International Scoliosis Awareness Day 2020
This International Scoliosis Day 2020, National Clinical Training Manager, Richard Harvey, discusses what a scoliosis is, types of scoliosis, complications and how a scoliosis can be supported with Jiraffe’s range of postural support equipment.
What is a scoliosis?
Scoliosis is the lateral curving of the spine which can cause rotation and buckling of the spinal column. The internal tensile and compression forces can cause adaptation of soft tissues, deformities to the skeletal system and many other secondary complications.
There are a number of different types of scoliosis (1) which include, but are not limited to:
Congenital scoliosis is a type of scoliosis that you are born with. This type of scoliosis happens because the spine does not develop fully in the womb.
Early onset scoliosis
Early onset scoliosis is when a curve appears between birth and age 10, or before puberty.
Adolescent idiopathic scoliosis
Adolescent idiopathic scoliosis is a change in the shape of the spine when a child is growing. It results in the spine curving sideways and twisting at the same time.
Degenerative scoliosis occurs in adults for two main reasons. Degenerative scoliosis of both kinds can happen because the bones get weaker as we age.
Neuromuscular scoliosis is a curvature of the spine caused by a neurological or muscular condition.
A lot of the children who use are products have neuromuscular disorder/diseases which can end up causing a scoliosis. There are a number of potential complications that can be associated with a scoliosis. We should ensure that these are taken into consideration when managing a curvature of the spine.
Complications from scoliosis
Some children will not develop any secondary complications directly related to their scoliosis. The information given below outlines the potential risks associated with scoliosis.
Pain and discomfort
It is possible that when a scoliosis is forming, pain and discomfort may be felt by the child. If the curve of the spine is left unmanaged, the weight of gravity bearing down on the child’s spine can cause further complications. We have probably experienced ourselves whenever we have slept at a funny angle, or sat in the same position for a prolonged period of time, we can experience pain and discomfort. We need to adjust our position to find a more comfortable one and off load pressure. Children with Neurodisabilities cannot always do this for themselves, which is why it is necessary to manage a person’s posture who cannot do it for themselves 24 hours a day 7 days a week.
The human body is highly flexible and inherently vulnerable to damage. Over time soft tissues can adapt to the supporting surface. You may have heard the term ‘becoming chair shaped.’ This pertains to a person who has adopted a seated position for a prolonged period of time. Due to gravity and internal forces, the body begins to adapt to this shape. Range of motion can start to become limited in hips, knees and ankles. Also our soft tissues can mould around the shape of seat, meaning that we are now adopting the shape of that chair.
The same can happen with a Scoliosis. If left unmanaged the ligaments and muscles in between each vertebrae of the spine can become over stretched or shortened. If they remain in the same position for too long these adaptations can cause a fixed asymmetry
Other secondary complications could include:
- Compression of internal organs
- Poor bowel and bladder function
- Respiratory issues
- Digestion issues
- Skeletal deformities
Supporting a scoliosis
It is important to ascertain whether the scoliosis is fixed or if it is flexible. If the curve is correctable this is known as flexible. However if you are not able to correct the curve it will be referred to as fixed. Whether or not the scoliosis is fixed or flexible, it is still important to manage the spinal curve.
A flexible scoliosis requires the intervention to correct the curve and bring the spine back into as aligned a position as possible. When using an adaptive piece of equipment, this is usually achieved by applying pressure at the apex of the curve using a lateral support. It is important to then apply pressure (counter forces) below and above the curve on the adjacent side of the body. This will evenly disperse the pressure along the spine. The desired outcome is that the scoliosis will remain flexible and not become fixed. Therefore avoiding the complications outlined above.
A fixed scoliosis is a curve where the soft tissues and skeleton has adapted. The spine is unable to be brought back into its most aligned position. Our main aim is now to manage the scoliosis so it does not deteriorate and become more severe. As gravity is constantly applying force to the body, the risk of developing more secondary complications is increased. Contouring the supports around the curve and making as much contact with the surface area of the trunk will help to reduce issues around pressure. It is still important to offer support at the apex of the curve initially and offer additional supports above and below as counter forces.
Within the Jiraffe range of products, there are a number of different thoracic/lateral support options, with multiple features and benefits:
- Flexible supports that can contour the chest
- Firm supports to offer more of a prompt around the required area
- The ability to ‘off set’ the laterals, to support an A-symmetrical spine
- Different sizes to accommodate all sizes of users
- Soft padding to reduce pressure related injuries
Scoliosis Association UK launched ISAD in 2013 to unite people across the world to create positive public awareness of scoliosis, promote education, and bring together those affected by the condition.
Blog written by Richard Harvey, National Clinical Training Manager