Scoliosis

If someone asks you what you know about scoliosis, your memory might jog back to middle school when you were quickly tested for scoliosis. This quick, painless test can detect early signs of scoliosis, which can become problematic for teens and adults if not treated promptly. Most scoliosis cases are mild, but severe cases can cause extreme spinal curvature, chronic pain, and persistent abnormal posture. Nevada Advanced Pain Specialists in Reno, Sparks, and Carson City excel at early scoliosis diagnosis and treatment. They help prevent long-term disruptions to life and lifestyle goals.

What is Scoliosis?

Scoliosis is a condition that involves an abnormal side-to-side curvature of the spine. The word comes from the Greek word “skolios,” which means crooked. A healthy spine, or backbone, has a slight forward and backward curve. But for people who have scoliosis, their spine curves to the left and right, in more of a C or S shape. 

Scoliosis can affect anyone at any age but is more common in girls and women, especially with a family history. About 2% to 3% of children are diagnosed during adolescence, a period of rapid growth. Around 50% of all adults over the age of 60 also develop scoliosis, generally because as adults age, their soft connective tissue, ligaments, and discs degenerate, which leads to an abnormal stacking, or curvature, of the vertebrae in the spine. 

There are three main types of scoliosis, which include: 

1. Idiopathic: this is the most common and is caused by unknown causes
2. Congenital: a rare form of scoliosis that is present at birth and is caused by the abnormal formation of the vertebrae during embryonic development
3. Secondary condition: neuromuscular scoliosis is caused by abnormalities in the muscles and nerves, which lead to the development of an irregular spine. Some common neuromuscular diseases include spina bifida, cerebral palsy, as well as hereditary musculoskeletal disorders. Less common causes include injuries, spinal stenosis, or bone collapse from osteoporosis. 

What are the Signs and Symptoms of Scoliosis?

The main sign of scoliosis is an abnormal spine curvature, but additional signs can appear before the curvature becomes noticeable. These include: 

• Uneven shoulders and waist
• Shoulder blades that stick out
• Constant leaning to one side
• Uneven leg length
• Imbalance

While scoliosis doesn’t always cause noticeable symptoms, a person could expect to experience: 

• Back pain
• Difficulty standing upright, especially for extended periods of time
• Core muscle weakness
• Pain, numbness or weakness in the legs

In severe scoliosis, a curvature over 25 degrees can cause breathing difficulties, severe pain, and reduced back functionality. Infarction and damage to the vital organs can also occur as a result of the rib cage rubbing against them. 

It’s important to seek professional care as the symptoms will continue to progress. Without treatment, a person can suffer from: 

• Chronic pain
• Physical deformity
• Organ and nerve damage
• Arthritis
• Spinal fluid leakage
• Difficulty breathing

How is Scoliosis Treated?

The first step in beginning treatment for scoliosis is to receive an accurate diagnosis. Treatment options vary depending on a person’s age, the progression of the condition, as well as the degree to which the spine curves. Your pain management specialist will measure the curvature of the spine, which is measured by Cobb’s Angle using an X-ray. This will help to determine any spinal curvature greater than 10 degrees in any direction. 

It is important to note that scoliosis occurs in three different dimensions: left to right, forward (lordosis), and backward (kyphosis). 

After assessing the curvature and symptoms, your provider will recommend a multi-pronged treatment plan. Moreover, The goal is to prevent further curvature of the spine and manage symptoms to optimize current and future functionality.

The most often recommended treatment options for scoliosis include: 

• Physical therapy: this treatment helps to strengthen the back muscles as well as the core muscles, which in turn help to promote healthy spine developments. This is most often used in conjunction with a spinal brace. 
• Spinal brace: a great option for patients who are in adolescence, a spinal brace can help to properly direct the spine’s growth into a normal shape
• Chiropractic care: receiving spinal adjustments helps to correct any misalignment in the vertebrae of the spine with the goal to encourage proper growth
• Occupational therapy: a trained occupational therapist is able to evaluate a patient’s daily activities and lifestyle and make recommendations as far as posture and making lifestyle adjustments (i.e. changing jobs) to better support their condition
• Surgery: most often the last resort and only for those who have a severe curvature of the spine (45 degrees or more) and who suffer from chronic pain and disability, surgery is a helpful treatment option. A spinal fusion can help to stop the progression of the curve as well as reduce deformity, as well as an expandable rod that is placed along the child’s spine that can be adjusted as they grow. 

The outlook for patients who have been diagnosed with scoliosis varies depending on the age of the person and the progression of the curvature. While many people who have begun treatment in the beginning stages can feel no symptoms and have no lifestyle restrictions, there are those who need constant management to reduce the continuation of the curvature, as well as any worsening symptoms. It’s important to partner with a pain management specialist so that treatment can begin as soon as possible with the goal to reduce symptoms and associated lifestyle or health complications. 

If you believe you might have the beginning stages of scoliosis, or your child has been diagnosed with scoliosis after a school exam, please schedule an appointment with the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas today. We are committed to providing the most minimally-invasive treatment options with the goal to help our family of patients live a healthy and active lifestyle.

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.

Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.

Additionally, Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

Treatments

Facet Joint Injection:

A facet joint injection is a precise diagnostic tool that also provides excellent therapeutic results. Using fluoroscopic (x-ray) guidance, physicians are able to see and accurately target the affected joint(s). Facet joints are the small joints located between each vertebra that provide the spine with both stability and flexibility. Moreover, Facet syndrome occurs when one or more of these joints become inflamed or irritated. Furthermore, Arthritis occurs when the cartilage lining the joint surface shrinks and wears thin, causing stress on the bone (bone spurs), inflammation, and enlargement of the joint.

Medial Branch Block:

 A medial branch block interrupts the sensory nerve supply to the involved facet joint through the use of a precise administration of an anesthetic agent and steroid. After a local skin anesthetic is applied, the physician uses fluoroscopy (x-ray) guidance to place a needle along the nerves that supply the inflamed joint.

Cervical Facet Radiofrequency Neurotomy:

Cervical facet radiofrequency neurotomy uses heat to create a lesion (damaged area) on the medial nerve. Moreover, The lesion impairs the medial nerve’s ability to transmit signals about facet joint pain. Because the nerve is “turned off,” pain is not felt.

Lumbar Radiofrequency Neurotomy:

Radiofrequency neurotomy is a procedure to reduce back and neck pain. It uses heat generated by radio waves to damage specific nerves and temporarily interfere with their ability to transmit pain signals.

Thoracic Facet Radiofrequency Neurotomy:

Thoracic facet radiofrequency neurotomy uses heat to create a lesion on the medial nerve. The lesion impairs the medial nerve’s ability to transmit signals about facet joint pain. Because the nerve is “turned off,” pain is not felt.

Nevada Advanced Pain Specialists is recognized as an industry leader in pain management. We have a state-of-the-art facility in Reno, Nevada, that allows for us to offer the highest possible level of quality care of our patients.

We are committed to providing a comprehensive and multi-disciplinary approach for each individual’s pain complaints to provide the most appropriate care. Our approach includes analysis of biomechanics, joint motion, as well as skeletal, nerve and muscle tissues. Every individual is evaluated for the root cause of their pain – not just a “quick fix” approach to only provide symptomatic relief.

Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.