine.

Also consider incorporating relaxation techniques into your schedule, such as meditation, yoga, or biofeedback, which teaches you to control involuntary body responses like muscle tension and heart rate. Studies show that using these therapies, either alone or in combination, can improve symptoms in up to 80 percent of patients suffering from headaches.

2. Self-treating your headache pain.

Taken too frequently (more than two or three times a week on a regular basis), the over-the-counter acetaminophen, ibuprofen, or naproxen you depend on to quell the throbbing may be hurting you instead of helping. It can cause rebound headaches, a condition estimated to affect 2 percent of all adults. A woman may start taking pain relievers a few times a week to treat her tension headaches. Soon the headaches become more frequent, so she starts taking these medicines more often. Before long, she has headaches every day.

These drugs affect the pain-control systems in the brain and can lower levels of the feel-good chemical serotonin. Young women also seem to be more susceptible showed that about 75 percent of rebound-headache sufferers are women, most commonly in their 30s.

Head it off

Occasional use of OTC medicine is fine, but be sure to follow the label instructions exactly. Taking a higher than suggested dose increases the odds of getting a rebound headache.

If you suspect that your pain is related to self-medicating, ask your primary care physician to refer you to a headache specialist. The only solution is to stop taking your OTC pills, a remedy that may be painful at first.

To help you through this withdrawal period, your doctor may prescribe temporary measures like triptans, a class of powerful migraine drugs that stimulate serotonin receptors, resulting in reduced inflammation and constriction of blood vessels in the head. The frequency and intensity of your headaches should improve in one to three weeks, but it may take up to three months before your brain’s pain control system returns to normal.

3. Menstruation.

About 60 percent of all female migraine sufferers experience their migraines just before or at the start of their periods, according to the National Headache Foundation. These hormonally driven headaches typically occur with the drop of estrogen levels right before menstruation, which affects your body’s serotonin levels. The frequency and severity usually improve during pregnancy, when hormone levels stabilize, and worsen during perimenopause, when estrogen levels start fluctuating even more.

Head it off

Many doctors treat menstrual-related headaches with a prescription triptan, such as Frova. Your doctor may recommend taking triptans either a couple of days before your period starts or continuously during your period, depending on the severity and frequency of your migraines.

A nonsteroidal anti-inflammatory, such as ibuprofen, taken every day for the five to seven days around your period may also help reduce headache frequency. Experts used to believe that the birth control pill made migraines worse, but they’ve since concluded that the higher estrogen content of oral contraceptives a decade ago may have been to blame. Today’s pill may actually help. Research shows that when female migraine sufferers take the pill, about one-third report an improvement in symptoms, one-third a worsening, and the other third no change.

If you’re already on the pill, ask your doctor about taking it every day of the month (i.e., skipping the placebo pills and starting a new pack immediately) to keep estrogen levels steady. A recent study published in the journal Headache found that women who used a continuous method had less severe headaches than those who stuck to the traditional 28-day pill cycle.

4. Built-up anger.

Bottling up your feelings won’t do anyone—especially you—any favors. In fact, according to a study at Saint Louis University, this is the biggest emotional cause of headaches, even more so than depression or anxiety.

When you’re angry, all your muscles tense up, including those in the back of your neck and scalp. The prolonged contraction of the head and neck muscles causes a tight band-like sensation around your head, which is a classic sign of a tension headache.

Head it off

The next time that you’re silently simmering, take in a larger than normal breath; hold it for three to five seconds while pressing together the thumb and index finger on one of your hands, suggests Elkin. Then exhale slowly through parted lips, until all the air has been drained from your lungs. Repeat two or three times. This soothing move stops you from tensing your neck and shoulder muscles, which has been shown to bring on a headache.

After you’ve cooled down, ask yourself how important the immediate issue is to you. Will you remember it in two months? Two days? The answer will help put the problem in perspective. “If you tell yourself to let it go for now, chances are even an hour later you’ll be able to deal with it better,” says Elkin. “Otherwise, you’ll just hold on to the anger all day and tense up even more.”

If you already feel a headache coming on, wrap a hot compress or a heating pad around your neck for a few minutes, making sure that it hits the base of your skull. This will relax your sternocleidomastoid muscles, which are key in tension headaches, says Jacob Teitelbaum, M.D., medical director of the Fibromyalgia & Fatigue Centers, which have clinics throughout the United States.

5. Your lunch.

A turkey sandwich with a slice of cheddar, a diet soda, and a small piece of dark chocolate may make for a waistline- friendly meal, but for headache sufferers, it’s a decidedly unhealthy combo. All these foods contain chemicals with the potential to trigger migraines. (Cheddar, as well as other aged cheeses, like Brie and Stilton, contains tyramine, while chocolate has theobromine and phenylethylamine.) In diet sodas, the culprit is the sweetener aspartame. In a study of migraine sufferers conducted at the Montefiore Medical Center Headache Unit in the Bronx, New York, a little more than 8 percent of patients linked their head pain to aspartame. While researchers aren’t exactly sure why this chemical causes pain, one theory is that it alters neurotransmitter levels.

Head it off

Keeping a food diary can be helpful in identifying potential headache triggers. Once you suspect a food may be to blame, try eliminating it from your diet and see whether it alleviates your symptoms. But be sure to eat regularly.

6. Your co-worker’s fragrance.

Even if you think it smells nice, just a little whiff can bring on head-splitting pain. In one

study from the Headache Center of Atlanta, almost 50 percent of migraine sufferers attributed strong scents, such as perfume or household cleaners, to an attack. Odors reach the center of your brain via direct nerve pathways from your nose. For scent-sensitive individuals, this causes a cascade of neurotransmitters that can initiate a migraine.

Head it off

Unfortunately, many scents are difficult to avoid. You can’t live in a bubble.No matter how hard you try to stay away from strong smells, you’ll still end up in an elevator next to someone wearing heavy cologne. But there are a few ways to keep odors at bay. First, try to keep your home and work spaces as ventilated as possible. Also, in your own home, use fragrance-free cleaning supplies, such as EnviroRite, and keep all doors and windows open.

If these strategies don’t work, combat one odor with another. A German study found that applying a drop of peppermint oil to the forehead was as effective as OTC acetaminophen in relieving some headaches.