Article by Elise Browning Miller   Yoga Journal: May-June 1990

What is Scoliosis

scoliosis spineThe word scoliosis is derived from the Greek word “skol” which means twists and turns, and is defined as a lateral curve of the spine with a rotational component. As shown in Figure 1, the ribs are connected to the spine and move with the spine. With scoliosis, the spine moves laterally, forming an “S” (or “C”) curve and rotates at the same time. The ribs follow both this lateral and rotational movement of the spine. On this lateral curve side, the ribs and intercostal muscles between the ribs move sideways, spread apart and rotate backwards with the spine [this is called the convex side of the back]. On the opposite side of the lateral curve, the intercostal muscles are underdeveloped and the ribs are compressed. Because of the rotation of the spine, the ribs are pushed forward forming a flat back. [this is called the concave side of the back].

As a result of these lateral and rotational movements, there is postural misalignment: the ribs are rotated, the shoulders can be at different heights with one shoulder blade more prominent than the other, and one hip may be higher than the other, resulting in an uneven waist. The head is sometimes not centered directly above the pelvis and the entire body can be leaning to one side. The most obvious symptoms of scoliosis are cosmetic, yet pain and discomfort are also common. In extreme cases, there can be cardiopulmonary complications. This booklet, as well as the video "Yoga for Scoliosis with Elise Browning Miller", discusses the role that yoga poses can play in addressing these conditions.

Structural and Functional Scoliosis

Scoliosis can be either structural or functional (non-structural).

a. Structural scoliosis is much more serious and develops as a result of unequal growth of the two sides of the vertebral bodies. Usually appearing during adolescence, its causes are not well understood by medical science.

b. Functional (Non-structural) scoliosis only affects the muscular back and does not alter the body structurally. It can result from such things as poor posture or repeated unbalanced activity such as carrying heavy books or any heavy object always on one side. It is much more common than structural scoliosis, and usually much less noticeable, since the degree of curvature is less and almost always reversible.

A simple way to determine whether someone has a structural or functional scoliosis is to have them bend forward into a forward bend. This is a standard screening test given in junior high to determine if students have adolescent structural scoliosis. If a lateral curve is visible in a standing position yet disappears in a forward bend, the scoliosis is functional. If it remains and the rotational component becomes more obvious, it is within the structure of the ribs and spine and is a structural scoliosis.

Approximately 80% of all structural scoliosis are idiopathic, meaning doctors do not know why or from where it comes. Idiopathic scoliosis first develops in girls between the ages of 10 and 14; and in boys between the ages of 12 and 15. Other causes of structural scoliosis are: congenital where the vertebrae fail to separate, or neuromuscular, such as polio or cerebral palsy and also from accidents that involve the spine and/or ribs. In some cases, leg differentiation can cause scoliosis in the lumbar ( lower back) region. This results in uneven hips.

The Major Scoliosis Curve Patterns

Curvature can take place anywhere along the length of the spinal column, however there are four most common patterns of curvature. To be able to use yoga effectively for your scoliosis, find out what pattern you have from an orthopedic surgeon or knowledgeable professional in this field.

a. Right thoracic Scoliosis indicates that the major scoliosis is concentrated in the thoracic (mid-back) region and curves to the right. In the right thoracic scoliosis there may also be a counter curve to the left in the lumbar (lower back) region, but this is a less severe curve.

b. Left lumbar Scoliosis indicates that the major curve is to the left and is concentrated in the lumbar region. There may be an opposite curve less extreme to the right in the thoracic region.

c. Right thoraco-lumbar Scoliosis indicates that the major curve is to the right in the thoracic and lumbar region. This is commonly known as a “C” curve.

d. Right thoracic-left lumbar Scoliosis. The last type of curvature is the combined curve where the major curve is in the thoracic region with an equal counter curve to the left in the lumbar region. This is commonly known as an “S” curve.

For unknown reasons, 90 percent of thoracic and double curves are right convexity (curve to the right); 80 percent of the thoraco-lumbar curves also are right convexity; and 70 percent of the lumbar curves are left convexity. There can also be triple curves with an additional lateral curve in the cervical or neck region. Also two or more lateral curves can be in the thoracic region of the back with a major lumbar curve. With a more severe scoliosis, seven times as many women as men have scoliosis.

Scoliosis Resources:

Visit Dr. Deutchman’s website, www.scoliosissystems.com to learn about non-surgical scoliosis treatments, including the SpineCor brace, the first dynamic flexible brace for the treatment of idiopathic scoliosis. You can also visit his website, www.scoliosiscare.org to learn more about research & education for non-surgical treatment of scoliosis.