Spinal curvature

Doctors speak of a pathological one Spinal curvaturewhen their curvature goes beyond the normal degree. The curvature of the spine occurs as a rounded back, hollow back or scoliosis. The therapy takes place with physiotherapy, aids to support the back or surgically and has very good chances of recovery in childhood.

What is a curvature of the spine?

A Spinal curvature occurs when the curvature of the spine is not normal. You have to know that the healthy spine has two curves: lordosis and kyphosis.

Kyphosis is the backward tilt of the spine in the chest area, lordosis the prevention of the cervical and lumbar spine. If the lumbar and / or cervical spine are excessively curved backwards, the affected person has a hollow back.

If the thoracic spine is bent too much forward, the back becomes hunched. Both diagnoses are more likely to be seen as symptoms of incorrect posture or lack of exercise than as independent diseases. As a rule, initially no changes or damage can be detected in the spine.

Another form of curvature of the spine is scoliosis, in which there is a lateral bending of the spine with a twisting of the vertebral bodies against each other. This disease occurs in around two to three percent of the population, with more girls than boys being affected.

causes

As causes of Spinal curvature Poor posture and poor movement and the associated insufficiently trained abdominal and back muscles can often be identified.

Excessive stretching of the spine backwards, as occurs in some sports, can cause spinal curvature in the form of a hollow back, if the conditions are right.

Other causes of the hunchback are genetic predisposition, bone diseases, osteoporosis and age-related disc wear. Scoliosis is a special case of spinal curvature, for which no causes are known. Research suspects a malfunctioning trunk muscles with staggered growth of the vertebral bodies as the cause of the problem.

As a result, individual vertebrae appear to rotate and then the entire spine appears to be twisted and bent sideways. Bone diseases, pelvic inclination due to unequal leg lengths, muscular or neurological complaints can rarely be identified as causes of scoliosis.

Symptoms, ailments & signs

A curvature of the spine usually remains symptom-free at first. Those affected perceive them only as a visual flaw, which is why shame sets in in swimming pools or on beaches. With increasing age, however, if there is no treatment, further negative side effects appear. These are particularly evident in back pain.

Other organs can also be affected by the malformation. A curvature in the back is regularly associated with muscle tension. Signs of wear and tear, which are only to be expected in old age, then appear much earlier. The back hurts regularly, even without any stress. From a visual point of view, many posture damage is possible.

In some patients, the center of the pelvis is to the right or left of the center of the head. There is also the possibility that the pelvis is crooked. Sometimes one shoulder protrudes more clearly than the other. The typical S-shape of the spine is no longer there. Often the ventral part of the spine shows a stronger growth than usual.

The curvature of the spine can affect the entire musculoskeletal system. The feet and knees then also suffer from the deformity. In rare cases, severe deformation has consequences for the internal organs. The heart, kidneys, and lungs then become dysfunctional.

Diagnosis & course

The Spinal curvature is determined on the basis of a physical examination and posture diagnostics. Usually, an X-ray is also taken to diagnose the shape and strength of the curvature of the spine. In the case of scoliosis, suitable therapeutic measures can also be determined using an X-ray.

If the patient suffers from scoliosis, changes in the spine can be seen and felt. If the scoliosis affects the lumbar spine, for example, the formation of the waist is conspicuous; if the thoracic spine is curved, the ribs protrude on one side.

The Matthias posture test is carried out to diagnose poor posture. The examinee has to stand up straight, close his eyes and hold his arms straight forward for thirty seconds. If the muscles are working properly, the patient can maintain the posture he has assumed for the entire period. Muscle weaknesses show up accordingly.

Complications

Curvature of the spine can lead to various complications. Whether and which sequelae occur depends on the causes of the scoliosis, the time of diagnosis and the age of the patient. Complications are primarily threatened with a long-term curvature of the spine.

Long-term misalignment can lead to signs of wear and tear on the spine or intervertebral discs. In most cases, these are accompanied by severe pain. There is also the risk of a herniated disc or increasing spinal stiffening. Furthermore, other joints such as the hips or knees can be affected due to the disease.

Some people suffer from discomfort in the chest or abdominal region due to a curvature of the spine and the associated shortening of the trunk. For example, the chest and abdomen sometimes shrink, which in turn has a negative effect on organ functions. The heart, lungs, intestines and kidneys are most commonly affected. A severe scoliosis with a pronounced functional impairment of the organs can even endanger life such as cardiac insufficiency.

There is also a risk of complications during surgery to treat a curvature of the spine. However, the risk rate is considered to be low and is less than five percent. Possible sequelae of a scoliosis operation are pseudarthroses, metal fractures including loss of correction, injuries to the spinal cord, partial or complete paraplegia and infections that require the removal of the implant.

When should you go to the doctor?

If there are abnormalities in the body structure during the growth and development of the child, these must be observed. In the event of a curvature of the spine, the child must be informed about the correctness of physical stress and general movement sequences. Regular corrections should be carried out in everyday life so that long-term damage can be prevented. If the curvature of the spine can no longer be changed by independent measures or if it takes on a permanent shape, a doctor should be consulted.

If there is bad posture in the body, muscular complaints or limitations in physical resilience, a doctor's visit is necessary. Pain in the back, irregularities in general locomotion, unsteady gait or headaches indicate a health disorder. A doctor's visit is necessary so that the cause can be clarified and then targeted therapies to alleviate the symptoms can be carried out. If there are general malfunctions, changes in the heart rhythm or a misalignment of the feet or knees, a doctor's visit is also necessary.

Breathing problems, digestive tract disorders and a diffuse experience of pain in the organism indicate organic impairments. A doctor should be consulted so that the cause can be clarified. If sporting activities can no longer be carried out without symptoms or if the person concerned has problems coping with everyday life, he needs a doctor.

Treatment & Therapy

The therapy is postural Spinal curvature takes place with physiotherapy and exercise therapy. Abdominal and core muscles in particular need to be trained, as strong core muscles stabilize the spine. However, the patient must not exercise too much, only a slow build-up of the muscles promises improvement of the symptoms.

Therapy for scoliosis is more difficult. This is based on a timely diagnosis, ideally during puberty. Because only during this time can growth be positively influenced with conservative and operational measures. Before the therapy, the severity of the curvature of the spine is defined and the therapy is based on this:

An angle of curvature below 20 degrees is observed while trying to promote a healthy posture with physiotherapeutic measures. If the angle is between 20 and 40 degrees, a corset is also prescribed, which must be worn daily for two to three years. With a scoliosis angle of over 40 degrees, vertebral segments are surgically stiffened to stop the disease from progressing.

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prevention

Functional Spinal curvature can be prevented by targeted training of the core muscles and sufficient exercise. Scoliosis cannot be counteracted.

Aftercare

Follow-up treatment is particularly important if the curvature of the spine or scoliosis has been treated surgically. Following the procedure, the patient is transferred from the intensive care unit to the normal ward of the hospital after a day or two. As a rule, the patient can then gradually get out of bed.

The follow-up treatment begins early on with daily physiotherapy exercises.When considering the scope of physiotherapy, however, the scope of the operation must be considered. The patient is often given opiates or opioids for the pain that occurs after the surgical procedure.

If the surgical treatment is a minor one, a less effective opioid such as tramadol is usually given. If the pain is more pronounced, stronger analgesics such as piritramide or morphine can also be given.

It usually takes 12 to 14 days before the patient can leave the hospital after the operation. Healing progresses faster the younger the patient is. It usually takes six to nine months for the spine to ossify. During this time, the patient must not exercise for the first six months. Medical training therapy (MTT) is an exception.

The regular check-ups are an important part of the follow-up care. It takes about three to six months to complete medical rehabilitation. Children and adolescents often do not need rehab at all.

You can do that yourself

In the case of a curvature of the spine, the physical strain must be adapted to the health possibilities. Overexertion of any kind should be avoided. Do not lift and carry heavy loads. In addition, the correct movement sequences should be trained and optimized in everyday life. In this way, the fulfillment of everyday tasks can take place better.

The taking of a healthy posture must be checked independently several times during the course of the day so that the symptoms do not increase. At the same time, it is important not to trigger secondary diseases through persistent bad posture. Unilateral movements and rigid postures should be avoided and balancing movements should be carried out regularly. Physical therapy exercises can help in improving overall health. These should also be used outside of therapy. Sports activities must be tailored to the needs of the organism. The muscles as a whole are to be protected from hardening. Massages, warming clothes, avoidance of drafts and stimulation of the blood circulation are helpful.

Walking aids have proven to be effective in cases of severe curvature. These can lead to an straightening of the gait and protect against a deterioration in health. In addition, sleep hygiene must be checked. The mattress should not show any damage and its hardness should be optimized. In some cases the slatted frame settings need to be improved so that an optimal sleep can ensue.