Idiopathic scoliosis is a 3-dimensional distortion of the spine and trunk that occurs in otherwise healthy children. 80 % of scoliosis cases are considered to be “Idiopathic” and the exact cause is currently unknown.
Although the exact cause is unknown, it is regarded as being multi-factorial. It is thought that there is a strong genetic predisposition and that a gene is turned on by initiation factors, progression factors then make the scoliosis worse. Initiation and progression factors include growth issues, nervous system development, hormone levels, muscular imbalance and many others.
A well recognised theory about how scoliosis develops in adolescence, is associated with asymmetrical growth of the vertebrae which de-stabilises the spine and makes the vertebrae prone to becoming wedged. Wedging of the vertebrae then creates a lateral spinal curve which places uneven loading on the vertebrae and precipitates further asymmetrical growth and progression. It is then thought that spinal cord tension develops as the spine bends and twists and brain function and growth is altered as muscle asymmetry develops.
Due to the multi-factorial nature of idiopathic scoliosis, it is important that a multi-factorial treatment approach is taken and includes:
- Scoliosis specific exercise to help improve neurological motor patterns, muscular balance, postural balance and spinal alignment
- Self-correction of posture that is incorporated into daily life activities, not just periods of exercise
- Scoliosis bracing when necessary to reduce the uneven spinal loading and help normalise spinal growth and movement
When considering which approach to take towards scoliosis, it is always best to remember that smaller curves are easier to treat with scoliosis specific exercise and bracing. This contrasts the commonly prescribed “wait and see” approach, where it is recommended that the child or adolescent is observed until the scoliosis develops into a spinal deformity which is then treated. The larger the curve becomes, the greater the risk it has for progression throughout life and the more likely that it will progress to a surgical level.
Idiopathic scoliosis is classified according to the time it is diagnosed. Infantile is from age 0-3 years, Juvenile is between 4-10 years and Adolescent Idiopathic is from 10-18 years. Typically, the earlier the scoliosis onsets the greater the risk of progression, however infantile curves may sometimes spontaneously resolve while those in juvenile scoliosis rarely do.
Idiopathic scoliosis, becomes most noticeable during growth spurts, when curves and posture start to worsen.