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Well Women Guide to ScoliosisScoliosis can affect anyone whether they are well or not. Being well will depend on the size of the curvature, but most people with the condition are very well and lead perfectly normal lives. It is a spinal deformity condition which usually starts at around the age of 11 or 12 and is triggered by the adolescent growth spurt. This causes the spine to curve and rotate as it grows and has no known cause. However in general, the main causes are clearly inherited and genetic. There are various types of the condition, the most common being “Idiopathic” Idiopathic comes from the Greek word meaning unknown cause. One thing that is known is that it is not caused by sitting badly or slouching or the carrying of heavy bags, although these things will exacerbate it in the predisposed person. You can also be born with the condition(“congenital”) and some illnesses can also cause it, such as cerebral palsy, spina bifida or spinal muscular atrophy. Latest findings It appears that scoliosis and thyroid conditions may be associated. Also those with scoliosis may also suffer from chronic fatigue syndrome (M.E) Please see this article from scoliosis.com
It is generally not painful in adolescents and young adults or children, with pain being reserved for later adulthood. I personally began to suffer more with actual pain and discomfort during my first pregnancy, aged 26, and unfortunately this continued and remains with me today. Curves under 20 degrees are usually monitored by the specialist, with curves greater than 25 requiring bracing. Curves over 40 degrees which show signs of steady progression are best treated with surgery. A good check for parents who are concerned that their child may be developing scoliosis is to ask them to stand in front of you and bend to touch their toes. Step back from them and look at their rib cage. The sign is if the rib cage is raised on one side more than the other. This is the check I performed on my daughter, Clare, after she complained of discomfort in her shoulder blade when sitting on hard chairs. After I had confirmed my suspicions, I took her to the doctor who immediately referred her to an orthopaedic consultant. It was easy for me to spot the condition in my daughter, Clare, as I have scoliosis myself, but the bend check is a good indicator and if you are in any doubt, it is best to take your child to the doctor if only to ease your worries. Diagnosis You will be referred by your GP to an orthopaedic consultant who will examine you and check your spine by asking you to bend over and touch your toes. From this the consultant can clearly see the raised ribcage and curve in the spinal column. They will check your hips and shoulders and often your legs to see if one is slightly longer than the other. Abdominal reflex and muscles are also checked. You will also be sent for X-rays, which involves an x-ray of you standing looking straight ahead (scoli) and one with you standing facing to one side (A-P lateral). Depending on the size of the curvature, (some are too small to measure) the consultant will then take measurements (Cobb Angle measurement) in order that they can monitor any progressive increase in the size of the curvature
The consultant will keep checking your back and may sometimes take an X-ray of your spine. They try to limit the amount of times that X-rays are taken due to the radiation risk and today is very different from when I was assessed back in the seventies when X-rays were taken about every three weeks. The consultant may then decide to treat the condition with a brace. (see below) This will stabilise (and sometimes partially correct) the progression of the scoliosis.
You will generally need to wear the brace for 23 hours a day until skeletal maturity (age 16-17 in females)
Wearing the brace is naturally upsetting,it's hard enough accepting that you have scoliosis, but believe me, when you get older, you will be glad you did. It is difficult to adjust to, but a positive attitude towards the reduction/correction of the curvature should help and pay dividends. Today’s braces are so much more acceptable and less obtrusive than the ones when I was young. I have given two illustrations. Which one would you rather wear?
In School I would sometimes take it off and put it in the needlework room dressed up with bits of material to make others laugh. It worked, and my rather feisty attitude probably saved my bacon in terms of being bullied or ridiculed. I took my frustrations out on it by kicking and punching it, usually with an audience and it had to be replaced many times over, much to the annoyance of the hospital (Queen Mary’s Childrens Hospital in Carshalton under the care of Mr. Cheong Ling and Mr Polly. Also, for a huge confidence boost, here is a list of famous people and celebrities who have Scoliosis: Liza Minnelli (Actress) Rene Russo (Actress) Sarah Michelle Geller (Actress) Melanie Blatt (Singer, All Saints) Catherine Oxenberg (Actress and Model) Elizabeth Taylor (Actress) Chloe Sevigny (Actress) Sarah Polley (Actress) Janet Evans (Olympic Swimmer) Jessica Andrews (Country Singer) Jeanette Lee (Professional Pool Player) Alexandra Marinescu (Olympic Gymnast) To name but a few, so we certainly are with the elite!!!! I have also put photographs of some of these people below. Self confidence can be a real problem with scoliosis and naturally so, but don’t feel it is the end of the world and don’t let it stop you achieving your goals. These people did not.
Both myself and my daughter Clare who is only 14 have scoliosis. We will share our experiences with you on this website. We are both at different stages at the moment, with Clare only being diagnosed within the last 8 months. She is only at the monitoring stage at present as her curve is too small to be measured. (As of June 2007) She has said that I can include pictures and I have added these a bit later on. I myself have had a long relationship with Scoliosis and have also had 4 pregnancies. My curvature has progressed from 35 degrees immediately after coming out of the brace at 17, to 76 degrees today. I did not have surgery by my own choice. This is a decision that I now very much regret. The reason I regret it is because had I had the surgery during my teenage years, they would have got a near perfect correction. Now all I can hope for is a 50% correction, which to me is better than nothing, and back to where I started. Surgery Prior to surgery you will need to have a pre op assessment. Lateral bending X-rays will be taken and an MRI scan (magnetic resonance imaging) MRI scanning is harmless to the patient and provides the consultant with detailed images so that they can ensure there is no nerve damage prior to surgery. I must say at this point, that an MRI scan can be pretty scary due to lying within the scanner and the extremely loud noise during the process and would not be suited to those with claustrophobia but realistically all you do is lie there, sometimes for up to an hour. It’s just whether you can tolerate the noise in the process. Since I have not yet undergone surgery I can not report from personal experience, although I know precisely what is involved. Bone grafts are taken from somewhere in the body, usually a rib or hip, and are grafted to the vertebrae to make it ridgid and prevent the escalation of the curve, the object being to obtain a solid fusion. A selection of rods, wires, hooks and screws are used to stabilise this or sometimes a brace or cast is used until fusion is achieved through healing (3-12 months). The Harrington rods once used are now obsolete. There are various methods for achieving the correction and the consultant will decide which method is best for the patient. Posterior fusion is where the surgeon will operate through the back with an incision straight down the back. For most of these operations a brace or cast will not be required as rods, hooks and screws will hold the spine in place until full fusion is achieved. In congenital scoliosis, instruments are not used and a brace or cast will be needed to hold the spine until fusion takes place. Anterior fusion is where the surgeon will operate through the front or side through the abdominal cavity so that access to the front of the spine is made and bone grafting screws and rods are used. The surgeon can also sometimes use a thorascope so that minimal incisions are required. This is a method where a telescope and camera are used. Hospitalisation is required, and depending on the age of the patient, this can be up to two weeks. There is another surgical procedure that can be carried out called a Costoplasty or thorcoplasty which is a cosmetic treatment to the rib hump where scoliosis has caused significant deformity. This operation can either be part of the same operation as the fusion or at any time in the future. It is a painful procedure leaving you feeling a bit like you have been kicked by a horse, and is not always successful. The main issue with scoliosis patients is the cosmetic appearance of the rib hump and rightly so. In the summer, I am extremely self conscious about my back. I am very slim and the ribs are so prominent, I am constantly aware of it and used to wear jackets even though the temperature was 80 or 90 degrees. I have just been looking at the Forum here where the costoplasty is being discussed by those that have had this procedure. Some are very happy with it and some have had it done more than once and are still not happy with the results. Some are in a lot of pain. It is probably something that needs much weighing up of the pro’s and con’s and plenty of discussion with your surgeon to ensure that he can get a good enough correction of the curve before embarking on such a painful procedure. I would not settle for anything less than 50%. Some scoliosis patients can end up worse. Please watch the YouTube video below to see the story of a very successful outcome for a young lady.
There are also alternative private treatments available and I am going to a private consultation with them see www.scoliosissos.com This is a centre in the UK which teaches a programme of exercises tailored to each specific patient and is based on the Katharina Schroth method. It is non invasive and some great results have been achieved on scoliosis patients. It is a four week block of treatments and patients are provided with a DVD of their own specific treatment and continue with this at home for life. It involves only 30 minutes a day. Not much when you consider the benefits. My husband has just called them on 01394 389 670 to find out what is involved. You go for an initial free consultation where you will be assessed. They only take you onto the programme if they can help you which is great as you are not given false hope or waste money. It costs around £2,400 if you are accepted. However, if they can help you, which will be made clear at the free consultation, this is a small price to pay, although I appreciate that not everyone has that kind of money available. It is not a cure for Scoliosis but a treatment that when used every day for life, can stabilise the curvature and also reduce the deformity in some patients. I am intending to go for the free consultation with my daughter Clare, so will let you all know what happens and whether I feel that this is a good option. If so, I will have to start saving as it will be £2,400 for me and the same for Clare!! My husband Mike has also just pointed out that you need to stay there for 4 weeks, so if that is difficult they may be able to arrange something else. It is an intensive treatment and exercises are performed daily 5 days a weeks, from 10am until 5pm for 4 weeks. Sounds gruelling? Yes but so does the surgery. Although I am on the waiting list at Guys hospital in London under the care of Mr K Lam who is a specialist in scoliosis surgery, I must admit to being daunted by it and would like to find an alternative. Scoliosis is harrowing and strips self esteem. However, much can be done to help and no matter what route is taken, it is important to first choose the right one for you. There are many websites on the subject, many of which I have listed here. Also, it is far more common than you think, although I appreciate that it is hard to find someone with it when you are walking around your shopping centre or mall. New ideas are coming out all the time, new types of brace, new alternative therapies. Investigate them all before deciding on spinal fusion surgery and/or costoplasty. Also, keep exercising, daily for about 20 mins!!! Swimming is brilliant for scoliosis as it stretches out the back and strengthens the muscles. Exercise keeps your back muscles strong therefore helping to stabilise the curvature and remember to sit up straight!!! Posture is very important as not only does it keep the muscles around the spine strong but it actually helps with the appearance. A slouched posture makes the rib hump look worse. Sitting, standing and walking nice and straight lead the eye away from your back and gives an elegant appearance. (Models, eat your heart out!!) Remember, posture is key in the maintenance of scoliosis as it allows your back muscles to correctly support your spine, so no slouching!! Slouching weakens your already weak back muscles which is turn will cause an escalation of the curvature unecessarily. Also, incorrect posture makes scoliosis more noticeable. In a straight posture, scoliosis is more difficult to see. I will keep you updated of further information and it is my intention to keep you all informed of both mine and Clare’s progress and any therapies we decide upon ourselves and their benefits or failings. Last of all, don’t worry. There are many people out there with scoliosis, some have had surgery, some have not and choose not to either. At the end of the day, it is your choice. Don’t be pressured and do your research but also remember to choose the right thing for you and your future. We hope our site will help you all Please see these Scoliosis websites for further information
www.scoliosissos.com
If you are facing the possibility of scoliosis surgery, you need to read Scoliosis Surgery: The Definitive Patient's Reference. Written in plain English by someone who has been through it, this book explains everything you need to know about: What is involved in scoliosis surgery How to decide whether surgery is the right course of action What the surgical options are What alternatives to surgery exist, and How to prepare for surgery and the lengthy recovery process Through detailed explanations of complex medical terminology and informative illustrations, this book will provide you with a solid understanding of scoliosis surgery, enabling you to better understand what your surgeon tells you and to empower you to ask more meaningful questions. I thoroughly recommend this book.
Please Click here to see the above excellent book. A must have.
1. Lie flat on the floor on your tummy, arms straight down by your sides. Keeping your hips and legs flat on the floor, raise your torso upwards at right angles to your lower body heading stretching upwards and backwards. It will probably feel uncomfortablle. Hold for 10 seconds and slowly lower to the floor to the count of 10. Repeat 5 times, building up to 20. 2. Lie flat on the floor on your back, arms straight by your sides, fingers flat on the floor by your legs. Slowly raise up and stretch your fingers to touch your knees. (Do not come up all the way. You are strengthening your abdominal muscles, so these will tighten. Hold for 10 seconds and slowly lower to the floor to the count of 10. Repeat 5 times, building up to 20. 3. Sit on a chair. Arms hanging down by your sides. Raise your left arm above your head and hold straight. Bend slowly over to your right until a full stretch is achieved on the left side. (as far as you can go)hold for 5 seconds. Repeat 5 times building up to 20. Then repeat same principle on the other side (raise right arm and bend towards left and repeat same amount of times) 4. Sit on a chair. Bend your arms at elbow and touch your shoulders keeping your arms out to the side of you. Twist slowly and simultaneously at waist (as though your were turning to see behind you) Hold for 5 seconds, then twist other way. Repeat 5 times building up to 20. I am getting copies of these exercises with pictures to put on the site so watch out for these as well as others as they are quite difficult to describe accurately. Please go to this website for more exercises for scoliosis.
Please click here to go to Clare's Story
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Adolescent Scoliosis is 8 times more common in females than males, the latter being more likely to develop the juvenile type. Also, curves to the right (dextroscoliosis) are more common than curves to the left (levoscoliosis). The spine can develop either a C shape curve or an S shaped curve and C shaped curves are slightly more common. Females tend to develop larger curves that require treatment.
Monitoring will be by regular appointments, either every three months or every six months.
,b>Boston Brace
The Milwaukee Brace
The Milwaukee brace was awful in summer because of the leather girdle and my self conscious need to wear a polo neck no matter what the temperature. The metal column used to press on my chest and cause pain and the chin support used to rub away and chafe the underneath of my chin. It was very difficult to sleep in and hard to decide whether to lie on your back or side. Usually in the mornings you would wake to discover that one side of your neck and face had gone numb due to the metal head support pressing on your neck in the night.
