The spine is very important to structure of the body. It holds and supports the entire body structure. Considered one of the most debilitating spine conditions, scoliosis is often also associated with a condition called osteoporosis. Let us discuss scoliosis and osteoporosis.
What is Scoliosis?
The spine is considered abnormal when it moves away from its normal alignment. Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurts just before puberty. Scoliosis can be structural or functional. Structure scoliosis can be caused by a condition such as cerebral palsy and muscular dystrophy. Functional scoliosis usually presents at the puberty age or over time from poor posture at work or typical daily activities.
What is Osteoporosis?
Osteoporosis is a bone condition that occurs when the body loses too much bone mass, produces too little bone, or both. Due to this weakening of the bone, premature decomposition or breaking down of the spine begins to occur. In severe cases, bone can become increasingly fragile, breaking if you fall, or in even more severe cases, with sneezing or minor bumps.
Both of these conditions are interconnected.
Postural Deviation due to Scoliosis and Osteoporosis
The spine can be either S-spine or C-spine due to scoliosis. Most commonly seen is S-spine. Scoliosis is identified when the thoracic spine moves either right or left and then compensatory movement happens to the lumbar spine.
Let’s use the following as an example; if the thoracic spine moves towards to right side, then the lumbar spine moves to the left side. Scoliosis is identified by its convex curvature. If the convexity is on the right side of the thoracic spine, then it is called right thoracic scoliosis. Ribs are also attached to the thoracic spine, so these also move from typical alignment. This leads to ribs hump. On the convex side, the ribs hump happens posteriorly. The forward bend test is important to distinguish whether it is structural or functional scoliosis. If the posterior rib hump is lost with forwarding bend, then it is called functional scoliosis. The body also moves from its normal alignment. The shoulder on the convex side is higher than the other side. The pelvis is also higher on the convex thoracic spine.
Osteoporosis leads to many deformities in the spine. It affects both men and women, in particular, white and Asian women, older and past menopause – are at higher risk. People with osteoporosis are prone to experience more occurrence of fractures. The most common areas of these fractures are the spine, wrist, hip, and ankle. In the spine, people with osteoporosis can lead to wedge fractures on the body of the vertebra. A person with osteoporosis in the spine needs to practice extra caution with movements such as bending, turning, twisting and lifting weights.
Clinical Presentation of Scoliosis
- Sideways curvature of the spine and sideways body posture
- One shoulder and hip are higher than the other shoulder and hip.
- Clothes not hanging properly
- Local muscular pain and ache
- Local ligament pain
- Reduced pulmonary function with severe scoliosis
- Chronic low back pain
What are the treatments for Scoliosis and Osteoporosis?
Medical management is beneficial for early-onset scoliosis. Medical management is helpful for younger clients because their spine can be successfully corrected. Surgical treatment is necessary for major curvature that remains progressive.
Physiotherapy treatment is very important for scoliosis and osteoporosis. Weight-bearing exercises are helpful for osteoporosis patients. These exercises increase bone growth and bone mass, which helps to strengthen the bone, as well as in the prevention and future osteoporosis-related fractures.
Bracing, a less invasive treatment method, is used to treat mild forms of scoliosis helping avoid surgical intervention. ROM exercises for the spine helps to maintain the available ROM of the spine and to improve the mobility of the spine. Strengthening exercises are important for the muscles, which are stretched and weak on the convex side of the spine. Stretching exercises are also helpful for muscles, which are tight and weak on the concave side of the spine. Electrical stimulation and TENS are necessary to work on affected muscles and to relieve the pain in scoliosis.
The physiotherapist will educate patients afflicted by scoliosis and osteoporosis, of precautions needed to take care to prevent further injury to the spine.