What is Scoliosis? Should I be Worried?

As school starts around the country, many parents have concerns about backpacks and scoliosis screenings. What’s the truth?

As I speak to more and more patients, I’ve come to a realization that there is quite a bit of confusion about what scoliosis is, and how it can affect your child’s health. Many people remember going into the school nurse’s office every so often and get a scoliosis test where they bend down from their waste and touch their toes, as shown below.

The most common screening test for scoliosis.

But what is scoliosis? Scoliosis involves a curved deformity in the spine. Now here’s where it gets funky. There are good curves and bad curves in the spine. When you look at someone from the side, the spine normally has 3 curves that curve to the front, back, and front again. These curves provide strength and stability to the spine in gravity. A scoliotic curve is seen from the front or back, and may indicate a structural abnormality or congenital deformity.

Good curves are visible if you look at someone from the side.

When you look at someone from the front or back, curves in the spine are a bad sign and may indicate the presence of scoliosis.

Many people can have a scoliosis and never feel any effects or symptoms from it.  Others may experience more common symptoms like back pain, neck/shoulder tension and posture/cosmetic problems. In rare cases, the curvature can become large enough (50 degrees or more), that it can compress the chest cavity causing respiratory and cardiac problems, and become a surgical issue.

Scoliosis comes in 2 main forms. There are is a functional scoliosis which is typically named idiopathic scoliosis, and there is a scoliosis called structural/anatomical scoliosis.

• A structural/anatomical scoliosis is called by a malformed vertebra which can force the spine to a curved position as it seeks to get back to center. This type of scoliosis cannot be fully corrected and it can also lead to larger curvatures depending on how malformed the vertebra is.
• A functional/idiopathic scoliosis is named as such because there is typically no medically known cause. This is the most common type of scoliosis.  These types of curvatures can be corrected and reduced significantly through conservative means when caught before a person is fully developed.

The real question is, should you be worried?

The truth is, if you’re just worried about pain, then probably not. Many times, scoliosis is asymptomatic, especially in children. In fact, most people will probably go through their childhood with no knowledge that it is even there. For the category of idiopathic scoliosis, it is often the secondary result of a structural shift in one or more bones in the spine.

A curve is usually not described as a scoliosis until it reaches the 10 degree mark. Most people are concerned when the curvature surpasses 20 degrees, as that’s when bracing becomes a common recommendation, and cosmetic concerns become more obvious (postural problems, protruding shoulder blade, etc). When the curve grows 40 degrees, surgery starts to become a real option for treatment.

The key is catching these curves early. Scoliosis is most commonly found in girls during adolescence, which is a great window of opportunity for structural correction, no matter how small the curve may be. Just like how a bent frame of a car can create suspension problems and tire wear/tear, a bent spine can increase the damage the spine experiences throughout life. I’ve seen x-rays of people well into their 40’s and 50’s who have never experienced spine pain, but will show a scoliotic spine with disc degeneration and bone spurs in the exact pattern that the structural alignment would dictate.

As the spine shows early wear and tear, the nerves can get damaged and cause secondary conditions as well as changes into the muscles, ligaments, and even the vital organs of the body can start to show.

As a worried parent, what can you do? Here are a few tips:

1. Get a spinal check up by someone who is focused on the health of the spine! Nurses and general practitioners do a great job of identifying major curvatures using basic screening tools, but these will typically identify cases of scoliosis that are excessively large and may be candidates for surgery. A chiropractor focused on structural correction instead of pain relief can recognize smaller deviations and provide tools to correct them if necessary.
2. Avoid the one shoulder back pack routine. It may look cooler and be more comfortable, but extra forces on a spine that isn’t optimally positioned can increase scoliotic curves.
3. Stay active. Movement is life and a spine that moves early and often has more pliability and flexibility than one that is sedentary and stiff.
4. Keep the weight down. If you had a crooked house and you add more weight to it, what happens to the house? It breaks down faster. The same thing happens to the body. If you build more mass on top of a crooked structure, it will lead to earlier degeneration. Stay fit.

TMJ Pain is Ruining My Life!

Outline:

·         When treating TMJ pain seems hopeless

·         Surgery may not be your best solution

·         TMJ pain may not be a jaw problem

Patients with TMJ often see a large drop in the quality of their life:

·         “I feel like a baby because I can’t eat solid foods anymore”

·         “There are times where I just have to stop talking because all I can think about is the pain”

·         “That popping sound creeps me out and drives me nuts”

A lot of people will experience jaw pain for a day or two if they bite into a hard/chewy piece of food, but imagine if your life was plagued with jaw pain every single day. We underestimate the importance of our jaw, but it’s the piece of anatomy that allows you to enjoy some of the finest pleasures in life. Everything from kissing, to chewing, to a casual conversation with friends becomes a burden when your jaw fails to function.

Desperate Times and Desperate Measures

Severe cases of TMD (Temporomandibular Disorders) can make people reach their breaking point quickly. Many of the patients that come to our office are usually looking at surgery as their next and final option because they don’t know what to do.

Even worse is when a patient spends tens of thousands of dollars for surgery but the pain doesn’t go away. Procedures that help to remove or replace a degenerated disc in the joint are sometimes performed to eliminate this pain sensitive piece of anatomy. The problem is that a degenerated disc can show up on imaging, but it isn’t necessarily the cause of the pain.

Unfortunately this happens more often than you might think, and it’s something that can make a patient with TMD hopeless if even surgery couldn’t get the job done.

This isn’t to say that surgery is not the answer, or that surgery can’t help, but we have to remember that TMD is a problem that science has yet to reveal all of the answers, and dental surgery is still working on figuring out what works and when it’s appropriate.

TMJ Pain May Not Be A Jaw Problem

There are many different causes for TMJ pain. They can range from abnormal jaw movement, tight jaw muscles, and degenerated discs. These can all be problem areas for a TMJ patient, but they all have something in common.

In fact, their commonality goes back to some of the same neurological mechanisms that contribute to neck pain and headaches. That’s why people with TMJ don’t just have jaw pain; they often have neck pain and headaches at the same time. It’s because almost all pain signals from the head and neck go through a small piece of spinal cord called the trigemino-cervical nucleus.

Trigemino-cervical…..what????

Sometimes Pain is a Computer Problem

So if you don’t have a medical background, some of that terminology might jump over your head.

Instead of thinking anatomy, let’s talk about it like a computer.

 

Your brain and spinal cord are like a computer chip. The part of your computer chip that feels head and neck pain is the trigemino-cevical nucleus.

Just like all computer chips, the quality of information that comes out is dependent on the quality of information that comes in. If you put junk information in, you get junk information out.

The computer chip of your body relies heavily on information from the muscles and joints. These signals are like computer programs. Whenever these joints move poorly from bad positioning, then it’s like a bad program that gives faulty information about what’s happening inside the body. This can occur from malpositioning of the jaw, faulty jaw movement, neck positioning errors, and faulty neck movement.

It’s like a computer virus going into your system and scrambling important signals into the brain.

This tells the body to produce a junk signals including:

• Tight and tense jaw muscles
• Inappropriate inflammation
• Central pain sensitivity

Can This Program Get Shut Off?

Fortunately your body’s program for pain can be re-written by changing the way these joints move.

A specialist like a neuromuscular dentist can use non-invasive methods to change the way your jaw moves and alter your bite with an orthotic.

Chiropractors that can correct the craniocervical region can create a dramatic impact on the pain programming in the brain.

That’s why both of these doctors frequently see similar patients, and will actually co-manage them between each other. Neck pain patients may get better relief from a dentist changing their bite, while some TMJ patients will get better relief from correcting their neck.

While we can’t say for certain which takes priority, but many patients can benefit from an interdisciplinary approach to care. Take the time to get a Complimentary Consultation to find out what method fits with you. You may even find that getting the entire jaw/neck complex fixed may be the key to solving your TMD.

Call our office today for your free consultation – Premier Chiropractic 248-287-8700

Why Does My Back Hurt When I Breathe? What is it and how to fix it?

Overview:

• Pain from the ribs. How’d it happen?
• Why does it hurt so bad?
• Painful but fixable

“It hurts right here (points to middle of back), especially when I take a deep breath in.”

“It’s like someone is poking a knife in the middle of my back”

“Every time I try to stand up all the way, my back spasms.”

“I just want to crack this pinch in my back.”

There are times when pain can literally take your breath away.  That sharp, stabbing pain coming from a very pinpoint spot in the middle of your back.  Sometimes it’s just a really annoying feeling that won’t go away, but other times it can make you feel crippled by back spasms.

In many cases, this pain comes from the joint where your ribs connect to your spine. Sometimes people will say that you have a rib head that’s “out of place”, misaligned, or sprained. For the sake of today’s article, we’ll just call it rib pain.

It’s a frustrating problem because it can happen out of nowhere. Sometimes you just wake up with the pain, other times it’s from twisting or turning too quickly. Fortunately, even though we don’t know much about the pain, we do have effective strategies to help manage it when you feel it.

Why Does It Hurt So Bad?

The interesting thing about pain from a rib head is that the intensity and level of annoyance is really high for a problem that is pretty harmless. It’s not like a herniated disc where you may have other serious complications that arise, but the pain can sometimes be as debilitating.

Although this joint won’t result in pinched nerves that can cause muscle weakness or loss of feeling, it is extremely dense in pain generating tissue.

The ligaments shown on the image above, as well as the direct connection of the rib to the vertebra can be full of pain fibers called nociceptors. This joint is not supposed to have very much movement. If the joint gets overloaded and sprains the ligament, or if there is too much friction between the joint surfaces, then it stimulates an aggressive pain response in the brain.

When the pain response is initiated, the nervous system often looks to brace an area of injury, this typically comes in the form of muscle tightness and spasticity. As the muscles tighten around your ribs, it limits your ability to breathe in deeply. The muscle spasticity may also compress the nerves, arteries, and veins passing around the curvature of the ribs causing additional sources of pain and discomfort.

Unlike other parts of the body like the hand, shoulder, and low back, you don’t have a choice in moving your ribs. Your ribs move whenever you take a breath, and breathing is a little bit important to the maintenance of life. The more it moves, the more it can agitate the painful joint even if there’s minimal tissue damage.

How to fix it?

For most people, this pain will go away within a week without any treatment. However, if you have the pain for longer, you may need a little bit of outside help to correct the problem.

Most chiropractors can address the pain with a spinal adjustment to the thoracic spine or rib head. Typically patients will feel a substantial amount of relief within a few visits. When combined with some corrective exercise, you probably won’t have any further issues unless you reinjure the joint.

 

Whether your problem is brand new or chronic, a Structural Corrective approach to the spine can lead to substantial relief.