Scoliosis
(For more information, visit the National Scoliosis Foundation at www.Scoliosis.org or www.scoliosis-assoc.org)
What is Scoliosis?
Scoliosis is a curvature of the spine. Most often it is believed to be genetic, develops during adolescense, and either stops or continues progressing into adulthood. This is called "adolescent idiopathic scoliosis" and is much more commonly found in girls than boys. The spine curves laterally into an "S" , or sometimes into a "C", and also rotates, so common visible symptoms include ribs protruding on one side (creating a hump), one shoulder or hip higher than the other, and corresponding muscular imbalances or asymmetries throughout the body. The muscles on the concave side of the curve will be chronically tense from overworking, while those on the convex side will be overstretched and weak. Sometimes people's heads will be tipped at an angle. Some people have scoliosis with no pain, but soreness and stiffness are common complaints. The cosmetic issues can be upsetting, especially for adolescents.
Although adolescent idiopathic is the most common type of spinal curvature, there are other kinds as well, including congenital (at birth), infant idiopathic, Lordosis, and Kyphosis. There are also functional curvatures (developed through asymmetrical activities) and curvatures which develop in response to an accident.
Doctors still do not understand the physical causes of idiopathic scoliosis, and through the years there have been many theories. Most research now is looking at brain development and/or specific genes. Several studies have focused on the deformities in pineal gland , with some interesting results. It is possible melatonin, a hormone secreted in the pineal gland, may play a role in the development and progression of scoliosis (see Kindsfater, Lowe, et al. JBJS 76A:187,1994) . This is interesting, because the Pineal Gland is the physical point corresponding to the "third-eye" meditative focal point for Yogic meditation. It is also the same physical location as the "Head-Neck-Spine" nexus, which is the focus of Alexander technique, another non-medical therapy which has shown positive results for people with scoliosis.
Medical treatments for scoliosis include physical therapy, bracing and/or surgery with steel rods and fusion. Bracing is controversial, and there are studies which claim it is completely ineffective. (Goldberg, Dowling, Hall, Emans - Spine 18:902, 1993) (Allington - JBJS, 1996) Scientifically, it is a difficult topic to study, because one can never be sure what would have happened to a person's curve had the brace not been worn. We can only rely on overall statistical differences among large groups.
One thing which has been shown is that the flexibility of a patient increases the effectiveness of bracing: the more flexible a person is, the more likely their curve progression will be stopped by bracing. This is a significant finding for those who wish to practice yoga together with bracing as a supplementary thereapy, in hopes of preventing the need for surgery. But this is one study, more neeed to be done. My experirence is that a person can stretch too much, and that additional strength is needed as well to increase stability
Surgery for scoliosis is much improved in the last 30 years. There are still controversies about methods, equipment, etc., and there will always be good and bad surgeons, but based on what I've seen and heard, most people feel better with their surgeries than they did before them. However, it is important to remember that it does not address whatever the cause is. If the cause is something in the brain, and the disease is intent on progressing, it will continue to run its course even with a fusion and rods. It finds a way, time will tell what happens to us 30 years down the road from now.
Surgery is recommended (or not) depending on the degree of curvature and the rate of progression. For example, the average curve progresses at 1 degree/year. If you are age 25 and your curve is 30 degrees, and you are not in pain, then one might guess that by age 60 your curve would be 40 degrees and that would be something you could risk living with. But if a person is age 13 with a 50 degree curve progressing at2 degrees/year, that means that if she does not have surgery, that by the time she is 4o the odds are good she may be crippled without it. Maybe a disciplined, daily yoga practice would help, but maybe not. And the older one gets, the trickier the surgery is.
So, as frightening and restrictive as the idea of surgery may sound, it is important to remain open, as it may be the best course of action, and it may work out very well.