Kyphosis, lordosis and scoliosis - spinal curvatures, differentiation and treatment

Is it possible to mistake an elderly person for a young person from afar? In very, very rare cases, isn't it? After all, a person’s age is revealed, first of all, by posture. More precisely, its absence.

Due to natural causes, various diseases, and also due to the inability (unwillingness) to take care of the health of our back, over the years we begin to literally “bend to the ground.” It is no coincidence that even a child can portray an old man, bending over in an arc and leaning heavily on a stick.

Of course, you can always cite the example of ballet stars or actors who maintain excellent posture into old age. However, among ordinary citizens of advanced age, the percentage of “upright walkers” is very, very modest. And this is not surprising - the proportion of people with various pathologies of the musculoskeletal system in the world is 80%-85%.

The most distressing thing about all this is that in the vast majority of cases, problems with the spine, figuratively speaking, are the creation of our own hands. It’s not for nothing that parents and teachers constantly urge children not to slouch and straighten their backs. “Minor” childhood posture disorders are not at all harmless. They are harbingers of spinal curvature , a serious pathology fraught with a whole bunch of dangerous health consequences.

There are 3 main types of spinal curvature: scoliosis, kyphosis and lordosis .


1

Treatment of spinal curvature


2 Treatment of spinal curvature


3 Treatment of spinal curvature

Normal spinal curves

The spine of a healthy adult has 2 kyphosis (bend, convex back) - thoracic and sacral, and 2 lordoses (bend, convex forward) - cervical and lumbar. In a newborn, there are practically no curvatures of the spinal column: there is only mild kyphosis in the sacrococcygeal region, which formed while in the fetal position. When the child begins to hold his head, cervical lordosis forms.

At 4–6 months, the child makes attempts to sit up, which leads to the formation of a bend in the thoracic region. The last to form is the anterior curve in the lumbar region. This happens closer to the year when the child learns to hold the body in an upright position and begins to walk. In a small child, all the curves are very unstable, a clear expression is formed only at 6–7 years, and the curves acquire their final shape by the age of 20.

Clinical case

What does this look like in practice? As an example, consider a clinical case of a child with thoracolumbar kyphosis. Age – 1 year, weight is below normal (8.5 kg). He developed mentally and physically in accordance with age standards: he began to hold his head up, sit down, and walk on time. Upon examination, attention is drawn to thoracolumbar kyphosis, the spinous processes of the thoracic and lumbar vertebrae form a convex posterior arch. History: pregnancy was threatened with termination in the 1st and 3rd trimesters, the child was born premature, and suffered from pneumonia in infancy. He was also diagnosed with complex combined heart disease. Low weight from birth. Burps after every feeding, often belching air. Considering the problems with the visceral organs, the osteopath’s work during the treatment session was aimed at relaxing the thoraco-abdominal diaphragm, and work was also carried out with the mediastinal organs - the pericardium and esophagus. Using gentle visceral techniques, the doctor relaxed the ligaments that pass from the internal organs to the diaphragm. In addition, work was carried out on the abdominal organs - the stomach and intestines. The main goal was to mobilize these organs, improve their motility and mobility, give them greater mobility and relax tense ligaments. Recommendations were also given for further diagnostic examination and resolving the issue of surgical removal of the heart defect.

Causes of spinal curvature

Factors influencing the development of deviations in bends are almost the same for both kyphosis and lordosis. These include:

  • congenital anomalies;
  • spinal injuries;
  • diseases of the musculoskeletal system;
  • specific infections (tuberculosis, polio);
  • wrong lifestyle.

Congenital anomalies

The following congenital anomalies can lead to curvature of one or another part of the spine:

  • underdevelopment of the vertebrae;
  • wedge-shaped vertebrae;
  • accessory vertebrae;
  • hip dysplasia;
  • congenital torticollis.

Diseases

Acquired curvatures of the spinal column can occur under the influence of diseases:

  • tuberculosis;
  • rickets;
  • polio;
  • syringomyelia;
  • tick-borne encephalitis;
  • metabolic disorders (primarily osteoporosis);
  • Bekhterev's disease.

Wrong lifestyle

The most common cause of all spinal curvatures is an incorrect lifestyle. The most unfavorable factors are the following:

  • weakness of the muscular corset (back and abdominal muscles) due to low physical activity;
  • excess body weight;
  • unbalanced diet. Lack of vitamins and minerals (primarily calcium) with an excess of fast carbohydrates (sugar, confectionery, white flour products) and fats.

What factors provoke postural disorders in adults and children?

There are many factors that provoke an unnatural position of the physiological curves of the spine. Several main ones should be highlighted:

Anomalies of fetal development, genetic diseases, complicated pregnancy, poor nutrition of the mother during the period of intrauterine development of the baby. Lack of reasonable physical activity, leading to an imbalance of the musculoskeletal system and, as a consequence, to poor posture. Labor activity associated with monotonous, similar movements. Soft bed. Featherbeds often provoke a long-term unnatural position for a person during sleep. Incorrectly selected furniture, especially work tables and desks. Past diseases and surgical interventions (pneumonia, biliary dyskinesia, kidney prolapse, bronchitis, cesarean section, cicatricial adhesions after severe, large abdominal operations, traumatic scars on the body, amputation of limbs). Frequent, long-term wearing of high-heeled shoes. Unbalanced diet, absence or deficiency of calcium, vitamins, minerals, proteins. Increased physical or sports activity, heavy lifting, non-compliance with safety rules when carrying loads and lifting sports equipment. Lack of basic hygienic exercise. Chronic somatic illnesses. Wearing tight, uncomfortable clothing. Being in unfavorable environmental conditions. Increased psycho-emotional stress.

Pathological thoracic kyphosis

The normal bending angle in the thoracic region is 15–29 degrees. If this value is greater, then such kyphosis is considered pathological. There are 4 degrees:

  • 1st degree – curvature angle 30–40 degrees;
  • 2nd degree 41–50 degrees;
  • 3 degree 51–70 degrees;
  • 4th degree 71 degrees or more.

Externally, pathological kyphosis looks like a stoop: the back becomes rounded, in severe cases a hump is formed. Additionally, a person with kyphosis appears shorter in height. Cervical lordosis increases compensatoryly to balance the load on the spinal column. This causes the head to protrude more sharply and the shoulders to become even more rounded.


Thoracic kyphosis in a teenager

Due to this deformation, the chest narrows even more, which leads to disruption of the respiratory and circulatory systems. As thoracic kyphosis progresses, it can lead to the following symptoms:

  • dizziness;
  • changes in blood pressure;
  • back pain becomes constant;
  • disruption of the digestive tract.

Pathological lordosis of the cervical spine

The cervical spine has an anterior bend (lordosis) and is the most mobile of all sections. If the bend is less than 20 degrees, then such lordosis is considered smoothed or straightened, and if it is more than 40 degrees, then we speak of hyperlordosis. Such pathological changes can lead to the appearance of symptoms such as poor posture, a feeling of numbness in the neck and upper shoulder girdle, and limited mobility of the cervical spine.

There is pain in the neck when turning the head, headaches, tension in the neck muscles and soreness in them, the formation of intervertebral hernias. Since all the curves of the spinal column balance each other, straightening the cervical lordosis always leads to an increase in thoracic kyphosis.

Consequences caused by poor posture

Incorrect posture harms the body of a child and an adult. It is expressed:

Unaesthetic appearance of the figure. Impaired functioning of internal organs, and as a consequence the development of their diseases.

Violation of the symmetry of the placement of organs in the abdominal cavity. A compressed esophagus and stomach cannot fully process and assimilate food. Hence problems with digestion, a feeling of heaviness in the epigastrium, heartburn, hiccups, and impaired absorption of nutrients.

Prolapse of the kidneys, leading to genitourinary disorders. Difficulty in breathing, up to the development of chronic hypoxia and bronchial asthma. Development of weakness, headaches, fatigue and irritability. Poor performance of the cardiovascular system. The compressed heart tries to compensate for the rhythm by increasing the number of contractions with the formation of arrhythmia, tachycardia and high blood pressure. And this is a direct path to heart attacks and strokes. Constant pain in the spine. Rapid aging of the body due to multiple dysfunctions of organs and systems. Disturbances in the hormonal system, weakening of the body's immune defense, disruptions in the menstrual cycle. Impaired blood flow, leading to problems with brain activity, dissipation of attention, memory deterioration, and a decline in mental and adaptive abilities.

Poor posture and disharmony of appearance often become the causes of the development of inferiority complexes, isolation, and psycho-emotional disorders. A person feels unwanted, an “ugly duckling” towards whom the rest of the world is hostile.

Poor posture leads to the development of diseases of the thoracic cavity, osteochondrosis, the formation of a rib hump (hibus), and curvature of the spine to the left or right (scoliosis). Poor posture that is not corrected in time leads to the development of a severe, pathological situation. To prevent complications that later require expensive, long-term treatment, special measures should be taken.

Pathological lordosis of the lumbar region

In this section, the physiological bend is 40–60 degrees; deviations in one direction or another are pathological. The lumbar region bears the main static load, so curvature most often occurs in people with increased body weight. Less commonly, the causes are injuries, tumors, inflammatory diseases of the vertebral bodies and muscles of the lumbar region, and congenital dislocations of the hip.

The following signs are most characteristic of lumbar hyperlordosis:

  • bulging forward of the abdomen;
  • noticeable backward deviation of the pelvis visible to the eye;
  • knee joints spread to the side;
  • decreased endurance to normal physical activity;
  • pain in the lumbar spine;
  • impaired sensitivity in the lumbar region and lower extremities, which occurs when nerve roots are pinched.

Temporary hyperlordosis develops in pregnant women due to an increase in the volume of the abdomen and a shift in the center of gravity of the body. After childbirth, the curvature goes away.

Manual therapy and scoliosis

If you are curious and look at any manual therapy manual, then contraindications to treatment will be written there in black and white. It is not recommended to perform manual therapy techniques until the skeleton is completely ossified before the age of 25 and after 45 years, when the first signs of osteoporosis appear, that is, the bones lose their original strength due to the natural leaching of calcium. In general, manual therapy in this case will bring more harm than benefit, since any method is associated with traumatization of small intervertebral joints and subsequent loosening of not only the vertebrae, but also the motor segments. Treatment with just one massage is also not valid, since massage does not strengthen the muscle, but only improves its nutrition.

Diagnostics

To check your posture at home, you can do 2 tests. The first is to undress to the waist and stand directly in front of the mirror. Pay attention to shoulder level. If one shoulder is higher than the other, then there is a lateral curvature of posture - scoliosis.


You can do the initial diagnosis yourself

The second is to stand with your back to the wall, stepping back 5 centimeters from it. Feet hip-width apart. Lean back and press your back against the wall, noting which part of your back touches the wall first. If the posture is not impaired, then the buttocks and shoulders touch the wall at the same time; if this is not the case, there are curvatures. In this case, you need to consult a doctor.

If an examination reveals lordosis, kyphosis, or scoliosis (curvature of the spine to the right or left relative to the central axis), the doctor prescribes an X-ray examination in two projections - frontal and lateral. The images can reveal the degree and type of curvature of the spinal column. As a rule, disorders are combined, since the spine, in order to reduce the load in the affected section, is curved in another. In addition, the cause of the disease can often be seen on x-rays.

If necessary, your doctor may prescribe a computed tomography (CT) or magnetic nuclear tomography (MRI) scan of the spine.

Treatment

The basis of treatment for spinal curvatures is regular exercise therapy combined with proper nutrition, physical therapy techniques and, if necessary, orthopedic aids.

Physiotherapy

The task of exercise therapy (physical therapy) is to strengthen the muscular corset and ligamentous apparatus that supports the spine in the correct position. The general principles of therapeutic exercises will be as follows. You should start exercising after identifying the cause of the pathology and consulting with a specialist.

The intensity and duration of classes increases gradually. During exercises, sudden movements and jerks are unacceptable. Exercises in a lying position are performed on hard surfaces. Regularity of training. Swimming, yoga, kinesitherapy, joint gymnastics using the Norbekov method are effective.

Proper nutrition

The musculoskeletal system primarily requires minerals (calcium, magnesium, zinc, chromium), proteins, and polyunsaturated fatty acids. This is especially important for pregnant women, the elderly and for the growing bodies of children.

Treatment of spinal curvature

The diet should contain:

  • lean meat;
  • fresh fruits and vegetables;
  • cottage cheese, cheese;
  • egg;
  • Fish and seafood;
  • products containing natural gelatin.

Massage

Massage is a good addition to physical therapy and proper nutrition. It allows you to relax cramped muscles and tone stretched ones. In addition, an experienced specialist, using special massage techniques, eliminates blocks and clamps that prevent normal posture. The course is usually designed for 10–12 procedures and is carried out at intervals of 6 months.


Exercises for the cervical and thoracic spine can be performed with a straight and smooth stick

Physiotherapy

Physiotherapy is an auxiliary method of treating pathological kyphosis and lordosis. The procedures are aimed at improving local blood circulation in tissues, improving regeneration and metabolism processes. Applicable:

  • magnetic therapy;
  • laser therapy;
  • phonophoresis with medicinal substances;
  • baths (coniferous, radon);
  • paraffin therapy;
  • mud therapy.

Wearing orthopedic corsets

A doctor may prescribe orthopedic assistance in the case of an advanced stage of spinal curvature, when structural changes in the vertebral bodies occur. The selection of a corset is carried out individually by an orthopedic doctor.

Prevention of spinal curvature

Preventive measures come down to avoiding negative factors, under the influence of which pathological lordosis and kyphosis are formed. It is important to adhere to the following rules:

  • balanced diet;
  • daily physical activity: gymnastics, walking, swimming, skiing, fitness, yoga;
  • maintaining normal body weight;
  • undergoing preventive examinations and timely treatment of diseases of the musculoskeletal system and internal organs.

Thus, kyphosis and lordosis are physiological bends of the human spine. If these curves are violated, pain appears, incorrect posture develops, limited mobility of the spinal column and disruption of the functioning of internal organs. In order to return the vertebrae to their normal position, a long-term treatment, taking several months, is required, the basis of which is physical therapy, massage and proper nutrition.

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