Keep your back straight. How to treat scoliosis in a child?

This disease is observed in children. Scoliosis occurs when the spine curves to one side. There is a strong point of view that the prevalence of this problem in the society of the 21st century is associated, in comparison with the past, in addition to sitting at a desk, also with children spending time at the table with a computer. But in pediatric circles, in addition to congenital causes, about 80% of cases of scoliosis are based on errors during obstetrics, when obstetricians physically incorrectly influence the body of a newborn, helping him pass through the birth canal. The pathological process is typical for the age range from 5 to 15 years. This is due to the intermediate stage in the formation of the skeleton and the fact that the musculoskeletal system, having already received the natural destructive influence of obstetricians, experiences high loads for it during this period.

Scoliosis of the spine in children

On a note! The concept of “scoliosis” was first introduced by the ancient Greek physician Galen.

Parental inattention to the posture of their children is especially saddening. What is alarming is both the lack of attention to the initial stages of the pathological process and to the elimination of an already developed disease. This is fraught with the formation of irreparable stages of the disease. Timely treatment of scoliosis can prevent problems with the spinal column. There are many cases when scoliosis develops in conjunction with kyphosis. At the same time, in addition to curvature to the side, the spinal column also curves forward. A person with kyphosis is said to be slouched.

Timely treatment of scoliosis can prevent problems with the spinal column

On a note! Girls are 5-7 times more likely to develop scoliosis than boys.

Early stages of pathology are treated quickly and without any particular difficulties. For this purpose, physical therapy, massage and varieties of gymnastics are used. When the process is started, surgical methods are often used.

Severe degrees of curvature are treated surgically

Etiology

Scoliosis can occur for two categories of reasons:

• due to congenital factors - a quarter of patients with scoliosis are susceptible to it;
• due to acquired disease.

Congenital scoliosis should not be allowed to continue to be aggravated after the birth of a child. Unfortunately, this disease cannot be eliminated.

Forecast

With early screening and detection, the prognosis for children with idiopathic scoliosis is good. Most children with idiopathic scoliosis do not require treatment and only follow-up.

If necessary, fixation (bracing) and exercise therapy are performed, which helps prevent worsening of the curvature and allows the patient to avoid surgery. With proper treatment, whether conservative or surgical, the vast majority of children with scoliosis will go on to lead normal, independent lives, be active in the workforce, participate in non-contact sports, have healthy pregnancies, raise families, and have the same life expectancy as people without scoliosis .

Classification

According to the degree to which the curvature is developed, scoliosis is divided into 4 variants.

Types of scoliosis

Scoliosis degrees

Classification of scoliosis

Based on the location where the curvature formed, the disease is divided into:

• cervical (most often congenital);
• chest;
• thoracolumbar;
• lumbar.

Scoliosis of the thoracic region

Lumbar lordosis

Prices for orthopedic corsets and posture correctors

The age classification provides for 3 types of illness.

Surgery

Traditional conservative treatments for scoliosis include periods of observation, bracing (although this is usually for adolescents) and the use of other treatment methods (physical therapy, manual therapy, massage). But, if the curvature progresses significantly above 40 degrees, then we can talk about surgery.

Many doctors will say that surgery is the only way to treat a scoliotic curve above 45 degrees. But in some cases, non-surgical treatment options for scoliosis can be used.

Surgery can correct the curve by about 50 percent, but this does not necessarily prevent future progression. Rods have been known to bend or even break due to increased spinal deformity. In addition, surgical correction of scoliosis is also a fairly invasive surgery.

Before deciding to undergo scoliosis surgery, it is important to weigh all the information to ensure it is right for the patient.

Symptoms

There are a number of symptoms that can easily indicate the disease to both the child himself and his parents, which will help him respond in time to the emerging danger.

Symptoms of scoliosis

The following signs usually signal an alarm:

• shoulders are at different levels in a standing position;
• the shoulder blades also have different levels of placement;
• when the child leans forward, the curvature of the spinal column is obvious;
• the sacral fossae are located at different levels;
• pain in the back and/or lower back is observed.

Signs of scoliosis in a child

Important! The first signs of scoliosis should prompt those who discover them to seek medical advice as quickly as possible in order to understand what is happening to the body,, if necessary, undergo additional examination and avoid dangerous consequences.

Treatment methods

Observation and corseting

About 90% of cases of idiopathic scoliosis are mild and require only observation. Typically, follow-up is carried out by a doctor every 4-6 months until the adolescent reaches full skeletal maturity.

However, a brace may be recommended for the treatment of scoliosis if the following changes in the Cobb angle occur:

• Progression reaches 25 or 30 degrees, while significant skeletal growth remains
• Progress of at least 5 degrees over any 4-6 month period
• If the curvature has become severe or is rapidly progressing, the next step is active treatment.

Consequences

Among the consequences of the disease it is worth highlighting the following:

• pathology of the kidneys and digestive system;
• hernias between the vertebrae;
• breathing problems;
• as a complication of syphilis or tuberculosis;
• change in the shape of the sternum;
• inflammation in the muscles;
• disruption of the joint work of internal organs.

Why is scoliosis dangerous?

Diagnostics

Only specialists should diagnose scoliosis. As soon as complaints of back pain and, as an option, the obvious symptoms indicated above appear, those who have discovered these problems should seek the help of specialized medical specialists. Doctors who can be contacted for help in this case include a pediatric surgeon, an orthopedic surgeon and a vertebroneurologist. For a correct diagnosis, the child will need to completely undress at the doctor’s appointment.

Consultation with a vertebroneurologist is necessary if scoliosis is suspected.

The specialist will look at the development of the musculoskeletal system in three positions:

• standing;
• sitting;
• lying down.

In this case, specialists will pay special attention to the symmetry of the shoulders, pelvis and shoulder blades. The necessary measurements will be taken. In medical practice, there is the following term for diagnosing all such cases: line of the spinous processes. This is what specialists pay special attention to in order to make a correct diagnosis.

Diagnosis of scoliosis

Experts may confuse scoliosis with the following diseases:

Therapeutic measures

Scoliosis in children and adolescents can be treated exclusively in medical institutions:

• hospitals;
• medical centers;
• sanatoriums;
• rehabilitation centers;
• specialized children's camps with a health-improving focus.

Important! A massage therapist who is able to provide massage to patients with scoliosis must be guided by an x-ray. If you come to a massage therapist with this problem, and he does not require an x-ray, then it is pointless, and in all likelihood, downright dangerous, to undergo a massage course with such a specialist.

Massage for scoliosis

Specialists who are involved in conservative treatment include:

• vertebrologist;
• physical therapy instructor;
• physiotherapist;
• chiropractor;
• masseur.

On a note! Manual therapy and acupuncture cannot treat scoliosis.

Scoliosis of the first, second and third degrees implies treatment, which is based on spinal traction. It often involves activities related to physical therapy:

• hanging with load exercises on the horizontal bar;
• hanging with load exercises on a wall bars;
• rope climbing.

Dry traction of the spine for scoliosis

Important! An orthopedic doctor will have to tell a girl with scoliosis the permissible heel height based on the degree of development of the pathology. High heels are definitely contraindicated for a girl’s unformed skeleton!

At the same time, jumping gymnastics is strictly prohibited, including jumping from the horizontal bar, wall bars and rope. General strengthening sports such as basketball and volleyball are prohibited.

To avoid progression of the disease, children are prescribed swimming, exercise therapy, gymnastics, and back massage. To get rid of progressive scoliosis of the second or first degree, in addition to the activities indicated in the previous sentence, children are shown a set of individual physical therapy exercises, manual therapy, physiotherapy, and orthopedic massage. The need for massage in children prone to scoliosis is due to the fact that their muscles in some areas of the back are weakened and they need to be toned to restore their correct position. Gymnastics and other exercises for a child susceptible to scoliosis are developed by the doctor responsible for his treatment. Moreover, all exercises are purely individual.

Exercise therapy for scoliosis in children

On a note! The famous doctor S. Bubnovsky, speaking about the approach to movements for the purpose of healing, argues that the movement itself, depending on whether it is “right” or “wrong,” can both cure and cripple, therefore a competent choice of motor strategy is very important for overall health.

Particularly complex advanced variants require surgical orthopedic treatment. This type of intervention will be used in some cases with the third degree of illness and in all cases with the fourth. If scoliosis creates conditions for the incorrect functioning of some internal organs, then surgical intervention is also indicated. The most optimal conditions for this operation are when the patient is between 10 and 22 years old. Surgical intervention involves the introduction of special fixation devices into the patient’s body. Before surgically changing the patient's body, spinal traction must be a mandatory procedure. After the operation, a period of adaptation to wearing implanted structures begins.

Corseting parameters

There are two main options for treating scoliosis with braces:

• 24 hours a day. These corsets are designed to be worn 16 to 23 hours a day. The goal is to wear them all the time, with exceptions for swimming, skin care and sports.
• Night fixation. These corsets use hyper-corrective forces and should be worn at least 8 hours a day.

The choice between permanent bracing and overnight bracing may depend on the size and location of the curves, as well as what the patient wants to do. Some studies have found that overnight bracing may be more effective because patients are more likely to wear the brace at night as prescribed, but other studies have found that permanent bracing—if targeted—may work even better.

Prevention

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Prevention of scoliosis

The bulk of preventive measures involve measures that would reduce the rate of progression of curvature. For a child, all procedures and measures with a preventive focus must be agreed upon with a specialist in order to avoid the development of scoliosis and the complications associated with its progression. Scheduled activities usually include:

• morning exercises or gymnastics. Regularity is important in this matter;
• A special back massage is also suitable.

Exercise therapy for scoliosis

Important! Swimming is an excellent prevention of scoliosis.

How can you swim with scoliosis?

To avoid the appearance of scoliosis, these measures can be taken as preventive measures with a healthy child, but still, a more attentive attitude to the skills of the specialists responsible for obstetric care - obstetricians - will help to radically solve the problem.

Causes of scoliosis

Scoliosis can be congenital or acquired. Congenital scoliosis is usually caused by abnormalities in the development of the vertebrae and ribs.

Acquired scoliosis in most cases develops in childhood or adolescence, when the body is actively growing. Basically, these are ages from 6 to 17 years. Bone growth ends before the age of 20, after which the development of scoliosis is less likely. In 80% of cases, scoliosis is detected in girls.

Scoliosis can be of myopathic origin, that is, it occurs due to insufficiency of the muscular and ligamentous apparatus. The development of such scoliosis is facilitated by long-term uneven loads on the spine: the habit of a lopsided posture at a desk or desk, carrying a bag in the same hand (on one shoulder), playing sports associated with the work of only one hand (tennis, badminton, shot throwing). and so on.).

The following diseases can lead to the development of scoliosis:

• rickets (impaired mineralization of bone tissue). Rachitic scoliosis; discovered, as a rule, at the age of 2-3 years;
• congenital torticollis (the disease is characterized by a constant tilt of the head to the right or left);
• cerebral palsy (CP);
• polio;
• osteochondrosis;
• intervertebral disc herniation;
• and also some others.

However, in most cases the cause cannot be identified. This type of scoliosis is called idiopathic. The hereditary factor appears to be of great importance, since scoliosis is quite often detected in members of the same family.