Cervical scoliosis can affect your sleep
Written by Till von Bracht • Medical editor
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When the spine becomes crooked, doctors call it "scoliosis". If this is recognized in good time, special physiotherapy exercises and a corset can help. Surgery is only necessary in severe cases.
What is scoliosis?
Scoliosis is a curvature of the spine (Greek. scoliosis = crooked). It usually begins with growth: Die individual vertebrae grow unevenly, so that the spine gradually deviates from its axis: you bends to the side and twists.
Also uneven loading and one-sided wear can lead to a curvature of the spine. Doctors refer to this form of scoliosis as "degenerative scoliosis"As a rule, it occurs in old age.
Scoliosis usually begins in childhood or in the puberty, so in growth. Many patients are between 10 and 12 years old when they see a doctor with the curvature. Often they were made aware of their "crooked back" by friends, family members or teachers - for example in the swimming pool or during physical education. Because at the beginning scoliosis does not cause any pain.
In the long run, however, the curvature leads to the spine being put under incorrect strain. As a result, it wears out more in places. Also Muscle tension and pain are common consequences of scoliosis. The symptoms can worsen with increasing age. Internal organs such as the heart, lungs, kidneys, stomach and intestines can also be affected by the consequences of scoliosis.
The symptoms also depend on where exactly the spine is deformed and how strong. Based on these two characteristics, scoliosis can be divided into different types.
Classification according to the affected spinal column:
- Thoracic scoliosis: The turning point of the main curvature is in the thoracic spine (BWS) area.
- Lumbar scoliosis: The turning point of the main curvature is in the lumbar spine area.
- Thoracolumbar scoliosis: The turning point of the main curvature is in the transition area between the thoracic and lumbar spine.
- Thoracic and Lumbar Scoliosis: The turning points of curvature are in the thoracic and lumbar spine area.
Classification according to the strength of the curvature:
- below 40 degrees: 1st degree scoliosis (mild scoliosis)
- 40 to 60 degrees: 2nd degree scoliosis (moderate scoliosis)
- 61 to 80 degrees: 3rd degree scoliosis (severe scoliosis)
- more than 80 degrees: 4th degree scoliosis (very severe scoliosis)
In most cases - at 85 out of 100 people affected - the doctor can the cause the scoliosis not notice. A scoliosis with unknown root cause is referred to as idiopathic scoliosis (Greek idios = own, pathos = Suffering, idiopathic = independent suffering without a recognizable cause).
How scoliosis develops, but it is known:
- The Vertebral bodies grow unevenly: One side grows more slowly than the other.
- This takes one side of the vertebral bodies more space one than the other.
- The vertebral bodies rotate against each other.
- There the spine twists around its own axis and bends to the right (right convex scoliosis) or left (left convex scoliosis).
In addition to the idiopathic scoliosis occur other forms the curvature of the spine, whose Causes known are. The most common trigger are:
- Congenital malformations: Congenital malformations of the vertebrae can cause malformation scoliosis or osteopathic scoliosis.
- Disturbed nerve functions: Possible causes of neuropathic scoliosis include syringomyelia, infantile cerebral palsy and poliomyelitis.
- Muscle diseases: Myopathic scoliosis can occur, for example, in the context of muscular dystrophy (e.g. of the Duchenne type).
- Systemic diseases: Diseases that affect an entire organ system or the entire body can also cause a crooked spine. For example, scoliosis can occur with neurofibromatosis or with osteogenesis imperfecta (so-called glass bone disease).
- Medical measures: Radiation treatment in childhood can Development of the vertebral bodies affect. The result can be a so-called radiogenic scoliosis be.
- Disturbed statics: Some people have legs of different lengths. To compensate for the pelvic inclination, they change their posture. In the long run, this bad posture can lead to permanent curvature of the spine (scoliosis).
- wear: When parts of the vertebrae wear out with age, a so-called degenerative scoliosis be the consequence.
At first develops idiopathic scoliosis only noticeable visually. Possible visible symptoms of scoliosis are:
- different shoulder height,
- unilateral arching of the chest towards the back (so-called rib hump),
- differently positioned shoulder blades as well
- pelvis shifted to the side or inclined.
As a rule, those affected do not feel pain until they reach adulthood. Because the uneven load favors the Wear of vertebrae and Band washers and leads to Tension.
In addition to the typical back pain, this can also cause shoulder pain, neck pain and headache, and sometimes the knees and ankles also hurt.
The curvature of the spine can also be caused by a Shortening of the trunk accompanied. This may reduce the performance of the heart and lungs. Other internal organs such as the stomach, intestines and kidneys can also be affected. Possible consequences are:
The extent the discomfort generally depends on how heavy the curvature of the spine is and how Long it already exists.
Symptoms of Infant Scoliosis
Characteristic of scoliosis in infancy are symptoms that can be called Leaning Syndrome denotes: The affected children assume a crooked position, which is caused by a C-shaped curved spine in the chest and lumbar area. Usually one of the hip joints is turned inwards (adduction position). In addition, the baby's neck is crooked.
The doctor can diagnose scoliosis by looking at the person's back examined: Using the so-called spinous processes of the vertebrae, it can pass through the skin see and feelhow the spine runs. A lateral curvature of the spine is so easy to detect.
Since scoliosis is usually in the Chest area the doctor carries out the so-called Prevention test by: When the patient leans forward, the arching of the chest increases in the direction of the back and forms the so-called. Rib hump.
Scoliosis im upper chest area the doctor can determine that the Shoulders not level stand.
Scoliosis affects the Lumbar region, the two triangles between the waist and the arms hanging down on the sides of the torso (waist triangles) are different and there is a Lumbar bulge on one side.
If the physical exam shows that the patient has scoliosis, the doctor asks the patient to Pre-existing illness (Anamnesis) that could be the cause of the spinal curvature.
About the shape and extent of the scoliosis to be able to judge more preciselythe doctor also lets X-rays make from the back. With the help of the pictures he can:
- the angle of the lateral bend (so-called Cobb angle) and
- determine the angle of rotation of the spine.
In children and adolescents Scoliosis can often be alleviated because the spine is still growing. To find out how much a child will grow, the doctor needs it X-rays of the iliac crest processesthat are part of the pelvic bone. These processes ossify in the course of life. With the help of the X-ray images, the doctor can recognize the state of the ossification and thus estimate the expected growth.
Which therapy is required initially depends on the age of the patient: Infants help with scoliosis consistent prone positioning and various physiotherapy exercises to a straighter back. The aim of this scoliosis therapy is to direct the child's normal movements in such a way that the incorrect posture is corrected.
If scoliosis occurs in childhood or adolescence, Therapy depends on the cause and extent of the scoliosis:
- The doctor usually prescribes people with the onset of scoliosis physiotherapy exercises.
- In the case of severe scoliosis (Cobb angle between 20 and 50 degrees), you will also receive a corset.
- With a strong curvature of more than 50 degrees, it can surgery is necessary be.
Physiotherapy and physiotherapy exercises
In people with scoliosis, the muscles are stressed unevenly: Certain muscle parts are overstretched and overloaded, others weakened. Specific Exercises can compensate by them
- the weakened muscles strengthen in a targeted manner,
- the tense muscles relieve,
- the spine more agile do.
The aim of physiotherapy is also to promote the patient's sense of posture. He learns to avoid behaviors that can increase the curvature. The physiotherapist also helps him improve his posture with the help of certain techniques to actively correct.
In addition to these exercises, you can with mild scoliosis in addition to treatment neurophysiological and electrical stimulation procedures are used to stimulate certain muscle groups.
At a advanced scoliosis can the doctor one corset prescribe. Most often the so-called passive corset made of rigid plastic is used, which covers the entire torso from the shoulders to the hips. It is shaped to create pressure and relief zones that the Counteract misalignment of the upper body.
This method of therapy is usually stressful for children: In order to achieve good results, they have to keep the corset consistently until the end of their growth Wear 23 hours a day. In the best case scenario, this will prevent the scoliosis from progressing. Correct or even fix it However, the corset can reduce the curvature of the spine Not.
People with severe scoliosis often suffer so badly from the effects of the curvature that the doctor recommends an operation. This is used to make the Straighten the spine. To the spine in the new, straight shape to stabilize, the surgeon attaches to the affected sections small screws and plates.
He also runs a so-called Spinal fusion by. That is, it ensures that movable sections of the spine ossify and thus become stiff. Various methods are available to him for this. Either way, the result is one less agile, for that more resilient active pillar.
Before the operation it is necessary to loosen the muscles that surround the spine. There are various ways of doing this Pretreatment, for example the Halo Gravity Extension: This means stretching the crooked spine under tension over a metal ring attached to the skull.
Whether and how strong the curvature is progresses depends on the root cause the scoliosis as well as from Age the person concerned and the Time of diagnosis from:
- At Infants is a cure Only possible through consistent prone positioning and physiotherapy.
- Infantile scolioses occur more often in boys in the second and third year of life and worsen often.
- Juvenile scolioses occur between the age of four and puberty. Your prognosis improves as the children get older.
- Adolescent colioses develop during puberty and have one favorable forecast.
A regular controll Also during scoliosis therapy, especially in the growth spurts and puberty, is crucial for the further course. The following applies in general: Ever earlier it is possible to recognize the scoliosis, the more less time-consuming and stressful are the necessary therapeutic measures.
Scoliosis can cause long-term course With various complications be connected: caused by the permanent misalignment of the spine premature wear and tear on the spine on intervertebral discs and vertebral bodies, which are often noticeable in great pain. Possible consequences of scoliosis can be a herniated disc and increasing stiffening of the spine. Other joints, such as the hip and knee joints, are also affected by the permanent incorrect stress caused by the crooked spine.
The twisting of the spine that is typical of scoliosis and the associated twist Shortening of the trunk can in severe cases to Chest and abdominal complications lead: This can lead to the chest and abdomen shrinking and the function of various internal organs (heart, lungs, kidneys, stomach, intestines) is restricted. With severe scoliosis, the severe functional impairment can result in life-threatening (right) heart failure.
You can have scoliosis Not effective prevention, as in most cases the root cause for the curvature of the spine unknown is.
However, you can Prevent the unfavorable course of scoliosis: The sooner you realize that a misalignment of the spine is developing, the less time-consuming and stressful the therapy required and the greater the chances of success. If scoliosis is recognized and treated in good time, it is usually possible to avert an operation.
Therefore, it is advisable to use the Check your child's posture regularly. Here is the easy one Prevention test suitable to detect the particularly common scoliosis in the chest area:
- Ask your child to bend forward with their torso bare and with their arms hanging loosely.
- Pay attention to the course of the spine, which is marked through the skin: does it form a straight line or is a curvature recognizable? Can you see a rib hump on either side?
- If you suspect an irregularity, have your child examined by an orthopedic surgeon.
Is due to another illness increased risk For the development of scoliosis before, it is advisable in any case to have that Regularly check spinal posture orthopedically allow.
In certain circumstances, you can have scoliosis too prevent by special measures: So it is with one Leg length difference It is advisable to compensate for the difference with a one-sided heel increase and to strengthen the back muscles with appropriate physiotherapy.
ICD-10 Diagnostic Key:
You can find the appropriate ICD-10 code for "Scoliosis" here:
Scoliosis. Online information from the Mayo Clinic: www.mayoclinic.org (as of August 15, 2017)
Scoliosis. Online information from the Pschyrembel: www.pschyrembel.de (as of July 12, 2017)
Niethard, F.U., Pfeil, J., Biberthaler, P .: Orthopedics and trauma surgery. Thieme, Stuttgart 2014
Guidelines of the German Society for Orthopedics and Orthopedic Surgery and the Professional Association of Doctors for Orthopedics (BVO): Idiopathic scoliosis in growing age. AWMF guidelines register No. 033/025 (status: October 2009)
Last content check:06.11.2017
Last change: 17.09.2020
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