QUESTION FROM READER:SCOLIOSIS

My daughter has just been diagnosed with scoliosis and I would like to find out more about the disorder. The initial diagnosis says that the S shape of my daughter’s spine is caused by lax ligaments. The doctor is suggesting she wear a brace. This apparatus, which is like a plastic vest, is something which she would have to wear 23 out of 24 hours each day to help stop her back developing more wrongly.

We are currently on a one year plus waiting list for a specialist in Leeds and would like to know what other treatments might be helpful to her. JN, Bradley……..

Scoliosis is surprisingly common, especially in youngsters. It affects both sexes, but is seen twice as often in girls. It is defined as a sideways curvature of the spine and can be caused by a number of different factors, such as weakened muscles on one side. Some believe that it is hereditary, though this is by no means certain.

It can also be caused by diseases of the vertebrae, such as rickets, by chronic diseases of one lung when the muscles of the affected side are held taut, and by sciatica or diseases of the hip joint, when the pelvis is tilted to relieve strain on the painful side and the spine is bent in the opposite direction to compensate.

The S shape is usually a result of compensation the body’s attempt to maintain an upright position.

In young children and adolescents, it can be an ongoing developmental problem. There are different growth centres in the spine and surrounding tissues. If one side develops quicker than the other, scoliosis can be the result. While your daughter’s case does not sound as if it has a postural element to it, some types of scoliosis can be caused by postural problems. Just as often, however, the cause is difficult to pinpoint.

Left untreated, scoliosis can create a rib hump and, as a result, begin to squeeze internal organs and pinch nerves. In severe cases, the growth of the heart and lungs can be compromised.

WDDTY panellist David Charlaff, a practising osteopath, recommends that the first step should be to get second, even third opinions as to whether scoliosis is really the problem.

If you suspect scoliosis, have the condition properly diagnosed, that is, with a scan or an x-ray. This should distinguish between a problem caused by lax ligaments and one of bony malformation (which is difficult to cure and certainly cannot be helped by an external brace). A competent doctor should be able to give you some idea of the extent of the problem.

Adolescents with a spinal curve of less than 10 per cent are not considered to have scoliosis. The best treatment for this kind of curvature is to wait and see, supported perhaps by some form of physiotherapy or body work. Adolescents with a 20 to 30 per cent curve, although defined as having scoliosis, may also benefit from a wait and see policy. A curvature of up to 30 per cent (up to 40 per cent in adults) is considered a mild case, and often the curvature will not progress past this point. Ninety per cent of cases of scoliosis are considered to be mild.

However, if the spinal curve increases or is greater than 30 per cent, and your child has more than a year left of potential growth, a part time brace, being a non surgical solution, may be the best of a bad lot of options, which can include surgery to fuse the vertebrae together using rods, hooks and/or bone grafts.

Mild to moderate forms of scoliosis usually respond well to a multifactoral regime, which can include body work such as Pilates, Alexander technique and intensive osteopathic and/or physiotherapeutic treatment. You should also consider visiting a nutritionist to begin a programme of supplements specifically aimed at supporting tissue and bone growth.

According to Charlaff, “In cases of scoliosis, it is important to seek a variety of opinions, both conventional and alternative. While diagnosis is fairly straightforward, treatment options are a subject of great debate. The rate of success in treating scoliosis often depends on the age of the patients. Obviously the younger the better, but my experience is that with a combination of treatments, an external brace can usually be avoided.”

There are only a few studies into the nutritional profiles of individuals with scoliosis. Although there is also a theory that scoliosis patients may be suffering from a melatonin deficiency, this link remains unproved (Spine, 1998; 23: 41-46). One of the more interesting studies showed that sufferers have persistently lower bone mineral density than non sufferers (Spine, 1997; 22: 1716-21). Although the researchers could find no link between bone mineral density and the degree or pattern of progression of the disease, the finding presents the intriguing possibility that nutritional interventions may be appropriate as part of treatment.

This means your daughter should concentrate on helping to make stronger bones and muscles.

Calcium is usually the first thing we think of when considering healthy bones. But don’t have your daughter mega dose, as excessive calcium raises the risk of kidney stones. Research has shown that other nutrients are just as important. Consider checking for deficiencies in B vitamins, vitamins C, phosphorus, magnesium and zinc.

Vitamin D is also important because it works with calcium to build strong bones.

In addition you should discuss with your nutritionist whether or not your daughter should take boron supplements, and how to keep intake of essential fatty acids high. It’s also worth investigating whether your daughter suffers from a food allergy or intolerance, which may be interfering with her ability to absorb essential nutrients from her food.