I am posting an interview (health chat) I stumbled upon a while back that I keep forgetting to post. It is really quite fascinating. The doctor is Dr. Douglas Orr of the Cleveland Clinic. Most interesting is that he mentions that smoking is a risk factor for progression of scoliosis in adults...twice!!
His most important advice:
connorb: Is there any way to prevent scoliosis from getting worse and avoiding surgery?
Speaker_-_Dr__Douglas_Orr: Stay active, keep your weight down, don’t smoke and prevent osteoporosis with appropriate diet, weight bearing exercise and sometimes medication.
A few interesting highlights (click the link below for the whole chat):
http://my.clevelandclinic.org/multim...ranscript.aspx
His most important advice:
connorb: Is there any way to prevent scoliosis from getting worse and avoiding surgery?
Speaker_-_Dr__Douglas_Orr: Stay active, keep your weight down, don’t smoke and prevent osteoporosis with appropriate diet, weight bearing exercise and sometimes medication.
A few interesting highlights (click the link below for the whole chat):
lauramc: Is it true that scoliosis cannot progress in adulthood?
Speaker_-_Dr__Douglas_Orr: No, this is not true. As the spine ages, the degenerative process can cause the curve to worsen. Typically, lumbar curves are more likely to progress. In general the curves progress about 1 degree per year if they are going to progress.
lauramc: You mentioned that a curve of 30 degree or greater may progress during adulthood - what's the likelihood of progression of a 40 degree curve? Is there anything that we can do to try to prevent it? Thanks.
Speaker_-_Dr__Douglas_Orr: It depends on whether a 40 degree curve is in the thoracic (rib cage) spine or the lumbar spine.
If it is thoracic, the risk of progression after skeletal maturity doesn't really go up significantly unless the curve is over 50 degrees.
There is little that can be done to prevent progression other than not smoking and maintaining an ideal body weight.
ladams9200: Hello Dr. Orr! I have had a previous spinal fusion surgery with 2 Harrington rods fused down to L4. I then had a small second surgery. Now, 13 years later, I am curving between the L4-S1 region and it is causing me a lot of pain to the point I'm developing insomnia also. The surgery suggested is not realistic for me this time in my life and was wondering if there was anything you would suggest helping this progressive curve and pain, other than living on pain meds of course. My insurance doesn't cover PT very well so that's not feasible right now either. Anything I could do at home? Why do you think this happens after having previous surgeries? I thought I would be completely fixed but that's not the case.
Speaker_-_Dr__Douglas_Orr: Fusions for scoliosis immobilize the vertebrae that are fused, but you continue to move through the other discs and these discs may wear out more rapidly as a result. A fusion to L4 with Harrington rods has approximately an 85% chance of leading to problems like you have. If surgery is not realistic for you at this time, there is little other than pain management that can be done.
lauramc: Is there any correlation between osteoporosis and scoliosis? Should scoliosis patients take extra measures to prevent osteoporosis? If so, do you have any suggestions?
Speaker_-_Dr__Douglas_Orr: If a patient with scoliosis develops osteoporosis their curve can get much worse and there may come a point where the bone quality is so bad, it becomes impossible to correct. It is vitally important that people with scoliosis be screened for osteoporosis and be treated aggressively if they have osteoporosis.
Prevention
connorb: Is there any way to prevent scoliosis from getting worse and avoiding surgery?
Speaker_-_Dr__Douglas_Orr: Stay active, keep your weight down, don’t smoke and prevent osteoporosis with appropriate diet, weight bearing exercise and sometimes medication.
execute: What types of exercises are beneficial for people with scoliosis?
Speaker_-_Dr__Douglas_Orr: Exercise is beneficial for any spine problems and there are 2 parts to it. One is a cardiovascular fitness program such as brisk walking, bicycling, swimming, and low impact aerobics. Second is a trunk strengthening exercise program that may be specifically designed for you by a therapist though Pilates and yoga are also quite good.
michald: I wore a Milwaukee brace for 3 years in the 70's. My scoliosis did not get worse but it is still there. I seem to have a difficult time with exercise. My spine doesn't seem to work like everyone else's. Are there exercises designed particularly for people with scoliosis, or are there some exercises I should just avoid? I think it sometimes causes me not to do the exercise properly and I end up straining another part of my body.
Speaker_-_Dr__Douglas_Orr: There are no exercises that will cause damage to your spine or worsen your scoliosis. Exercises to strengthen your trunk muscles (commonly called core strengthening) are the most beneficial. Scoliosis does limit the mobility of the spine through the curve and patients with scoliosis may feel stiffer. Stretching exercises may improve but will not eliminate this.
2cats1dog: What are the risks involved in pregnancy with mild scoliosis?
Speaker_-_Dr__Douglas_Orr: In the past, it was felt that women with scoliosis would progress their curves during pregnancy. We now know that this is not true. There may be a transient increase in the curve due to hormonal influences but this corrects about 6 months after you stop breast feeding.
Another myth is that women with scoliosis have a higher incidence of caesarian sections.
Speaker_-_Dr__Douglas_Orr: No, this is not true. As the spine ages, the degenerative process can cause the curve to worsen. Typically, lumbar curves are more likely to progress. In general the curves progress about 1 degree per year if they are going to progress.
lauramc: You mentioned that a curve of 30 degree or greater may progress during adulthood - what's the likelihood of progression of a 40 degree curve? Is there anything that we can do to try to prevent it? Thanks.
Speaker_-_Dr__Douglas_Orr: It depends on whether a 40 degree curve is in the thoracic (rib cage) spine or the lumbar spine.
If it is thoracic, the risk of progression after skeletal maturity doesn't really go up significantly unless the curve is over 50 degrees.
There is little that can be done to prevent progression other than not smoking and maintaining an ideal body weight.
ladams9200: Hello Dr. Orr! I have had a previous spinal fusion surgery with 2 Harrington rods fused down to L4. I then had a small second surgery. Now, 13 years later, I am curving between the L4-S1 region and it is causing me a lot of pain to the point I'm developing insomnia also. The surgery suggested is not realistic for me this time in my life and was wondering if there was anything you would suggest helping this progressive curve and pain, other than living on pain meds of course. My insurance doesn't cover PT very well so that's not feasible right now either. Anything I could do at home? Why do you think this happens after having previous surgeries? I thought I would be completely fixed but that's not the case.
Speaker_-_Dr__Douglas_Orr: Fusions for scoliosis immobilize the vertebrae that are fused, but you continue to move through the other discs and these discs may wear out more rapidly as a result. A fusion to L4 with Harrington rods has approximately an 85% chance of leading to problems like you have. If surgery is not realistic for you at this time, there is little other than pain management that can be done.
lauramc: Is there any correlation between osteoporosis and scoliosis? Should scoliosis patients take extra measures to prevent osteoporosis? If so, do you have any suggestions?
Speaker_-_Dr__Douglas_Orr: If a patient with scoliosis develops osteoporosis their curve can get much worse and there may come a point where the bone quality is so bad, it becomes impossible to correct. It is vitally important that people with scoliosis be screened for osteoporosis and be treated aggressively if they have osteoporosis.
Prevention
connorb: Is there any way to prevent scoliosis from getting worse and avoiding surgery?
Speaker_-_Dr__Douglas_Orr: Stay active, keep your weight down, don’t smoke and prevent osteoporosis with appropriate diet, weight bearing exercise and sometimes medication.
execute: What types of exercises are beneficial for people with scoliosis?
Speaker_-_Dr__Douglas_Orr: Exercise is beneficial for any spine problems and there are 2 parts to it. One is a cardiovascular fitness program such as brisk walking, bicycling, swimming, and low impact aerobics. Second is a trunk strengthening exercise program that may be specifically designed for you by a therapist though Pilates and yoga are also quite good.
michald: I wore a Milwaukee brace for 3 years in the 70's. My scoliosis did not get worse but it is still there. I seem to have a difficult time with exercise. My spine doesn't seem to work like everyone else's. Are there exercises designed particularly for people with scoliosis, or are there some exercises I should just avoid? I think it sometimes causes me not to do the exercise properly and I end up straining another part of my body.
Speaker_-_Dr__Douglas_Orr: There are no exercises that will cause damage to your spine or worsen your scoliosis. Exercises to strengthen your trunk muscles (commonly called core strengthening) are the most beneficial. Scoliosis does limit the mobility of the spine through the curve and patients with scoliosis may feel stiffer. Stretching exercises may improve but will not eliminate this.
2cats1dog: What are the risks involved in pregnancy with mild scoliosis?
Speaker_-_Dr__Douglas_Orr: In the past, it was felt that women with scoliosis would progress their curves during pregnancy. We now know that this is not true. There may be a transient increase in the curve due to hormonal influences but this corrects about 6 months after you stop breast feeding.
Another myth is that women with scoliosis have a higher incidence of caesarian sections.
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