Spine Health & Spinal Hygiene

Idiopathic scoliosis means that no cause congenital or neuromuscular that created the spinal deformation has been identified. However, idiopathic scoliosis is the most common type, affecting 2% to 3% of individuals. Individuals diagnosed with an idiopathic disease or condition can be frustrated with more questions than answers, but it can still be treated in adults and kids.

Congenital Scoliosis

• Congenital scoliosis is an abnormal curvature of the spine related to which the patient was born.
• Usually, a failure of formation or segmentation during normal development leads to the spinal condition.

Neuromuscular Scoliosis

• Individuals with neuromuscular scoliosis are usually born with neurological disorders that contribute to muscular unevenness, often resulting in the development of the condition.
• For example, individuals with cerebral palsy are born with muscular unevenness that can contribute to scoliosis development.

Who Is Affected

Anyone can develop scoliosis, but children and adults are divided into separate categories.

Children

• Children with this condition are divided into three subcategories:
• Infantile idiopathic scoliosis
• Juvenile idiopathic scoliosis
• Adolescent idiopathic scoliosis

These classifications are based on age and skeletal maturity.

• Infantile is zero to 3 years old.
• A juvenile is 3 to 10 years old.
• Adolescents are from 11 onward or when starting puberty, to the point where the skeleton fully matures.

Adults

• Idiopathic scoliosis in adults results from undiagnosed or untreated scoliosis in childhood that gradually progressed.

Causes

Research has found a genetic predisposition to developing scoliosis, as it has been found to run in families. Genetic testing has been designed to help determine the risk of developing progressive scoliosis. Theories have been presented about abnormalities that affect the nervous system. These include:

• Dysfunctions of the brain stem or equilibrium have been frequently identified in individuals with idiopathic scoliosis.
• Other theories suggest skeletal growth abnormalities or hormonal/metabolic dysfunction may contribute to the condition.
• However, determining its exact cause remains unknown.

Signs and Symptoms

Here are some things to look out for.

• The body leans to one side.
• There is an unevenness of the ribcage or hips.
• Uneven shoulders.
• Shoulder blades may protrude or stick out.
• The head is not positioned directly above the pelvis.

Diagnosis

Idiopathic scoliosis curves tend to follow predictable patterns.

• Right thoracic or middle back scoliosis
• Left thoracolumbar or mid and low-back scoliosis
• Relative thoracic hyper or hypo kyphosis

Magnetic resonance images/MRIs of the spine can show evidence of any significant abnormalities. If no other related condition is present to suggest different causes, then the idiopathic scoliosis diagnosis can be made.

Treatment

Treatment depends on the individual's age and the degree of curvature in the spine.

• In many cases, adolescent or juvenile idiopathic scoliosis patients that have a mild curve can be treated with a brace.
• Adults could need surgical intervention, such as a fusion surgery where rods and screws are added to realign the spine and relieve the pressure on the nerves.

Chiropractor

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Burnei, G et al. “Congenital scoliosis: an up-to-date.” Journal of medicine and life vol. 8,3 (2015): 388-97.

Clément, Jean-Luc, et al. "Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis." The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 22,11 (2013): 2414-20. doi:10.1007/s00586-013-2852-z

Giampietro, Philip F et al. “Congenital and idiopathic scoliosis: clinical and genetic aspects.” Clinical medicine & research vol. 1,2 (2003): 125-36. doi:10.3121/cmr.1.2.125

"Scoliosis – Symptoms, Diagnosis and Treatment." https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis

"Thoracic Hyperkyphosis." Physiopedia, 2009, https://www.physiopedia.com/Thoracic_Hyperkyphosis

Osteoid osteoma refers to a benign tumor/s that can grow on the spine as well as other areas of the body. They are not cancerous, but they can cause pain and abnormal curvature of the spine. It can begin as a small benign spinal tumor that can cause pain, especially at night. They do respond well to over-the-counter pain relievers and can go away on its own. However, if symptoms are unmanageable, other treatments are available.

Osteoid Osteoma

Osteoid means a type of tissue that eventually turns to bone. Osteoma means a type of tumor unique to bones. They are small typical size is less than one inch across. These growths represent around ten percent of all benign bone tumors, with one percent representing spinal tumors.

They can appear and also affect the bones of the arms, hands, fingers, ankles, or feet. They are discovered on the spine around fifteen percent of the time. Osteoid osteomas of the spine affect the posterior, or back area of the vertebrae rather than the anterior, or front region. However, any area of the spine could be affected. But they are most common in the low back.

• 60% affect the lumbar spine lower back
• 27% affect the cervical spine or neck region
• 12% affects the thoracic spine or middle back

Risks

Osteoid osteoma is not cancerous and will not spread out to the various organ systems the way malignant cancer does. It can be discomforting, painful, and could have to be removed. There are some risks associated with osteoid osteomas including:

Scoliosis

It could provoke muscle spasms of the erector spinae. These are the muscles that support the spine and could lead to scoliosis. The spine has a natural curvature. Scoliosis generates an S or C shaped curve to the left, right, or both ways affecting function and mobility. This type is more likely to contribute to the left or right curve of the spine affecting the lower back.

Incorrect diagnosis

Because osteoid osteoma can cause scoliosis, sometimes a doctor will focus on treating the abnormal curve instead of the osteoma.

Nerve root compression

Most individuals do not pose a risk for nerve root compression. But there is a risk if the growth begins to press against the spinal cord, as it can interfere with nerve function. This can lead to spreading/radiating pain and sciatica.

Causes

The causes of osteoid osteoma are not completely understood. What is known is that men are three times more likely to be diagnosed than women. Young people also pose a risk at development. It can develop at any age, but around eighty percent are diagnosed in individuals under 30 years of age. The core of an osteoma is a growth called a nidus. Inside are growing tumor cells, blood vessels, along with cells that progress to bone. A bony shell encapsulates the whole thing.

Signs and Symptoms

Osteoid osteomas usually cause a dull ache at the site of the tumor along with muscle spasms. The pain often gets worse at night. It can be relieved with non-steroidal anti-inflammatory medications like ibuprofen and aspirin. The pain can also be sharp, and occur during the day, worsening with activity and sometimes progressing to severe pain over time. In some cases, however, there are no symptoms.

Diagnosis

Doctors usually notice painful or swollen soft tissue around the tumor during a physical examination. There could be a lump, but this is rare. Imaging tests like an X-ray or a CT scan will be ordered. An x-ray can show the bone thickening, but a CT scan will show the nidus clearly as a dark center surrounded by white cortical bone. Sometimes a CT and MRI imaging scan is used in conjunction to diagnose osteoid osteomas. In some cases, a biopsy could be needed. This is taking a tissue sample and sending it to a lab to be examined under a microscope. However, this is rarely needed.

Treatment

Nonsurgical

Non-steroidal anti-inflammatory medications can be effective relieving symptoms. If it can be controlled with just medication, then this could be the only treatment necessary. Some patients do well trying a different painkiller if the preferred medication no longer works. This needs to be discussed with your doctor, as chronic medication use is associated with issues like ulcers, kidney damage, and concerns about opioid addiction. When this approach is taken, the pain lasts for about three years with the lesion breaking down in five to seven years.

Surgical

If the pain cannot be controlled or the osteoma develops to scoliosis, surgery could be the next step. Most spinal osteomas are surgically removed with open curettage. It is a small incision. The nidus is scooped/scraped out and the cavity walls are removed with a motorized burr. Often a small amount of bone graft material is used to fill in the area. Unfortunately, surgical resection means having to stay at the hospital. Recovery time can be painful.

Radiofrequency ablation

For osteomas that affect the bones other than the spine, radiofrequency ablation. It is a minimally invasive outpatient procedure with a short recovery time. During the procedure, radiofrequency waves generate heat within the nidus around six minutes destroying the tumor. Surgeons use CT scans to precisely target the tumor. The procedure takes one to two hours and afterward, the patient waits in a recovery room for up to four hours.

However, radiofrequency ablation is not as commonly used to treat spinal osteomas. This comes from the risk of thermal nerve damage. The needle tip can reach 194 degrees Fahrenheit, which is more than enough to damage the nerves. Candidates for radiofrequency ablation are usually young patients with no history of neurological problems. Osteoid osteoma is not as scary as it sounds, remember the best defense is a knowledgeable doctor and chiropractor. If back pain is presenting, do not wait to get treatment. There is a spine specialist who can help.

Chronic Pain Chiropractic Care

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Scoliosis causes the spinal curvature to go sideways and can cause various symptoms. One of the most common symptoms is scoliosis hip pain. This happens because the spine's curvature can pull the hips out of alignment, causing one side to be raised higher than the other. A result of this is one hip begins to take on more weight. This overloads the hip causing strain, soreness, aches, and pain, especially after standing or walking.

Scoliosis Hip Pain

Idiopathic scoliosis typically occurs in children, but often there are no pain symptoms. This type of scoliosis can go on unnoticed and undiagnosed for years even until adulthood. When the spine stops growing, even a small scoliosis curve can cause hip pain. The hip pain varies but generally presents with:

• Sharp pain.
• Throbbing pain.
• Pain that increases with activity like walking, running, standing for a long time.
• Stiffness with combined pain after sitting or lying down for a long time.
• Sciatica.
• Numbness.
• Tingling.
• Tight hip flexors.

The amount of pain depends on:

• The misalignment severity.
• The type of scoliosis - degenerative or idiopathic.
• Bodyweight. Individuals that are obese are more likely to have severe hip pain because of the added weight.
• Activity level. Physical activity can cause the pain to worsen.
• Lifestyle.
• It varies from person to person.

The Higher Hip

When scoliosis has progressed enough, the curvature and uneven hips are pretty apparent. However, only around 10% of scoliosis cases get this far. If the curvature is minimal, which is usually the case, trying to determine which hip is higher usually requires medical assistance.

• The hip that presents with pain is generally the one taking on more weight.
• This causes the muscles to fatigue faster and places added stress on that hip joint.
• A way to tell which hip is higher stand on bare feet in front of a mirror holding a piece of yarn, or string with both hands.
• Place the heel of each hand on the corresponding hip bone.
• The string will be tilted if the hips are uneven or will be straight if they are not.

Adult Scoliosis 

Hip pain caused by scoliosis is most common in adults. However, it is not the only cause of hip pain. Unless diagnosed with scoliosis as a child, individuals may be suffering from de novo scoliosis or degenerative scoliosis.

De Novo/Degenerative Scoliosis

As the body ages, the spinal discs between the vertebrae begin to wear down. The worn-down discs can cause the spine to develop a sideways curve, that can pull the hips out of alignment. Studies are showing that this type of scoliosis is widespread. Loss of bone density can be a contributor to scoliosis in older adults. Bone density loss from menopause means women are more susceptible than men. Past the age of 70, both men and women lose on average, the same amount of bone density. There are effective integrative, natural treatment therapies that incorporate:

• Exercises
• Nutrition
• Posture correction
• Chiropractic
• Physical therapy

Scoliosis Hip Exercises

For uneven hips, there are exercises to help relieve pain and strengthen weak muscles.

Hip Stretch

• Lie on the back with both legs straight out.
• Lift the right leg
• Using the hands pull the knee toward you, keeping the foot pointed up.
• Pull the knee to your chest as far as you can without causing discomfort or pain.
• Hold for 5 to 8 seconds.
• Release.
• Switch to the other leg.
• Repeat 4 to 6 times on each leg.

Wide Leg Stretch

• Sit on the floor with the legs as wide as they can go.
• With the right hand, reach toward the left foot, touching if possible.
• Return to the original position.
• With the left hand, reach toward the right foot.
• Repeat 6 to 8 times.

Chiropractic

If misaligned and uneven hips are causing pain, chiropractic care for scoliosis is recommended. Spine and hip realignments help relieve pain, stretch the muscles, and corrects posture. One study showed that multi-approach chiropractic for adult scoliosis was found to be beneficial even two years after treatment was finished. Injury Medical Chiropractic and Functional Medicine Clinic can help with recommending nutrition and lifestyle tips. Instead of just treating symptoms, our team helps manage the cause.

Body Composition

Body Analysis for Disease Prevention

Early identification of disease is imperative for developing the proper treatment plan. Testing can help improve long-term health outcomes. Testing is made easy with the data being easily implemented into patient management software. A comprehensive printout is ready for engaging and educating patients in understanding health risk management and reduction. In 60 seconds, an InBody Test will generate easy-to-understand, accurate, and objective measurements to evaluate potential disease risk. Medical providers can use the InBody to:

• Monitor muscle, and visceral fat to provide an accurate measure of health risk.
• Monitor muscle distribution to determine specific health risks related to diseases.
• Identify fluid imbalances associated with certain diseases.
• Track changes for effective long-term risk identification and reduction.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

https://www.aafp.org/afp/2001/0701/p111.html#afp20010701p111-b1

https://link.springer.com/content/pdf/10.1007/s00586-020-06453-0.pdf

https://www.healthline.com/health/uneven-hips

https://www.sciencedirect.com/science/article/abs/pii/S1556370711000915