TREATMENT OF SCOLIOSIS IN CHILDREN, CAUSES OF DEVELOPMENT AND PREVENTION

Osteopathic correction in the treatment of scoliosis in children

With scoliosis, curvature of the spine of varying severity occurs, and the vertebrae change shape. The problem is not limited to the aesthetic side; the consequences of scoliosis can be a number of quite serious diseases that affect the entire body as a whole. It is important to detect the beginning of the pathological process in time and carry out treatment in childhood, since the adult spine is difficult to correct.

Scoliosis is a persistent curvature of the spine to the side relative to its axis (in the frontal plane). All parts of the spine are involved in the process, therefore the lateral curvature is subsequently joined by curvature in the anteroposterior direction and twisting of the spine. As scoliosis progresses, secondary deformation of the chest and pelvis occurs, accompanied by dysfunction of the heart, lungs and pelvic organs. Pathology is diagnosed based on examination and radiography. Treatment can be either conservative or surgical.

Make an appointment Myasoedov Ilya Glebovich Osteopathic neurologist Uses classical manual techniques: articulation, myoenergetic (MET), PIRs, trust, slug, recoil, etc. Also uses classical osteopathic techniques in his work, especially when working with children, pregnant women, for the elderly - myofascial, legamentous tension, cranial-sacral, visceral, biodynamic, etc. techniques. All techniques used in the work, which do not cause pain, are aimed at relaxing tissues and eliminating dysfunctions that have arisen. Consultation from 2700 rub.

Scoliosis is a complex persistent deformity of the spine, accompanied, first of all, by curvature in the lateral plane, followed by twisting of the vertebrae and increased physiological curves of the spine. As scoliosis progresses, deformation of the chest and pelvic bones develops with concomitant dysfunction of the thoracic cavity and pelvic organs.

The most dangerous periods in relation to the development and progression of scoliosis are the stages of intensive growth: from 4 to 6 years and from 10 to 14 years. In this case, you should be especially attentive to the child’s health at the stage of puberty, which occurs in boys at 11-14 years old, and in girls at 10-13 years old. The risk of worsening scoliotic deformity increases in cases where, at the beginning of these periods, the child already has radiologically confirmed first degree of scoliosis (up to 10 degrees).

Scoliosis should not be confused with ordinary poor posture. Poor posture can be corrected through regular exercise, learning how to sit properly at a desk, and other similar activities. Scoliosis requires special comprehensive systematic treatment throughout the entire period of the patient’s growth.

Treatment of torticollis - which methods are safe for a child

The main goal of treatment is to ensure normal position and mobility of the child’s head, strengthen muscles, restore normal blood flow and prevent the development of complications.

The method of treating torticollis depends on how severe the shortening of the muscle is. In advanced cases, surgery may be necessary. To limit yourself to conservative methods, it is important to begin therapy immediately after diagnosis.

At the Quality of Life clinic, we use only conservative treatment to correct torticollis in newborns, older children and adults.

Osteopathy and exercise therapy are the most effective. Let's take a closer look at how they help in the treatment of torticollis. Moreover, these methods are effective and are indicated even after surgery for quick recovery.

Osteopathy

The goal of osteopathic treatment is to eliminate the true cause of the disease and set the body on the path to recovery.

Now you know that congenital torticollis is caused by damage to the sternocleidomastoid muscles or vertebrae of the newborn as a result of complicated pregnancy and childbirth. To stop the progression of the deformity, the osteopathic doctor uses gentle manual techniques that are safe even for infants.

Knowing perfectly the structure and features of the human body, with his own hands, without any tools, drugs or devices, he finds the causes of diseases in it, eliminates them and restores the structure and function of damaged organs:

– normalizes blood circulation; – eliminates muscle tension and spasm; – returns normal mobility to organs and tissues; – corrects the asymmetry of the skull bones; – balances the spine and pelvic bones.

An osteopath removes all obstacles to the full development of the musculoskeletal system as a whole, and not just the sternocleidomastoid muscle and the cervical spine. The baby’s body begins to develop correctly, and its organs begin to function normally.

You can learn more about osteopathy, its treatment principles and indications here.

Our specialists believe that any problem must be solved comprehensively, therefore, to consolidate the effect of osteopathic correction of torticollis in a child, we definitely recommend a course of exercise therapy.

Exercise therapy methods

Physical therapy is necessarily included in the treatment program for patients with torticollis. It effectively corrects deformation and also promotes the growth and development of a healthy body.

Goals of exercise therapy for torticollis:

– improve blood supply to muscles (both affected and healthy); – eliminate contracture; – normalize muscle tone; – ensure full neck mobility; – prevent the development of complications that are dangerous for torticollis (poor posture, skull asymmetry); – increase the nonspecific resistance of the child’s body to diseases.

To achieve these goals, it is important to treat torticollis immediately after diagnosis.

Doctors and exercise therapists at the Quality of Life clinic use active and passive means of physical therapy: corrective exercises, positional therapy, massage, Vojta therapy. Let's take a closer look at how each of these methods helps correct torticollis.

Therapeutic exercises The complex is selected individually for each patient, depending on his age, motor capabilities, and whether he has right or left-sided torticollis. Infants cannot perform the exercises themselves, so they are carried out by a physical therapy methodologist.

Conduct 15–20 classes (daily or every two days). The break between courses is 4–6 weeks. In total, to correct torticollis, there should be 3-4 courses in the first year of life, then another 2-3 until the patient reaches the age of seven.

Correction by position In the first year of life, children lie almost all the time, so to cure torticollis, different types of placing the child in bed are widely used. It is important to consider the position of toys, lights and sounds. When performed properly, the baby's head is in the correct position.

The type of placement depends on the exact diagnosis and is determined by a specialist. To achieve the effect, they are used for 1.5–2 hours 2–3 times a day.

Massage Gentle massage techniques help relax tense muscles and relieve spasm caused by torticollis. To do this, the exercise therapy methodologist carefully, so as not to cause pain, performs stroking, rubbing, and continuous vibration techniques.

On the opposite side, the massage is given to the child more intensely than on the patient in order to strengthen the muscle and increase its tone. Neck massage is combined with a massage of the arms, legs, back, chest, and abdomen.

Vojta Therapy The method is specially designed for the correction of neurological disorders and diseases of the musculoskeletal system. Its essence lies in the activation of motor reflexes in compliance with the starting positions.

The therapeutic effect is achieved through the natural movements that the child has, according to his age (turns, rolls over, crawls, etc.). Read more about Vojta therapy, its principles, indications and contraindications here.

Some parents try to correct the deformity by watching videos on the Internet, and further harm the child’s health. Each technique requires special knowledge and skills, so treatment should be carried out only by specialists.

You can learn more about exercise therapy methods, their effects and indications here.

Causes and manifestations of congenital scoliosis.

When the pathology occurs in the prenatal period, scoliosis is called congenital.

Congenital scoliosis - the basis of its origin are anomalies in the development of the spine and ribs (accessory, wedge-shaped vertebrae and hemivertebrae, synostosis of the spinous processes, accessory ribs), dysplasia of the lumbosacral spine, which defines the concept of “dysplastic scoliosis”.

In this case, it is impossible to prevent it, but timely correction helps stop the further development of scoliosis. Usually diagnosed only when visual manifestations become obvious:

• Asymmetrical arrangement of limbs
• Irregular back shape
• Signs of vegetative-vascular dystonia
• Asthenic body type

Infantile scoliosis is a type of idiopathic scoliosis. The infantile form develops in a child under 2 years of age and in 9 out of 10 patients disappears on its own, spontaneously and without treatment. The pathology is considered the rarest type of scoliosis.

Assessing a child's back condition

Parents at home can themselves try to determine the presence of postural disorders. First you need to visually examine the child from the back and sides. You need to ask him to stand up straight, but not to force his back to straighten, but to take his normal position. You need to visually draw a vertical line along the spine and see if there are deviations to the side, whether or not there is symmetry of the shoulder blades, pelvic bones, etc.

From the side, you need to evaluate the smoothness of the curves of the spine and the position of the head. Moreover, the chest should be slightly raised up, and the stomach should be slightly retracted. In preschool children, the stomach may protrude slightly in the middle, but not at the bottom.

Causes of acquired scoliosis

Acquired scoliosis in children develops after birth. There are many reasons that can contribute to its development.

The most common reasons:

• Various injuries, incl. intrauterine and birth injuries;
• Different leg lengths;
• Asymmetrical and inadequate physical activity;
• Sitting for long periods of time in an incorrect position while studying and using gadgets;
• Passive lifestyle and lack of necessary physical activity;
• Scoliosis in school-age children can develop due to uneven distribution of load on the back, for example, carrying a backpack on one shoulder;
• Deficiency of vitamin D and a number of minerals in the body necessary for proper bone formation (results from an imbalanced diet);
• Having excess weight; underdeveloped (weak) back muscles;
• Impact to the spine;
• Tumors;

Separately, neurogenic scoliosis is distinguished, which occurs in response to abnormalities in the functioning of the nervous system. It often results from:

• cerebral palsy;
• neurofibromatosis;
• polio;
• myopathies of various types;
• spastic paralysis;
• syringomyelia.

Scoliosis can be a consequence of rickets, which is most common in young children. The disease is caused by a deficiency of vitamin D in the body, which leads to decreased muscle tone and bone deformation.

There are also static and functional types of scoliosis. They are the result of disorders of the musculoskeletal system and inflammatory processes in the internal organs, respectively.

Disease prevention

To prevent a disease, you need to eliminate the factors that cause it. Prevention of the disease is simple and consists of the following steps:

• Pregnant women need to wear a bandage. This is necessary to prevent modification of the reproductive organs and prevent lordosis.
• Children and students need to properly organize their workplace and maintain good posture.
• Active people should avoid excessive physical activity and avoid overstressing their back.
• Children need to have an annual examination.
• Parents should monitor whether the child has correct posture when he is walking or doing homework at home.
• It is necessary to instill in your child the habit of doing morning exercises or introduce other moderate physical activity into his daily routine.
• Do not allow your child to overeat and become overweight.

Classification of scoliosis in children

Scoliosis is usually classified based on the age at which the first signs appear:

• Infantile scoliosis develops from birth to 3 years of age.
• From the age of 3 until the age of 10 - juvenile.
• Adolescent scoliosis develops in children over 10 years of age.

Localizations:

• Thoracic region
• Cervical region
• Lumbar
• Combined

Also, depending on the number of scoliotic arches, scoliosis in children can be:

• s-shaped;
• c-shaped;
• z-shaped.

Spinal scoliosis in children is divided according to the reasons that provoke it, including muscular, dysplastic, neurogenic and idiopathic scoliosis.

The degree of spinal curvature in children is classified according to the Chaklin system, where:

1. 1st degree – mild lateral curvature, noticeable only in a standing position. When the patient lies down on a flat surface, the curvature disappears. The angle of curvature is 5-10 degrees.
2. 2nd degree – the lateral curvature is more pronounced, but remains unchanged in a horizontal position. The angle of curvature is 11-25 degrees.
3. 3rd degree – lateral curvature is pronounced. At this degree, the patient develops a compensatory arch, and the angle of curvature is 26-50 degrees.
4. 4th degree is the most severe of all, difficult to correct. With scoliosis of the 4th degree, in addition to severe curvature of the spine and the presence of compensatory arches, deformations of muscle tissue are observed, and the functioning of internal organs deteriorates.

Torticollis: what is it, what types are there, why is it dangerous?

Torticollis is a disease in which deformity of the spine develops in the cervical region. It is accompanied by tilting the head and raising the scapula on the sore side and turning the face to the healthy side. Torticollis can be caused by problems with the development of muscles, fascia, nerves or vertebrae.

Due to deformation, doctors distinguish:

Congenital torticollis: – muscular – caused by dysfunction of the muscles that turn and tilt the head; – bone – caused by structural anomalies of the cervical or thoracic vertebrae.

Acquired torticollis (eg, Grisel's disease).

Depending on the side of the lesion:

– right-sided torticollis; - left-sided torticollis.

According to statistics, congenital, right-sided torticollis is more common and girls are affected less often than boys.

Deformity with torticollis can be:

– fixed – when the muscles have lost their extensibility and the child’s head does not change position, even if he turns over, if the parents put a special pillow under his head or try to straighten it with his hands; – not fixed – when the muscles still retain the ability to stretch, the listed manipulations help tilt the head to the healthy side.

If you suspect torticollis, do not try to correct the position of your head yourself. Only a specialist can make an accurate diagnosis, determine its type and prescribe therapy. Self-medication can only make the problem worse.

Why torticollis should not be ignored

The neck contains vital organs:

- spinal cord - controls movements, transmits information from all organs to the brain and back; - carotid arteries, jugular veins - provide blood supply to the head; - esophagus - ensures delivery of the bolus of food to the stomach; - trachea - participates in the act of breathing; - larynx - contains the voice-producing apparatus; - thyroid gland - participates in maintaining hormonal balance.

Pathological changes in torticollis can lead to disruption of the functions of these organs and the child may become disabled.

What complications are torticollis dangerous for:

– Change in the shape of the skull (plagiocephaly); – Asymmetry of facial bones; – Spinal deformities, for example, scoliosis; – Hydrocephalus - increased intracranial pressure as a result of disruption of the normal outflow and accumulation of cerebrospinal fluid; – Brain damage; – Neurological disorders (increased excitability, excessive regurgitation, muscle hypertonicity, etc.); – Difficulty breathing; – Strabismus; – Hearing impairment, underdevelopment of the auricle; – Delayed speech development; – Behavioral disorders (aggression, inappropriate actions, disobedience); – Poor sleep; – Incorrect development of the upper and lower jaws; – Late teething, improper growth; - Nosebleeds.

In newborn babies, the neck is involved in the act of sucking, so the deformation can interfere with normal feeding. Children with torticollis begin to crawl, sit and walk later than their healthy peers.

Torticollis is one of the three most common congenital diseases of the musculoskeletal system in children, second only to congenital dislocation of the hip joint and clubfoot. It can cause neurological disorders in the child, changes in the shape of the skull, spine and other complications.

Changes in the shape of the skull occur in every third baby with a diagnosed neck deformity. In addition to an aesthetic defect and, as a consequence, psycho-emotional disorders, it can lead to developmental delays.

Knowing the causes and signs of this disease will help young parents seek help from a doctor in time to prevent its development or for treatment.

Manifestations and symptoms of scoliosis in children

Clinical manifestations of the disease are difficult to distinguish in young children and with mild deformity. Some symptoms are only detectable in certain positions and are not noticeable while standing or sitting. In the later stages, the curvature becomes noticeable to the naked eye.

In children under one year old

Mild curvature of the spine in children under one year of age has virtually no symptoms. Parents can notice the problem by the banana-shaped body position - the child lies bent to one side. Another symptom is that the child prefers to keep his head turned in the same direction. when swaddling the baby only in case of severe deformation. After six months, when the child begins to sit, different positions of the shoulder blades and shoulders are noted, and when the baby is lifted into his arms, a pelvic distortion occurs. Any asymmetry at this age may indicate curvature of the spine, so if such symptoms are detected, you should seek medical help.

Spinal deformity under 3 years of age

It is difficult to independently suspect the disease in children at this age. The first suspicions among parents arise at the age of 1-1.5 years, when the child begins to walk. The severity of symptoms depends on the degree of curvature. With a mild degree, there is a slight asymmetry of the shoulders and shoulder blades, and the deformation of the spine is noticeable only when bending strongly forward with arms down. Severe curvature is noticeable in any position of the child, noticeable deformations of the chest, rib hump, retraction of muscles, asymmetry of bone and other landmarks appear.

Curvature of the spine between the ages of 3 and 10 years

Poor posture in children of preschool and primary school age is manifested by typical symptoms: curvature of the spinal axis and asymmetry of various landmarks on the body. With a weak degree of deformation, it is very difficult to identify the problem - it is noticeable only when the body is tilted forward, there are no other symptoms.

As the disease progresses, posture takes on a characteristic appearance. The child walks hunched over, the shoulders are located at different levels, the angles of the shoulder blades are not on the same line. When you feel the muscles of the shoulder girdle, there is a decrease in their tone, and sometimes pain. Spinal deformity is visible in standing and sitting positions. The child may also experience intermittent pain along the spine, rapid fatigue in one position, and an inability to maintain posture in a physiological position.

Curvature of the spine between the ages of 10 and 20 years

Spinal deformities of various types are most often recorded in school-age children. At the initial stages, the symptoms are scant: a slight asymmetry in the position of the shoulders and shoulder blades. Over time, deformation of the spine and chest appears in an inclined position in the form of protrusion of the ribs or a “muscle roll” along the spine. When standing, it also remains, but is less noticeable. In the later stages, the deformity becomes more pronounced, with weakening or hypertonicity of various muscle groups, protruding ribs, and distortion of the pelvis and shoulders.

Curvature of the spine in school-age children is often accompanied by a number of symptoms:

• neurocirculatory dystonia;
• general weakness and fatigue;
• exercise intolerance;
• periodic back pain.

Girls aged 13-17 years may experience menstrual irregularities: severe pain in the lower abdomen, heavy bleeding.

How does torticollis manifest?

With torticollis, its characteristic signs attract attention:

– the neck is deformed, the head is tilted; – mobility is limited, the child cannot hold his head straight or tilt it in the opposite direction; – the shoulder and shoulder blade on the affected side are higher than on the healthy side; – when trying to straighten the child’s head, he cries and resists; – facial asymmetry - the ear, eyebrow and eye on the affected side are lower compared to the healthy side. – already at 2–3 weeks of a child’s life, thickening and shortening of the sternocleidomastoid muscle can be felt to the touch.

By 1–1.5 months of life, the seal may disappear - it will become thinner and shorter than healthy. Therefore, attempts to straighten the child’s head will cause him pain and crying. This indicates that torticollis has become fixed and its treatment will require a special approach.

Facial asymmetry helps distinguish congenital torticollis from acquired. It takes time to form, so if the baby was born with asymmetry, then the pathology is congenital. If his face was normal and then changed - acquired.

Forecast

Scoliosis that appears for the first time in a 6-year-old child usually progresses quickly, and curvature appears early. It is not easy to completely cure the disease, especially if the parents did not seek help in a timely manner. If the disease began at the age of 10 years or older, the prognosis is more favorable. In this case, scoliosis usually does not progress so quickly; with timely treatment, there is every chance of a full recovery. Young people suffering from spinal scoliosis have concessions or are completely exempt from military service.

In particularly complex and advanced cases, children may experience irreversible consequences:

• Serious disturbances in the functioning of internal organs
• Chest deformities
• Pronounced asymmetries of the pelvis
• Muscular dystonia
• Breathing problems
• Formation of a hump in the rib area

How is pathology diagnosed?

When there is a suspicion of cervical lordosis in a child, the disease must be diagnosed with the help of an orthopedic doctor

and start treatment. Diagnostics is carried out using:

• visual inspection;
• palpation;
• x-ray
  ;
• MRI
  ;
• computed tomography
  .

Self-diagnosis helps to consult a doctor in a timely manner. Paying close attention to the symptoms of the disease, your child’s well-being and posture will help prevent the development of curvature. For self-diagnosis, you need to ask the child to stand close to the wall. Shoulder blades, back of head, heels and buttocks should touch the wall. Then place your hand, palm down, between your lower back and the wall. If the palm passes too easily or, conversely, does not pass at all, you need to consult an orthopedist.

Diagnostics

An experienced pediatrician or orthopedist will see the curvature during the examination, having additionally studied the anamnesis and complaints of the parents. Next, the child is sent for an in-depth examination, which includes the following diagnostic procedures:

1. X-ray of the spine in several projections, in a standing and lying position, to determine the degree of curvature.
2. Optical topography.
3. Computed tomography (CT) or MRI.
4. In some cases, myelography may be required to examine the subarachnoid space to identify hernias and neoplasms.

What increases the likelihood of developing this pathology?

There are various reasons for the development of grade 2 scoliosis. The main ones are:

• scoliotic posture;
• weak back muscles and ligaments;
• congenital developmental pathologies;
• deficiency of phosphorus and calcium;
• incorrect posture while working at the computer;
• carrying heavy objects in one hand;
• spastic paralysis;
• bruises of the spinal column;
• metabolic problems;
• polio;
• lack of vitamin D;
• the body remains in an uncomfortable position for a long time;
• removal of arms and/or legs.

The risk of developing grade 2 scoliosis is increased by staying in an uncomfortable position, carrying heavy objects, or lacking essential microelements.

Treatment of scoliosis in children

Treatment consists of a set of measures and is selected individually. Scoliosis of the 1st and 2nd degrees is most amenable to correction; in this case, osteopathic treatment, exercise therapy, ensuring the correct regime of physical activity, the use of a corset and other health measures prescribed by specialists are used.

Scoliosis of 3 and 4 degrees, accompanied by concomitant pathologies of internal organs, requires mandatory constant wearing of a corset and often requires surgical treatment. Although at this stage it is recommended to use osteopathy in combination with conservative treatment. The optimal age for surgery is from 10 to 14 years.

Treatment for lordosis

Treatment of lordosis in children is carried out after determining the causes and diagnosing the stage of the pathology. The doctor first collects anamnesis, examines the little patient and prescribes the necessary tests. During the examination, it is important to evaluate how the child stands and what his posture is. In some cases, tests are done to see if there are neurological problems. In addition, the doctor palpates the back muscles. At the first stage, the following stabilization methods are used:

• massage;
• Healing Fitness;
• wearing a corset;
• In case of complications, drug treatment is used.

The use of physiotherapy has a positive effect: hydrotherapy, treatment with magnets. Surgery is recommended only in the most difficult cases, when the curvature significantly reduces the patient’s quality of life.