Information On Lordosis, Kyphosis, and Scoliosis By: Stephanie Souder
Table of Contents
Table of Contents
Kyphosis Risk Factors
Kyphosis Prevention & Support
Scoliosis Lifestyle & Coping
Lordosis: What It Is
Lordosis is the word used to describe inward curvature of a portion of the vertebral column.
Tight low back muscles
Excessive visceral fat
Children can be born with Lordosis.
Other names for Lordosis are; Hollow back, Saddle back, and swayback.
A person can develop Lordosis through excessive weightlifting.
A woman can develop Lordosis due to strain on the back during pregnancy.
Lordosis of the lower back may be treated by strengthening the abdominal muscles and hamstrings, and by stretching the psoas muscles.
Anti-inflammatory pain relievers may be taken as directed for short-term relief.
Physical therapy effectively treats 70% of back pain due to Lordosis, Kyphosis and Scoliosis.
Severe Lordosis resulsts in nerve compression, or a pinched nerve, limiting the range of motion or loss of spinal integrity. In such a case, surgery is done.
Spinal Fusion is the most common form of corrective surgery indicated for extreme lordotic curvature.
Kyphosis: What It Is
Kyphosis is a curving of the spine that causes a bowing of the back, which leads to a hunchback or slouching posture.
It can cause difficulty breathing
Severe cases can cause great discomfort and even lead to death.
Types of Kyphosis:
Postural Kyphosis- The most common type
Scheuremann's Kyphosis- Significantly worse (cosmetically) and causes pain.
Congenital Kyphosis- results in infants whose spinal column has not developed correctly in the womb.
Nutritional Kyphosis- Results from nutritional deficiencies, such as vitamin D deficiency.
Difficulty breathing (in severe cases)
Mild back pain
Round back appearance
Tenderness and stiffness in the spine
Severe cases can affect your lungs, nerves, and other tissues and organs, causing pain and other problems.
Treatment for kyphosis depends on your age, the cause of the curvature and its effects.
Adolescents with Scheuermann's disease tend do well even if they need surgery, and the disease stops once they stop growing.
Kyphosis can occur as a result of developmental problems; degenerative diseases, such as arthritis of the spine; osteoporosis with compression fractures of the vertebrae; or trauma to the spine. It can affect all ages.
Congenital kyphosis requires corrective surgery at an early age.
Scheuermann's disease is treated with a brace and physical therapy. Occasionally surgery is needed for large (greater than 60 degrees), painful curves.
Multiple compression fractures from osteoporosis can be left alone if there are no nervous system problems.
Kyphosis caused by infection or tumor needs to be treated more aggressively, often with surgery and medications.
Risk Factors of Developing Kyphosis
Adolescent girls with poor posture are at greater risk of postural kyphosis.
Boys between the ages of 10 and 15 are at greater risk of Scheuermann's kyphosis.
Older adults with osteoporosis are at greater risk of spinal fractures that can contribute to kyphosis.
People who have connective tissue disorders, such as Marfan syndrome, also are at greater risk.
Complications of Kyphosis
Body image problems. Adolescents, especially, may develop a poor body image from having a rounded back or from wearing a brace to correct the condition.
Deformity. The hump on the back may become prominent over time.
Back pain. In some cases, the misalignment of the spine can lead to pain, which can become severe and disabling.
Breathing difficulties. In severe cases, the curve may cause the rib cage to press against your lungs, inhibiting your ability to breathe.
Neurological signs and symptoms. Although rare, these may include leg weakness or paralysis, a result of pressure on the spinal nerves.
If a person has Lordosis, they might develop Kyphosis to overcompensate for the pelvis being tilted forward.
Kyphosis Prevention & Support
Treating and preventing osteoporosis can prevent many cases of kyphosis in the elderly. Early diagnosis and bracing of Scheuermann's disease can reduce the need for surgery, but there is no way to prevent the disease.
Make sure you, someone you know, and especially children, have caring people to turn to, including supportive family and friends, or even a professional counselor, if necessary. Consider joining a support group for people, parents and kids with kyphosis or other spinal deformities to help you and others connect with people facing similar challenges.
Scoliosis: What It Is
Scoliosis is a curving of the spine.
The spine curves away from the middle or sideways.
A complex three-dimensional deformity.
Spine is in the shape of an "S" or "C", rather than a straight line.
Backache or low-back pain
Shoulders or hips appear uneven
Spine curves abnormally to the side (laterally)
A doctor may suspect scoliosis if one shoulder appears to be higher than the other, or the pelvis appears to be tilted. Untrained observers often do not notice the curving in the earlier stages.
Uneven musculature on one side of the spine.
A rib prominence and/or a prominent shoulder blade, caused by the rotation of the ribcage in thoracic scoliosis.
Uneven hips/ leg lengths
Slow nerve reactions (in some cases).
Tests to Determine Scoliosis
Scoliometer screening (a device measures the curvature of the spine)
MRI (if there are any neurologic changes noted on the exam or if there is something unusual in the x-ray)
Spine X-Rays (taken from the front and the side)
The health care provider will perform a physical exam, which includes a forward bending test that will help the doctor define the curve. The degree of curve seen on an exam may underestimate the actual curve seen on an x-ray, so any child found with a curve is likely to be referred for an x-ray. The health care provider will perform a neurologic exam to look for any changes in strength, sensation, or reflexes.
Causes of Scoliosis
Genetics are believed to play a role in adolescent idiopathic scoliosis, the most common form of Scoliosis.
Congenital (present at birth) Scoliosis is due to a problem with the formation of the spine bones (vertebrae) or fused ribs during development in the womb or early in life.
Neuromuscular Scoliosis is caused by problems such as poor muscle control or muscle weakness, or paralysis due to diseases such as Cerebral Palsy, Muscular Dystrophy, Spina bifida, and Polio.
Some people may be prone to curving of the spine. Most caseequally.s occur in girls. Curves generally worsen during growth spurts. Scoliosis in infants and young children are less common, and commonly affect boys and girls equally.
Types of Scoliosis
Adolescent Idiopathic Scoliosis - Most common type; over 10 years old.
Infantile Idiopathic Scoliosis - when aged under 3.
Juvenile Idiopathic Scoliosis - occurs ages 3-10.
Types of Scoliosis based on the cause of Scoliosis:
Nonstructural (functional) Scoliosis - a temporary condition caused by some underlying condition.
Structural Scoliosis - a fixed curve not always caused by an underlying condition.
Types of scoliosis based on the apex of the spinal curvature:
Thoracic Curve Scoliosis
Lumbar Curve Scoliosis
Thoracolumbar Curve Scoliosis
Treatment depends on the cause of the scoliosis, the size and location of the curve, and how much more growing the patient is expected to do. Most cases of adolescent idiopathic scoliosis (less than 20 degrees) require no treatment, but should be checked often, about every 6 months .
The choice of when to have surgery will vary. After the bones of the skeleton stop growing, the curve should not get much worse. Because of this, the surgeon may want to wait until your child’s bones stop growing. But your child may need surgery before this if the curve in their spine is severe or is getting worse quickly. Curves of 40 degrees or greater usually require surgery.
There are many different kinds of braces used.As curves get worse (above 25 to 30 degrees in a child who is still growing), bracing is usually recommended to help slow the progression of the curve .
Each brace looks different. There are different ways of using each type properly. The selection of a brace and the manner in which it is used depends on many factors, including the specific characteristics of the curve. The exact brace will be decided on by the patient and health care provider.
A back brace does not reverse the curve. Instead, it uses pressure to help straighten the spine. The brace can be adjusted with growth. Bracing does not work in congenital or neuromuscular scoliosis, and is less effective in infantile and juvenile idiopathic scoliosis.
Scoliosis Treatment (Continued)
Surgery involves correcting the curve (although not all the way) and fusing the bones in the curve together. The bones are held in place with one or two metal rods held down with hooks and screws until the bone heals together. Sometimes surgery is done through a cut in the back, on the abdomen, or beneath the ribs. A brace may be required to stabilize the spine after surgery.
Physical therapists and orthotists (orthopedic appliance specialists) can help explain the treatments and make sure the brace fits comfortably.
The limitations imposed by the treatments are often emotionally difficult and may threaten self-image, especially of teenagers. Emotional support is important.
The outcome depends on the cause, location, and severity of the curve. The greater the curve, the greater the chance the curve will get worse after growth has stopped.
The greater the initial curve of the spine, the greater the chance the scoliosis will get worse after growth is complete. Severe scoliosis (curves in the spine greater than 100 degrees) can cause breathing problems.
Mild cases treated with bracing alone do very well. People with these kinds of conditions tend not to have long-term problems, except an increased rate of low back pain when they get older. People with surgically corrected idiopathic scoliosis can do very well and can lead active, healthy lives.
Patients with neuromuscular scoliosis have another serious disorder (like cerebral palsy or muscular dystrophy) so their goals are much different. Often the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair.
Babies with congenital scoliosis have a wide variety of underlying birth defects. Management of this disease is difficult and often requires many surgeries.
Complications of Scoliosis
Emotional problems or lowered self-esteem may occur as a result of the condition or its treatment (specifically, wearing a brace)
Failure of the bone to join together (very rare in idiopathic scoliosis)
Low back arthritis and pain as an adult
Respiratory problems from severe curve
Spinal cord or nerve damage from surgery or severe, uncorrected curve
Spine infection after surgery
Lung and heart damage (in severe cases)
Back problems. Adults who had scoliosis as children are more likely to have chronic back pain than are people in the general population. People with untreated scoliosis may develop arthritis of the spine.
Lifestyle of a Person with Scoliosis
Although physical therapy exercises can't stop scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being.
Routine scoliosis screening is now done in middle and junior high schools. Because of screening, many cases that would have previously gone undetected until they were more advanced, have been diagnosed at an earlier stage.
Coping with Scoliosis
Coping with scoliosis is difficult for a young person in an already complicated stage of life. Teens are bombarded with physical changes and emotional and social challenges. With the added diagnosis of scoliosis, anger, insecurity and fear may occur.
A strong supportive peer group can have a significant impact on a child's or teen's acceptance of scoliosis, bracing or surgical treatment.
A support group is an excellent source of community for adults to share their experiences as well.
Yoga is considered a great exercise to deal with mild scoliosis.