How is scoliosis diagnosed
Scoliosis is a lateral bending of the spine, whereby the vertebral bodies are three-dimensionally deformed. At the same time, the spine rotates around its longitudinal axis. The thoracic and lumbar spine can be affected as well as the transition areas between different spine sections. The spine can bend to the left (left concave) or right (right concave). In addition, the pelvis is twisted in relation to the shoulder girdle.
Idiopathic, secondary, or acquired scoliosis
Medicine distinguishes one idiopathic scoliosis unknown cause from one secondary scoliosis (as a result of diseases or deformities) and z. B. through wear and tear acquired scoliosis in adulthood. In the latter case, scoliosis is often accompanied, exacerbated or triggered by other diseases of the spine such as osteoarthritis, disc changes or osteoporosis (bone loss). Fractures of the vertebral bodies caused by accidents, muscle diseases or paralysis can also occasionally trigger scoliosis.
Acquired scoliosis can occur at any age; idiopathic is usually noticeable shortly before puberty or during a pubertal growth spurt. Scoliosis is less common in younger children before the age of 10. The causes of idiopathic scoliosis are so far unknown, researchers suspect hormonal causes as well as genetic predisposition.
An untreated scoliosis of any kind does not resolve itself and must be treated in any case. If there is no treatment, the findings worsen, the curvature of the spine becomes more pronounced and can lead to massive problems.
Symptoms of scoliosis on the back and shoulders, ribs and pelvis
The symptoms of scoliosis are many and varied both visible and invisible in nature. In lighter cases, the curvature of the spine is hardly noticeable, in heavier cases the anatomical deformations are clearly visible. The severity of symptoms depends on the severity and type of scoliosis and can vary widely from patient to patient. The following are clearly visible:
- differently high shoulders,
- a rib hump / lumbar bulge as a sign of rotation,
- protruding and / or twisted pelvis and
- protruding shoulder blade.
As a rule, the visible changes do not show up all at once, but rather creeping and gradual with progression of scoliosis. As the disease progresses, the patient has increasing difficulty keeping their back straight and takes one while sitting, running, and standing crooked posture a. In the Adams forward bend test, the changes due to the rotation of the vertebrae are most evident.
Cobb angle as a measure of the severity of scoliosis
In the course of the disease, the muscles of the trunk are less and less effective against the deformations and twisting of the vertebrae in scoliosis. The spine forms several opposing arcs that compensate for each other and thus maintain body balance.
The Cobb angle (after the American orthopedic surgeon and surgeon John Robert Cobb) or the angle of curvature serves as a Measure for assessing scoliosis. Based on the Cobb angle that can be measured on the X-ray, the attending physician assigns the findings to mild, moderate or severe scoliosis.
At a mild scoliosis the angle of curvature is 10 to 20 degrees, but orthopedic care is usually only indicated from an angle of curvature of 20 degrees. Physiotherapy is the most important form of therapy for mild scoliosis.
If the angle of curvature is between 20 and 50 degrees, medicine speaks of one moderate scoliosis. If the Cobb angle is more than 20 degrees, depending on the individual case, a corset is indicated.
If the curvature is more than 50 degrees, the specialist speaks of one severe scoliosis. An operation may be necessary after this finding at the latest. The aim of a scoliosis operation is to stop an increasing curvature of the spine and to prevent the back from becoming increasingly misaligned.
From physiotherapy and physiotherapy to corsets and surgery
When diagnosing scoliosis, in milder cases or in the early stages, self-help measures such as attending a back school or physiotherapy can be counteracted. In the course of scoliosis, physiotherapy becomes a constant companion of the patient, with the Scoliosis gymnastics Proven to strengthen the core muscles according to Katharina Schroth. In any therapy, the effectiveness of the various treatment methods depends on the age of the patient as well as on the type and severity of the curvature and on the consistent implementation of a regular exercise program. Especially with children, a corset direct the development of the spine in the desired direction.
There are no known drugs to treat scoliosis. Painkillers such as ibuprofen provide relief as part of targeted pain therapy; in severe cases with very severe pain, the treating doctor uses opioids such as tramadol.
If left untreated, scoliosis worsens over the course of life, which becomes noticeable with increasing age in the form of increasing pain and impairment of the quality of life as a result of the progressive curvature. The last possible action is this Scoliosis surgerywhere the curved spine is stiffened by rods and screws. Most cases of scoliosis can be treated conservatively with the help of physiotherapy and, depending on the findings, a corset, and surgery is usually only performed in severe cases.
Rehabilitation for scoliosis as a healing method
A scoliosis rehab for children and adults is considered Healing method (HV) possible. The attending physician must state the need for rehab in writing. The doctor also checks, depending on the individual requirements, whether the health insurance (statutory or private) or the pension insurance is an option.
Medical necessity and a positive prognosis for the success of the rehab for scoliosis are required. The rehab usually lasts three weeks and takes place in an orthopedic rehabilitation center of choice with a focus on scoliosis. Learning the exercises according to Katharina Schroth with several exercise units daily, practicing certain breathing techniques and strengthening the muscles are in the foreground. Scoliosis rehab is recommended for children as well as for adolescents and adults.
In Germany there are various rehab centers that specialize in scoliosis patients and offer appropriate programs. You can submit the application to any social security provider, your family doctor will help you with this. Depending on the individual case, the scoliosis rehab is either inpatient or outpatient.
last changed on: 06/23/2020
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