(Keywords: chiropractic treatment for scoliosis, lumbar spinal stenosis, lower back and leg pain, chiropractic)
In this world of crooked and crumbling spines, of one thing you can be sure: you are not alone. In fact there are more crooked spines out there than straight ones. Hence this page on the Chiropractic treatment for scoliosis. The good news: Only some scolisoses give pain.
(PS. If you live in Kent, England, and you like the pic above by artist Lorraine Harrison, give her a call in Giggers Green, Aldington, near Ashford.)
But when an 82-year old female patient with severe lower back and leg pain consults you, you know it's going to be a challenge. When she's been to three other chiropractors, a physiotherapist, her own doctor and an orthopaedic surgeon, and the duration of the pain is two years and it's getting worse...
"Some problems are so complex that you have to be highly intelligent and well-informed just to be undecided about them."
Laurence J. Peter
Chiropractic treatment for scoliosis
It's really quite rare for the vertebra to be so rotated that the tip of the transverse process (TP) protrudes through all the muscles layers, and is visible just under the skin.
Each vertebra has three appendages for muscle attachment, giving the fine control of back movements. Two of them are called transverse processes, the third a spinous process.The SP below is unlabelled.
Miss M's scoliosis was "discovered" when she turned 19. Before that obviously nobody (with any clinical judgement) looked at her back. Mind you, I suspect her gardener, given the opportunity, could have seen that something was awry.
Since then she has been kept functional by a variety of chiropractors, old generation chiropractors who actually adjusted her back. She swears by them, but they alas are no longer.
A much respected orthopaedic surgeon made a crucial mistake. He prescribed a built up RIGHT shoe to be made by the hospital orthotist. But Miss M has a short LEFT leg. She reports that she could not wear it for more than two hours before she HAD to take it off. She's a gutsy woman and ignored threats that her body would take time to get used to the new built up shoe, and that she would soon be in a wheelchair if she didn't wear the prescribed shoe. Wise woman, she KNEW that that damned shoe was no good for her. Of course it wasn't! Sometimes that INNER WISDOM is far smarter than all the doctors, chiropractors too.
Had the correct lift been prescribed when she was 8 or 10, Miss M's life would have taken a very different course. She never married because of that back...
Chiropractic treatment for scoliosis
ASIDE: Have you taken your child to the chiropractor for a screening? You should you know.
"In health care, every doctor tends to rise to his level of incompetence."
adapted from "The Peter Principle".
CAUSES OF SCOLIOSIS
There are many causes of scoliosis. Frequently the cause is "idiopathic" - meaning arising spontaneously or from an obscure or unknown cause.
However, in Miss M's case this is clearly not so. She has no family history of scoliosis and there are two very recognisable causes.
PS: apologies for the mirror image of this X-ray. Just note where the L for left is. Chiropractors tend to read X-rays with the L on the left, as in this X-ray, and radiologists with the L on the right. It can be confusing.
Normally the sacral base line is parallel to a line through the hips joints, and normally both are very nearly parallel to the ground. She remembers someone pulling a chair out from under her a child.
If there has been an injury, such as a fall on the sacrum, causing it to shift, there is a 50/50 chance that it will compensate for the short leg. In Miss M's case it didn't. She has a double wammy of a short left leg, and a low left sacrum: SCOLIOSIS.
Mild scolioses are common, perhaps almost the norm. So to be termed a scoliosis, a Cobbs angle of 10 degrees is the cut off. At 60 degrees Miss M has the worst scoliosis I have seen in thirty years.
A sentient moment...
Chiropractic treatment for scoliosis
At a lecture to the Chiropractic Association of South Africa, the chairman of the Scoliosis Society gave a passionate lecture, inter alia stating that the treatment of scoliosis had no place in the clinic of the general practitioner or even the orthopaedic surgeon. In his opinion, it was a specialty so complex that it should remain in the domain of the specialist.
He was generally complimentary of Chiropractic, and was wise enough to make no special mention of whether the chiropractor could be the primary care-giver to the adolescent scoliosis. Nevertheless, his point was taken: the care and management of scoliosis is a multi-disciplinary and very complex subject.
The use of heel lift, a full shoe insert, a spinal brace, the correct exercise programme, what are the correct manipulations, these are all subjects that need to be very carefully considered and managed. It's not a condition for the average doctor, physiotherapist, orthopaedic surgeon, chiropractor who might see a scoliosis with a Cobb's angle of greater than 30 degrees on a regular basis.
I don't treat the adolescent scoliosis - the severe progressive ones - with any regularity, so you won't find anything at this website on the subject. They can progress with frightening rapidity around the age of 12-15. Make your child bend forward at least once a year, say on their birthday. Take a digi photograph and make a folder on your computer for each of your children. This is what you are looking for ...
Chiropractic treatment for scoliosis
One exciting and innovative Chiropractic approach is being developed
at the Clear Institute. They are treating adolescent scoliosis on a
daily basis, informed about the new research, developing new techniques.
If I was 20 years younger...! Scoliosis, like the treatment of the
infant has become a specialty within Chiropractic. And that's where in
my humble opinion it belongs.
CLEAR INSTITUTE ... adolescent scoliosis treatment.
The adult with scoliosis? Yes, of course, plenty.
Miss M was sorely neglected on all counts as a child, not least of which was the placing of the heel lift in the wrong shoe.
PROGRESS @ Chiropractic treatment for scoliosis
Update: That scoliosis extends of course right into the neck. Palapation of the cervical spine reveals ominous clicking and grinding sounds - osteoarthritic facet joints. Miss M has nasty left suboccipital pain too. With normal blood pressure and a negative Wallenberg test, I did a gentle adjustment of her axis on the left. At the following consult, her back much better, but the pain in her neck, now on the right had significantly increased. So we used a mobilising proceedure learnt from an Australian Physical Therapist. Magic. Miss M is almost painfree, neck and back and we are rapidly phasing out the treatment, the next consult in two weeks, all being well the following three weeks later. Sigh! I wish all spines respond as well as this! Perhaps her deep Christian faith, and enormously positive attitude to life, the prayers of her friends have contributed...
Update: Miss M continues to do well. Not that it's perfect, of course not, but she can walk normally, has no leg pain, and only mild neck and back discomfort. She's now coming once in three weeks for treatment.
Update: A very happy lady. There are many women in their eighties who would be glad to have as little pain as Miss M has. Extension and flexion are painfree, she can stand upright without pain. Of course, some niggling pain in the low back. No headaches either: we continue to adjust her neck very gently.
Update: M still works full time! She finds that after about two weeks the lower back pain increases again, and she has some pain down the side of her leg once more. The SLUMP TEST FOR SCIATICA fortunately is negative.
Chiropractic treatment for SCOLIOSIS
The first step, after proprioceptive testing, was to place a full insert, 3mm thick into her LEFT shoe. We may increase it later.
Secondly, we used the Thompson drop (Terminal Point) protocol to balance her pelvis.
Thirdly, some soft tissue work.
Fourthly, lying on her right side a Chiropractic adjustment of L5 using the Gonstead technique. With an audible release.
Fifthly, a supine adjustment, with drop, of the right ilium.
Sixthly, Active Release Therapy of the hamstring and sciatic nerve.
And of course, a set of exercises.
Chiropractic treatment for scoliosis
I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.
I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like.
However, do understand that, in the main, I'm going to be directing you, should it be pertinent, to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give as much detail as you can.
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There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. http://www.bernard-preston.com/Stones-in-my-Clog.html
Pose Me A Question! Pretty please, in decent grammar and spelling.
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Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.
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Interesting challenges of the day
1. Mr D has very severe midback back. He bent and twisted, feeding his son, and then laughed. Every breath is a nightmare. A sprung rib is every chiropractor's delight. He or she has golden hands. 30 percent better after one treatment.
2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.
3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.
7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.
8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.
9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine.
10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.
11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
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