Scoliosis

Dear Dr. B: My mother is 83 years old. She has osteoporosis and lumbar scoliosis. She has back pain. For several years she has been advised to lie on plywood without a mattress. Is this the right treatment for her scoliosis and back pain?

Answer: Spine has natural curves. There is a natural curve round our shoulders (kyphosis) and there is one in the lower back (lordosis). Theses curves are required to maintain appropriate trunk balance over the pelvis. In scoliosis, some people have abnormal curvature of the spine to the left or right.

Scoliosis is more common in females and may run in families.

What are the causes of scoliosis?

Eighty per cent of the cases of scoliosis have no definite cause (idiopathic). In some cases it may be congenital and present at birth. Some rare causes are: muscle weakness around the spine, cerebral palsy, poliomyelitis, unequal leg length, and spinal injury.

What are the symptoms?

In most cases the symptoms of spinal scoliosis develop gradually as a child grows. There is a visible curvature of the spine on one side; there is back pain and difficulty walking. The rib cage may be deformed in severe cases of upper spinal scoliosis and this may compromise the function of the heart and lungs.

How is it treated?

Mild cases of idiopathic scoliosis do not require treatment. They are carefully monitored to see if the curvature is getting worse. If there is an obvious cause then the treatment is geared to correct that problem.

If the scoliosis is severe and progressive then spinal brace is used to limit further progression. In some instances surgery (spinal fusion or metal rods and wires) is used to control the condition.

Scoliosis Research Society’s website (http://www.srs.org/patients/) says that there is no scientifically documented role for exercises, manipulation or electrical stimulation in the management of scoliosis. And I did not find any reference to lying on plywood as a remedy for backache due to scoliosis.

Is there a relationship between scoliosis and osteoporosis?

Osteoporosis is a very common condition amongst women. In one study, 48 per cent of the women with osteoporosis had scoliosis. Osteoporosis and scoliosis frequently occur together. Scoliosis of the lumbar area was more commonly seen. Elderly women with scoliosis are at a high risk of getting fractures of the vertebral bodies.

Recommended treatment for elderly women with osteoporosis includes pain killers, exercise, and certain types of braces to support the spine. Patient should be advised to increase intake of calcium and vitamin D.

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