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• 02 / 22 / 2010

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By Dr Miguel R. González Corona, Second Grade specialist in Orthopaedics and Traumatology, and Consultant Professor in Physical and Rehabilitation Medicine.

Our body is subjected to all the forces that act on living and inert elements of nature.

The main of all, gravity, takes us toward the Earth’s core, but millions of years ago our ancestors needed to draw themselves up from their four supporting points to reach a vertical position, hence their backbone developed four curves: fact that –among others– differentiates us from animals.

Without realizing or feeling it, we maintain a constant struggle to remain in the upright position through balance control.

What’s balance?

It’s the process through which we control the center of mass (COM) —also known as center of gravity of the body— in relation to the support base formed by our feet, either aesthetic (motionless) or dynamic (with motion).

For example, when we’re standing, our main objective is to keep the COM in the center of the support base, but when we walk, we continuously displace the center of gravity in relation to the support base, which is re-established at every step.

What is scoliosis?

It’s a lateral deformity of the spine in a frontal plane associated to a rotation of the vertebral bodies.

It can also be accompanied by an increase of swaybacks (cyphosis or hump and the popularly famous humpback) and lordosis.

Therefore, scoliosis has a 3D conception (in the three planes of space: frontal, lateral and transverse) the postural: it is generally detected between 8 and 10 years of age. The curves are always slight and disappear with the supine position (lying
face-up), and generally are due to incorrect sitting positions or carrying overweight on one shoulder, as is the case of school children, who have backpacks with two handles and only use one, thus altering balance and the center of gravity.

Usually, it can be caused by a length-difference of the lower limbs. The pelvis leans toward the shortest side.

Symptoms

•Painless: actual scoliosis rarely has a painful symptom. When there’s pain, it can be due to that fact that scoliotic curvatures cause compression processes of both the spinal cord and the nervous roots from discal hernias, arthrosis and muscular contractures.

•Visible lateral curving of the spine associated with a rotation of the vertebrae.

. Vertebral rotation leads to the formation of a costal hump on the convex side of the curvature. In pregnant women the

rotation may include the deviation of the pelvis and cause disorders at the moment of the childbirth.

•Rigidity, loss of mobility in the spine.

Restrictive respiratory alterations because of the lack of mobility of the ribs, which might even turn out to be, in some cases, deadly due to breathing failure.

Treatment

Scoliosis treatment can be carried out conservatively, through physiotherapy, corset application or surgery.

Since it is diagnosed starting at age 3 or younger, the orthopedic examination must include, besides the general study, the examination of the child’s back in erect position, in crouching position, in squatting position. The asymmetry between the
sides of the back shows up more markedly.

Thereof the importance of beginning the treatment in a physiotherapy service, in order to correct the deformity applying diverse therapeutic methods, such as massage to eliminate the muscular contracture of the paravertebral ligaments, the application of electrostimulation, posture correction to improve the balance and
coordination of movements, breathing exercises and the compensation of lower limb length discrepancies.

Advises for the treatment

•To do muscular stretching and strengthening exercises of the spine regularly.

•To avoid incorrect postures, unilateral efforts, to use a correct technique to lift weights, to avoid incorrect movements when ironing, sweeping, etc.

•To watch children’s postures at home when they sit down and while they study, and to watch whatever asymmetry in their body, for example, a lower shoulder, a longer leg, a hump in the back, a breast bigger than the other in girls.

•School teachers should form active part in scoliosis prevention and treatment.

•Sports such as swimming, volleyball, track and field, ballet and other dances are useful.

•Psychosomatic disorders, psychic efforts and stress make muscles contract and favor the appearance of scoliosis.

Source: Cubasí