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View Full Version : I'm discouraged by the lack or progress on scoliosis; new thinking is needed



Shaun26
06-26-2005, 05:57 AM
I'm a 26 year old male that was diagnosed with a 20 degree curve in highschool. I don't know if it's progressed or not, but if it has, it hasn't by much. Having lived with this condition it is a subject close to my heart.

I'm saddened by the lack of developments and treatments for scoliosis. It seems to me that the medical community has been and continues to approach many mild and medium forms of idiopathic scoliosis the wrong way.

The only mystery about "idiopathic" scoliosis is the specific reason why it initiates or begins. But there are essentially only two things to look at once it has already begun and focusing on one over the other is inappropriate. The areas that need attention are the spine and the muscles around the spine. If a spine is curved it is curved either because the spinal cord has for one reason or another begun to rotate and/or because the muscles around the spine are uneven in strength, thus pulling the spine in abnormal directions.

One thing to look at is the spine itself. Is the spine strong or weak. Has the spine developed properly except that it has rotated and begun to curve. Are the discs within the spine equal in strength and size. If one can determine that all things are fine except that the spine has begun to rotate, then we must look at another feature of the back that will influence spine curves. And let me just say that there is no such thing as a 'compensatory' curve. If you have a curve in your spine, it is a curve that may weave in and out and so long as the curve exists there is nothing compensatory about it.

The second area of study should be focused on muscles around the spine. A spine may begin to curve because the spine is weak, but it may only do so if the muscles in the back allow for it. If the muscles in the back are evenly distributed, even a weak back may stay straight. However, if the muscles in the back are stronger on one side over another, it will encourage curvature in a weak spine. Again, there is no such thing as 'compensatory' muscles in a curved spine. The muscles (the shorter, stronger mucles) on each side of the spine that are distributed unevenly are the muscles helping to increase the curve in the spine, not to compensate for it. Compensatory muscle development would be muscles that develop in precisely the same area of the spine opposite to the overzealous muscles on the other side. This does not happen. When the muscles are pulled toward the right on the top portion of the spine, we see increased muscle development in the lower left portion of the spine. What we want to see is increased muslce development on the top left portion of the spine to bring the spine back into alignment. Anything short of this type of muscle development is not compensatory. It is in fact almost gauranteed to increase the spine curve rather than compensate for it. We need studies on the muscles in the backs of scoliosis patients. Are muscles of the spine all created equal or do some have intrinsic properties that make them more aggressive when pulling the spine. Can these muscles be cut away and/or transfered to the areas with weak muscles. Can this muscle be encouraged to grow in sections that lack it to begin to truly compensate a curve. We know that in people with oversized hearts (the heart is a muscle) that doctors can literally cut off chunks of the heart and bring it down to size, and the heart remains in tact and functioning optimally. Perhaps the same can be done for much less potentially fatal muscles such as those of the spine.

I think the relationship of muscles and the spine in scoliosis patients was best described by somebody else who's article I read some years ago:


To think about it logically, I compare my spine to a tent pole and my muscles to tethers around the tent pole helping it to stay upright. If I had a tethered tent pole that was leaning to one side and I wanted to straighten it, I would pull tighter on some of the tethers and loosen up on others. If I applied equal force to all of the tethers on a pole that was unbalanced to start out, it would remain unbalanced. It was the same with my body. I had to loosen up the tight muscles (tethers) and tighten up the weak muscles (tethers) supporting my spine (my center pole).

In order to straighten out my body, I had to start thinking about it like an engineer would think about straightening a tilting column. The prevailing medical view about scoliosis seems to be that it is caused by some mysterious, as of yet undiscovered gene. Besides being unproven, I don't think this view takes into account gravity and the laws of physics. People's spinal columns are not exempt from the same laws of physics as other columns.

In thinking about my scoliosis from an engineering point of view, the first thing I did was to make make sure my spine (the column) itself was strong and stable. I think the reason there is such a strong link between osteopenia/osteoporosis and scoliosis is simply that weakened columns have more of a problem staying upright. A spine with lowered bone densities is probably less likely to be able to support its weight and stay upright, and hence will bend, buckle and curve as it tries to bear weight. This is exactly why people with rickets get scoliosis.

Another area to think about is that any small pull or unbalanced force placed on a column over a period of time is going to pull the column off center.



To summarize the following points thus far, there are two areas of idiopathic scoliosis that we can say influence spinal curvature. The spine and the muscles around the spine. If the bones of the spine have developed properly (there are no malformed vertebrea) but the spine has begun to twist, we can conclude that it has to do with either the spine strength or the muscles around the spine. Additionally we have to re-orient the ways that we describe the curves and muscles we see in scoliosis patients. By saying compensatory this and compensatory that we give the impression that the spine is trying to self correct the problem. It is not. It is furthering the problem. Intervention needs to correct the problem.

Now on to treatments of medium and mild idiopathic scloliosis. It seems to me that it is in the treatments that we see the lack of focus on the two essential elements of spinal curves that I outlined above. For example, scoliosis surgery appears to always only focus on the spine without any regard for the muscles around the spine. We fuse sections of the spine together, or we brace sections of the spine using rods, and so forth. While this is fine, we could also try working with the muscles around the spine. If muscles are much shorter on on side and/or stronger on one side of a curved spine, why not remove some of it or extend it - stretch it - or attempt to attach it to the alternate side of the spine. Removing some of this over grown muscle tissue may give the spine the mobility that it needs to shift it's way back into normal alignment. While there may be difficulty in manipulating muscles around the spine, I believe that it is essential to 'curing' or correcting scoliosis. Even if a brace could theoretically straighten the spine when it's being worn, the spine would resort back to the curved state once the brace was removed because nothing has been done to the back muscles. The back muscles are still disproportionate and one you remove the brace keeping the spine aligned, the muscles would begin to twist and pull it out of alignment again. Therefore braces are only a temporary fixture. A brace cannot and will not correct the curve and it cannot and will not stop curve progression. Why have doctors in this area not been able to reach this conclusion by simple observation and common sense thinking, I do not know.

Yoga and other excercises may be fine because they ensure that the back remains mobile and elastic however, they will never cure or help the actual scoliosis. Weight lifting, using specific weight training as to work out under developed spine muscles instead of already over zealous spine muscles can also help. However, scoliosis requires very specific focus on spine muscles. When you work out or do yoga, you are working out multiple muscles even when you want to work out only a handful. Most importantly with weight lifting, one must be careful that they understand the excercise they are doing is combating rather than aggravating the scoliosis by strengthening the already over bearing muscles. Because of the nature of scoliosis, all excercises that a person can do must be assisted by surgery that can reduce the uneven distribution of muscle tissue and slowly allow the spine to regain it's natural vertical shape.

Things like sleep patterns, sports bags, and daily physical routines must also be taken into consideration. When I was younger, I would always sleep with my body in a certain configuration. It felt comfortable this way, and incidentally, my spine developed a curve that is reminiscient of the configuration my body had when I slept. Did my sleeping pattern cause the scoliosis or did I feel more comfortable sleeping this way because I already had developed scoliosis all those years ago and didn't know it? I don't know, however in the years after I found out, I begin sleeping in the opposite configuration. One spends many hours of their lives sleeping so trying to 'correct' or brace the curve naturally this way is something I've tried. To this day I know it would be more comfortable resorting back to the previous configuration.

Shaun26
06-26-2005, 06:10 AM
continued..


I also used to carry sports bags with one strap so that the weight was unequally distributed across my back. I would suggest using a normal double strapped bag. I also began working out in 8th grade, probably too young because the spine is still developing. Any mistakes or overworked back muscles that are not noticeable at that stage may be magnified over time in the form of scoliosis. The same goes for activities such as basketball where you essentially use one half of your body differently repeatedly over the other half. When you throw the basketball using proper form, you're excercising your throwing arm more than your aiming arm and this repeated action may also mean that you're developing certain back muscles more than others.

In short, compensatory behavior is recommended. If you're used to sleeping in a specific way, sleep the opposite way. If you carry your wallet in one back pocket begin carrying it in the other. If you open doors with one hand, begin to always use the other instead to open doors. We could probably learn much from people who can write and play sports using both hands by studying their muscle development.

To summarize all points made, we have to begin taking the mystery out of most idiopathic scoliosis conditions. Common sense will tell us that a curved spine is that way because of the spine or the spine muscles and most likely an interaction between the two. Therefore any corrective effort should and must effectively take into consideration both in order to find an everlasting solution. Our piece meal approach that too often focuses on one over the other, or over emphasizes ineffective solutions such as yoga, have led the medical community to an impasse and there will be no breakthrough until these lines of thinking are dramatically changed. Perhaps it will take more peole suffering from the condition to propose these different approaches because living with it gives one intimate knowledge about it. If we continue to tread the current path, you and your children (who may be prone to mild scoliosis) will continue to suffer life long discomfort and even pain without any hope for solution.

Celia
06-26-2005, 01:54 PM
Wow Shaun !!!

You've really given this some thought ! I've been thinking along the same lines regarding muscle weakness, weight training etc... but I never considered that muscles could be surgically manipulated to make one side weaker than the other. Interesting....



Celia

Shaun26
06-26-2005, 02:16 PM
Thanks Celia...

Living with scoliosis for more than 10 years now I've had lots of time to think about it. I regularily stretch my back. Thankfully my scoliosis is mild but I think that I could do the same things with a medium form of scoliosis.

I'm just surprised that nobody seems to have touched on the subject. I've sent a copy of my 'message' to http://www.srs.org/ (Scoliosis Research Society) today. I'll keep you posted on what they say about my article.

I prefaced my email to them asking them not to simply disregard it because sometimes communities are resistant to change, the medical community included. There seems to me more ways to tackle scoliosis than what we're currently looking at. I hope it inspires some doctors or somebody who can actually do the research, run trials, and see if any real progress can be made.

Wearing braces seems so medieval and while I think there is still a place for it, clearly it's not a solution. People on this board who use it and have even had current forms of surgery are telling us their scoliosis is still present.

Karen Ocker
06-26-2005, 02:51 PM
Shaun:
Here is some new research from the National Library of Medicine regarding causes of idiopathic scoliosis:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15948477&itool=iconabstr&query_hl=9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15897833&itool=iconabstr&query_hl=2


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12973153&query_hl=10

These suggest a genetic cause and possible a metabolic component(melatonin?)

gerbo
06-27-2005, 11:46 AM
This line of thought isn't entirely new and if you type intogoogle something like muscles-paraspinal-scoliosis you are bound to come across articles looking at both musclestrength, but also muscle type on either side of the curve, and interestingly enough, muscletype (type 1 and 2) is not equal on either side, and yes, it is very tempting to think that the assymmetrical musclestrength either side this must cause could be a contributary factor to the worsening of a scoliosis

furthermore, go to medxonline.com/core/pdf_downloads/index.php and low down the list of articles you will comw down one called "role of measured resistance exercises in Adolescent scoliosis" by a Vert Mooney, as I understand it a now retired but respectable physician.

Worth downloading that one (will take a while )and reading it, as the results of the small study he did, and the background info, make for interesting reading.

gerbo

(ps, I have also wondered whether injecting the stronger side with botox would help)

Shaun26
06-27-2005, 11:53 AM
This line of thought isn't entirely new and if you type intogoogle something like muscles-paraspinal-scoliosis you are bound to come across articles looking at both musclestrength, but also muscle type on either side of the curve, and interestingly enough, muscletype (type 1 and 2) is not equal on either side, and yes, it is very tempting to think that the assymmetrical musclestrength either side this must cause could be a contributary factor to the worsening of a scoliosis

furthermore, go to medxonline.com/core/pdf_downloads/index.php and low down the list of articles you will comw down one called "role of measured resistance exercises in Adolescent scoliosis" by a Vert Mooney, as I understand it a now retired but respectable physician.

Worth downloading that one (will take a while )and reading it, as the results of the small study he did, and the background info, make for interesting reading.

gerbo

(ps, I have also wondered whether injecting the stronger side with botox would help)

Tnank you Gerbo!!!! This is the kind of feedback I was hoping for. I will look up the studies you've mentioned. I'm happy that others out there have begun to investigate this area and I'm intrigued at the findings that you mentioned. This brings me great hope because I believe this is where we will be able to solve most cases of scoliosis.

I've also thought about being able to inject the stronger side with some type of muscle relaxant. When I mentioned this to my chiropractor (I had one briefly years ago) he said there were too many muscles involved and it would be difficult. If we would be able to identify and only affect specific muscles or muscle groups I think the results could be astounding.

Again, thanks for your reply. It would seem to me the physician you speak of was on the right path. I hope others follow it. It seems to be the most rational path to consider.

Shaun26
06-27-2005, 12:25 PM
Gerbo, the link medxonline.com/core/pdf_downloads/index.php is inaccessible to me. Are you able to connect to it?

Celia
06-27-2005, 12:49 PM
Shaun/Gerbo,

I think botox is already being used. Check out this link:


http://www.pediatric-orthopedics.com/Treatments/Paraspinal_Botox/paraspinal_botox.html



Celia

Shaun26
06-28-2005, 01:31 AM
Shaun/Gerbo,

I think botox is already being used. Check out this link:


http://www.pediatric-orthopedics.com/Treatments/Paraspinal_Botox/paraspinal_botox.html



Celia

Excellent article and hits upon what's being discussed here. It does not surprise me that this type of treatment would prove effective.

I'm going to pursue this type of treatment for me. Instead of just getting the injection and bracing, I will skip bracing and resume specific weight training. Botox injections as shown in the article combined with the natural effects of proper weight training as shown in Vert Mooney's studies could possibly eradicate scoliosis is mild and medium scoliosis cases completely. It doesn't take a medical doctor to see something so clear. Basic physics and physiology are at play here. Some years from now I would be willing to bet that this becomes the most common form of treatment for scoliosis patients. I don't know why it already isn't.

gerbo
06-28-2005, 02:46 AM
Gerbo, the link medxonline.com/core/pdf_downloads/index.php is inaccessible to me. Are you able to connect to it?

just go to medxonline.com and go into their pdf downloads section, should work

gerbo

Shaun26
06-28-2005, 03:22 AM
just go to medxonline.com and go into their pdf downloads section, should work

gerbo

Thanks, I can get it now.

What's scary is that the journal article was published in 2003 and in the introduction he states the kind of studies have yet to be done like studies on the strength differentials on each side of adolesent scoliosis, and no study of specific excercises relating to the spine.

These are the most obvious types of studies to conduct. Instead, it seems researchers are more interested in having their articles published in obscure journals rather than helping to find solutions to the problem. It's baffling.

Any medical doctor working in this area should by now have conducted studies of this nature. It's no wonder we're still living in the 16th century when it comes to dealing with scoliosis, using obscene appartus' like braces to treat scoliosis. It's like trying to put out a flame with wood.

My theory that basketball using one hand can strengthen one side and possibly contribute to scoliosis is also evidenced in a study cited in this article. He notes a study where elite athletes in single arm skills like tennis and javelin developed scoliosis. These are the kinds of studies we need. It's crystal clear that muscle development one on side due to specific activities can influence the growth, development, and scoliosis.

A layman could surmise or hypothesize many of these studies.

My contention is that many forms of scoliosis should be relatively easy to treat. This is not a neurological or hidden or chemical condition in many cases. It's a strictly physical problem. And something as large and central to the body as the human spinal cord can and should be able to be straightened using appropriate and effective techniques. Too many so called professionals in this area are blinded sided thinking it's more complicated than it actually is. It's rather simple.

Yet if you raise the issue you will get a lot of resistance from those who claim to be in the know perhaps because the idea is so novel and they're unwilling to familiarize themselves with new ideas.

People with small curves should never have their curves increase in size. People with 30 degree curves should never wind up with 50 degree curves. We should not have to wait until a condition worsens to a degree where extreme surgery is necessary. Curves should and can be correct as soon as they're found. When you find that you have a cancer lump, you don't wait until it's rampant throughout your body to get it treated. The smaller the curve, the easier it should be to correct so efforts should be made at that stage to correct it and not just halt it from progressing. We have the information and technology at our disposal. Yet nobody has synthezised all this information into a robust treatment technique. Why haven't we begun utilizing what we know?

Too many people think that our current treatments are the only ones. It shows a complete lack of vision, creativity, and positivity needed to approach the problem of scoliosis. It can be beat.

Celia
06-28-2005, 08:22 AM
Shaun,

Who's Vert Mooney ? Sorry if you've already mentioned him, I haven't read your other posts yet. Has he published a book ?




Celia

gerbo
06-28-2005, 08:43 AM
Shaun,

Who's Vert Mooney ? Sorry if you've already mentioned him, I haven't read your other posts yet. Has he published a book ?




Celia
He is the writer of the article I quoted , an orthopaedic doctor (surgeon?)and appears to have good credentials, looking at his website and the apparant quality of his article. Also, one of our consultants in the UK seemed to know his name

gerbo

Celia
06-28-2005, 08:49 AM
Sorry Gerbo,

I guess I must be suffering from information overload. Don't get me wrong, I like it ! :D



Celia

gerbo
06-28-2005, 09:35 AM
Sorry Gerbo,

I guess I must be suffering from information overload. Don't get me wrong, I like it ! :D



Celia
information overload is our destiny for the forseeable future (at least for me), and how to distinguish the good from the bad, the absolute rubbish from the occasional pearl of wisdom???

its a tough life......

gerbo

(read that article though, you'll find it very interesting)

Shaun26
06-28-2005, 01:44 PM
It seems to me there are essentially two types of scoliosis:

1) Developmental Scoliosis - this type will usually be less severe and in many cases not even noticeable because the curve is so small and there is little or no pain nor discomfort.

Developmental scoliosis is probably due to a number of contributing factors including sleep patter and specific daily routines that strengthen one side of the back over the other. This would include single arm sports, lopsided heavy handbags, and so forth.

2) Genetic or Trauma Scoliosis - this type can take severe or non severe forms. It's most likely due to degenerative tissue (disks, muscles) and/or wedge shaped (or other abnormal shaped) vertebrae in parts or all sections of the spinal column.

It could be as simple as the muscles on one side of the spine either degenerate (weaken) while the other side remains normal, or one side becomes hyper active and thus much stronger than the other side. Studies have shown us that there are essentially two types of muscles on each side of the spine in scoliosis patients.



I think the reason why people have assumed scoliosis to be idiopathic is because 1) few studies have researched scoliosis and 2) it is so rare that even in a study conducted on normal people, the results are usually inconclusive because scoliosis will be found to develop in so few of the people that it's statistically insignificant, and that their are often more than a handful of variables involved. For example, if you're looking at the role of napsacks in scoliosis you may not get statistically significant results and you will only be looking at one out of many other contributory variables in the development of the scoliosis (note this is for Developmental rather than Genetic scoliosis). The lack of research or should I say unfocused research (because it seems the studies don't differentiate between Genetic versus Developmental scoliosis) has also made it difficult for researchers to pinpoint and troubleshoot Genetic scoliosis.

Karen Ocker
06-28-2005, 04:07 PM
Here is some info on the various types of scoliosis(Hospital for Special Surgery Columbia- Cornell Universities);

http://www.hss.edu/Conditions/Scoliosis/Idiopathic-Scoliosis

KRIS ATKINSON
06-28-2005, 06:18 PM
Shaun, for your information regarding sports and use of muscles on one side, etc., it occurs to me that my daughter is left-handed but her curve fits the "typical" pattern with the upper curve to the right and a right shoulder rib hump. She is around 70 degrees curve now. Thought the fact that she is left-handed might help your interests. Kris

Bamaro
07-05-2005, 11:24 AM
A brace cannot and will not correct the curve and it cannot and will not stop curve progression. Why have doctors in this area not been able to reach this conclusion by simple observation and common sense thinking, I do not know.
.
What makes you say this?

Tall Paul
10-01-2005, 06:24 PM
(ps, I have also wondered whether injecting the stronger side with botox would help)

I've had 3 series of botox injection in my left paraspinal muscles over the last year. For each series there were 5-7 injections, some in the throacic are and some in the lumbar. Due to my thoracalumbar scoliosis of 32 degrees my paraspinal muscles would become almost rigid from supporting my back over the years. After years of physical therapy I went to a new doctor who specalized in botox at a well know institution in Chicago. The relief was incredible. Long term however I'm not sure this was such a good idea. I now have more pain in the convex side of my curve, and I think by relaxing the muscles that supported my spine I actually put more stress on my spine and might have made the situation worse. But then again, it might have gotten worse anyway. The inections weren't very scientific, the doc felt around for the muscles in spasm and then injected. It was relatively pain free and I you start feeling better 3-4 weeks after the injections. Your body builds us an immunity to botox and therefore each subsequent injection requires more botox. Eventually your body builds an immunity and you'll need a new strain.

So to answer the question, yes botox did help and allowed me to begin working out and stretching a very stiff back, but long term I don't know if I did more harm to my spine than good temporarily paralyizing some of its support system.