Functional Scoliosis

Scoliosis is an abnormal curvature of the spine. If you were to look at an X-Ray of a healthy standing upright, the spinal column wound appear straight, despite the normal vertical curvatures of the spine. If you were to look at a standing person's X-Ray images, the spine would show some degree of lateral curvature. This abnormal lateral curvature may or may not cause a person to have back pain, but if the curvature increases over time, it could eventually cause a person to have pain and dysfunction. Regardless of the symptoms that person feels, the abnormal curvature will put stress on the joints and discs of the spine, raising the risk of degenerative joint disease and facet joint problems.

The twisting of the spinal column to the side may occur along the length or one or more sections of the vertebral column (spine). Scoliosis can be classified as true scoliosis or functional scoliosis. True scoliosis involves abnormal development of the spine, during fetal development, or during childhood and adolescence. Functional scoliosis is caused by a disease or condition that is not directly related to the spine. Specialist will be more likely to determine the cause of functional scoliosis, and trace it back to a specific structure (such as one leg being bigger than the other) or disease. Typical treatments of all types of scoliosis will involve treating the disease that caused it (if diagnosed), bracing, physiotherapy (physical therapy), or surgery if necessary.

Functional scoliosis: Functional scoliosis may be caused by asymmetries in either the structures of the body, or in the strength of the muscles that support the spine. If the muscles are stronger or vary in length compared to the same muscle or muscle group on the opposite side, the spine could be pulled in one direction, resulting in an abnormal curve. Functional scoliosis may occur if the patient child has one leg longer than the other, causing the pelvis to tilt to one side to compensate. This tilting of the pelvis can cause to spine to curve. If one side of an adolescent's body grows faster than the other, it can cause the two sides of the spine to be imbalanced, and the soft tissues of the affected side to shorten. Prognosis and treatment. The prognosis depends on where the abnormal curve is, the severity of the curve, and when the symptoms begin. The prognosis for treatment or cure will depend on how severe the curve is and how early the problem is discovered and treated. Early identification of childhood scoliosis may help to prevent further deformity or to even lessen the angle of spinal curvature. Treatments for this condition will vary depending on the person's/ child's stage of development. Is the person still growing. That may affect the type of treatment program.

Physiotherapy is likely to be successful for patients with mild to moderate angles of curvature whose deformity is discovered to be due to muscular asymmetries. The Schroth method is a safe and noninvasive physiotherapy exercise that has a proven record of success for nearly 100 years. The Schroth method is a program that uses isometric and other exercises to lengthen or strengthen asymmetrical muscles that support the back and assist in movements of the spine.

In a normal human spine, the structure would look completely straight if you were able to see into someone's body when standing directly in front of if or behind it. In the condition of scoliosis, the spine is curved from side to side. This condition usually develops early in life, due to congenital problems or unknown reasons, or late in life due to degenerative conditions that affect the vertebral bones, discs, and spinal ligaments. There are several different types of scoliosis, and the individual names given to each condition varies due to when it was first discovered and due to what caused this abnormal lateral curvature of the spine.

What is functional scoliosis? Functional scoliosis is a spine that has an abnormal lateral curve but not the kind of structural instability that results from congenital defects and diseases. Functional scoliosis is a correctable and reversible form of scoliosis which may be successfully treated when the underlying cause of the change in the spine is eliminated. Muscle spasms, inflammatory conditions, and differences in arm length may cause functional scoliosis. Despite the curve that is observed and present, the spine is determined to be structurally normal. This type of scoliosis may also be called structural scoliosis. Functional scoliosis, also called nonstructural scoliosis, is a temporary condition that may be corrected by treating the underlying cause of the abnormal lateral curvature.

Nonstructural scoliosis involves the temporary change to the spinal curvature, due to an inflammatory condition, prolonged muscle contractions (muscle spasm), medical condition, or anatomical abnormalities or imbalances.

Anatomical abnormalities may include muscle conditions which cause the spine to be pulled in one direction, such as a muscle spasm. Another structural abnormality of the body which may change the angle of the spine is differences in arm or leg length. Appendicitis is one example of an inflammatory condition which may affect the shape of the spine and cause nonstructural scoliosis. Functional scoliosis does not require treatment directly on the spine itself.

Other types of scoliosis conditions may be labeled as structural scoliosis. This type of scoliosis involves a fixed curve of the bones of the spine which won't be easily corrected with conservative back pain treatments.

Let's take a closer look at the other terms and definitions that are used to classify scoliosis conditions.

Scoliosis is usually apparent early, either at birth or in early childhood development. When grouped by age, this condition is categorized according to age:
  • Infantile scoliosis: from birth to 3 years
  • Juvenile scoliosis: from 3-9 years old
  • Adolescent scoliosis: from 10-18 years old
80% of all cases of idiopathic scoliosis (scoliosis of no known cause) are observed in adolescents between the ages of 10-18. These are the ages when the spine grows the most rapidly, which is why school healthcare workers and doctors inspect children in this age group the most often.

Scoliosis may also be classified according to the direction that the curve takes, either to the right or the left. In some cases, the abnormal curvature may angle in more than one direction. Here are some medical terms used to classify scoliosis based on its direction and location.
  • Dextroscoliosis: Dextro is a curve to the right. This type of directional curve is usually present in the thoracic spine. This type of curvature may be present in a C shaped or S shaped lateral curvature of the spine.
  • Levoscoliosis: Levoscoliosis describes a curved to the left. This type of curvature is usually located in the lumbar spine (lower back). When Levoscoliosis is discovered to be in the thoracic spine, the probable cause of the condition is a spinal tumor. When spinal tumors are suspected, doctors may order an MRI to conform the diagnosis.
Scoliosis may also be classified according to the location where the curve is seen. This curve may be located in one region of the spine or may border more than one region.
  • Thoracic scoliosis is found in the thoracic part of the spine. The thoracic spine begins near the base of the next and ends above the lumbar spine near the top of the lower back.
  • Lumbar scoliosis: This curvature is found in the lumbar spine (lower back)
  • Thoracolumbar scoliosis: The thoracic spine includes the T1-T12 thoracic vertebra, and the lumbar spine begins just below the thoracic spine and includes the bottom 5 vertebra. The bottom of the lumbar spine borders the top of the sacrum, which is located in the pelvis and is anchored to the interior margins of the pelvis at the sacroiliac joints. Thoracolumbar scoliosis affects vertebrae in the thoracic and lumbar spine.
The terms listed above may be used to describe both the locations and direction of curvature. For example, Thoracolumbar Levoscoliosis describes condition in which vertebra in the thoracic and lumbar spine is angled to the left. Treatment options for scoliosis. The western conventional options for treating scoliosis range from observation and non-intervention to back surgery for conditions that involve chronic pain and pressure on the spinal nerves. Conventional options/treatments include: 1. Observation
2. Physiotherapy (physical therapy)
3. Occupational therapy
4. Osteopathic therapy or chiropractic (both of these professions involve manual manipulations of the spine)
5. Casting (EDF)
6. Bracing (back braces)
7. Surgery