How We Treat Scoliosis

Jonathan Vellinga, MD -

Scoliosis is a disorder of the spine that affects about 3% of the population, with its severity ranging from mild to debilitating (1). While there is no “cure” for scoliosis, there are a number of treatments currently available conventionally, such as wearing a brace, different types of pain management, and surgery. However, integrative medicine offers alternatives to complement or replace these conventional treatments that can help to alleviate pain, prevent worsening of the condition, improve mobility and stability, and even promote greater healing after surgery.

What is scoliosis?

Scoliosis is any sideways curving or twisting of the spine (1, 2). Most commonly the upper (thoracic) spine curves to the right, although middle (thoracic-lumbar) or lower (lumbar) spine curvatures may also happen, either to the right or left (1). There is no consensus on the root cause of scoliosis, though certain conditions such as cerebral palsy or muscular dystrophy can increase the likelihood of it developing (1, 2).

There are a few different categories of scoliosis, generally based on when the condition begins to develop. The most common type of scoliosis is adolescent idiopathic scoliosis, meaning that it first appears from ages 10-18 years old, with no apparent root cause (1). Infantile (0-3 years) and juvenile (4-9 years) idiopathic scoliosis are other types that develop in childhood, as well as congenital scoliosis (caused by spinal birth defects). Scoliosis can also develop a bit later in life, either due to neuromuscular conditions as mentioned above, or due to the degeneration of facet joints in the spine (called degenerative scoliosis). The last known type of scoliosis is called nonstructural or functional scoliosis, in which the spine begins to curve due to other maladjusted parts of the body, such as a difference in leg heights. Nonstructural scoliosis is unique in that it can often be corrected fully by addressing the root cause (1).

What are the symptoms of scoliosis?

Interestingly enough, other people are the ones who usually first notice scoliosis developing in another person. A curving spine can lead to a visibly uneven waist, a higher hip or shoulder, a more prominent shoulder blade or side of the ribcage, or a prominence on one side of the back when bending over. As the curvature increases, scoliosis can lead to (1, 2):

• Back pain

• Spasms in back muscles

• Inflammation in back joints and muscles

• Intervertebral disc and facet joint degeneration

• Reduced range of motion

• Changes in movement and gait due to misaligned hips (such as one hand hitting against the hip while the other swings out wide)

• Muscles of back, hips, and core tiring faster

• Reduced range of spinal motion

• Trouble breathing

• Cardiovascular problems due to structural inhibition of the heart

• Lowered self esteem

Is scoliosis preventable? How can you treat it conventionally?

Unfortunately, scoliosis is not thought to be preventable at this time because the vast majority of cases are idiopathic (1, 2). Treatment varies based on the severity of the person’s scoliosis. Scoliosis is graded on the degree of spinal curvature, so if it has a 10 degrees curve or less, most people don’t notice it affecting their lives, or even notice it at all. If it is detected, most physicians will recommend a check-up 2-3 times a year to monitor progress and ensure that it isn’t worsening.

If the curve is worsening quickly or hits 20 degrees, generally physicians will prescribe interventions of some sort. The most common prescription is a back brace. While back braces don’t re-align the spine, they do prevent the curve from developing further and can be quite effective. Depending on the circumstances and person, either a full-time (16+ hours) or nighttime (8+ hours) brace may be recommended (1, 2).

For more severe cases, surgery may be necessary. For children who are still growing but their condition is worsening quickly, one option is a vertebral tethering system in which screws are placed alongside the outer edge of the curving spine, which is threaded with a strong but flexible cord that is tightened over time to straighten the spine (1, 2). Another type of surgery involves an expandable rod that is placed alongside the spine and mechanically lengthened via remote control as the child grows (1).

For adolescents and adults who have reached their fully mature height (usually around age 14 for females and 16 for males), another surgical option is spinal fusion. This procedure involves fusing two or more vertebrae together so that they can no longer move independently and thus curve further (1, 2). Bone or bone-like material is set between the vertebrae, and the spine as a whole is held together with metal rods, hooks, and/or screws to ensure that the spine stays straight while it heals and fuses to the new additions (2). However, this type of procedure is reserved for cases where the spinal curvature exceeds 40-50 degrees.

While the good news is that 90% of people with idiopathic scoliosis will not be prescribed braces or surgery, the unfortunate news is that anyone affected by scoliosis can still have side effects such as pain, inflammation, issues with misalignment, and a reduced range of motion (1).

What regenerative therapies can help with scoliosis?

At Temecula Center of Integrative Medicine, we offer a few types of regenerative therapies, including ozone therapy, platelet rich plasma (PRP) therapy, and pulsed electromagnetic field (PEMF) therapy.

Ozone Therapy

Ozone therapy involves injecting ozone (a form of oxygen) to activate the immune system, increase oxygen flow, and up red blood cell processes in a specific area of the body (3). It is used frequently for arthritis, degeneration, and troublesome joints, making it a great option for scoliosis. The reason for this is multifaceted. Although no conventional or regenerative therapies aside from surgery can actively move the spine into a straighter position (except, potentially, chiropractic care - more on that below!), all of the associated issues and pain that come with scoliosis can be alleviated and reduced through regenerative therapies. This can lead not only to less pain and discomfort, but the greater success of other treatments, higher adherence to treatment plans, reduced degeneration and risk of further complications (such as arthritis), and overall better quality of life.

The most common side effects of scoliosis involve pain, inflammation, and bone, joint, or disc degeneration (1, 2). Studies have shown that ozone therapy is a scientific-based approach that is shown to reduce inflammation, decrease pain signaling, increase blood flow, and treat a number of musculoskeletal disorders (specifically in spinal bone and discs) with little to no side effects (4, 5, 6, 7, 8).

Platelet Rich Plasma (PRP) Therapy

PRP therapy is the process of drawing the patient’s blood and putting it into a centrifuge which separates the blood components based on their density. PRP therapy isolates the platelets so that they can be injected into the site of injury, distributing growth factors that promote the body’s natural healing processes to a greater degree. Studies done on PRP therapy on the spine have found that this therapy can reduce overall disability and improve pain scores, lower inflammation, and increase collagen (9, 10). This is important not only because increased collagen improves the function of the musculoskeletal system as whole, but because reduced collagen function is actually one of the most common abnormalities in those with scoliosis (11).

Pulsed Electromagnetic Field (PEMF) Therapy

PEMF therapy uses a device that emits a low-level electromagnetic pulse in order to restore our cells’ charge back to optimal levels. Because our bodies have electrical currents running through them, if our cells are not functioning at a proper charge, our cells, tissues, organs, and systems can all be affected and exhibit dysfunction, leading to any number of conditions. PEMF therapy boosts cellular metabolism, resulting in improved tissue function and healing.

This is great news for a number of conditions, and especially for scoliosis, which has been linked to a higher negative platelet charge and thus can benefit from directly treating the charge imbalance (12). PEMF is also great for the most common symptoms of scoliosis, including muscle spasms, pain, poor range of motion, stiffness, inflammation, and general disability markers - all without needing to take any medication (13, 14, 15, 16, 17)!

Additionally, for those who have undergone fusion surgery to correct scoliosis, PEMF can not only improve pain, inflammation, stiffness, and general discomfort, but can also aid in post-operative healing. Because PEMF therapy stimulates cellular function, regular PEMF therapy can increase bone formation and fusion rates and potentially speed up recovery time, especially in those with comorbidities that increase the risk of complications (18).

Chiropractic Care

Although it is not considered to be a regenerative therapy, chiropractic care can be a big help to people with scoliosis. It is a treasured part of integrative medicine and something that we frequently recommend as a part of many treatment plans in our clinic. Regular chiropractic care has been shown to improve pain, disability, and even the angle of the spinal curve not only immediately following treatment, but even up to 2 years later for adults with scoliosis (19).

If you, your child, or another loved one are suffering from the many side effects of scoliosis and are interested in any of the treatment options above, please reach out to us! We can discuss your health history, determine the severity, and discuss which treatment options and therapies could be the most beneficial to you. It is our joy to partner with our patients to improve their quality of life, health, and healing!

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Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.​

Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.

info@tcimedicine.com

951-383-4333

www.tcimedicine.com

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Sources:

1. Ali Baaj, M. D. (n.d.). Scoliosis: Symptoms, treatment and surgery. Spine. Retrieved February 2, 2022, from https://www.spine-health.com/conditions/scoliosis/scoliosis-what-you-need-know

2. Mayo Foundation for Medical Education and Research. (2021, August 3). Scoliosis. Mayo Clinic. Retrieved February 2, 2022, from https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716#:~:text=Scoliosis%20is%20a%20sideways%20curvature%20of%20the%20spine%20that%20most,curves%20worsen%20as%20children%20grow.

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9. David Levi, MD, Scott Horn, DO, Sara Tyszko, PA, Josh Levin, MD, Charles Hecht-Leavitt, MD, Edward Walko, DO, Intradiscal Platelet-Rich Plasma Injection for Chronic Discogenic Low Back Pain: Preliminary Results from a Prospective Trial, Pain Medicine, Volume 17, Issue 6, June 2016, Pages 1010–1022, https://doi.org/10.1093/pm/pnv053

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11. Collagen changes in congenital and idiopathic scoliosis. Taylor & Francis. (n.d.). Retrieved February 2, 2022, from https://www.tandfonline.com/doi/abs/10.3109/17453678008990798

12. Yarom, R., Meyer, S., & More, R. (2009, April 17). Negative surface charge on platelets of patients with idiopathic scoliosis. Pathophysiology of Haemostasis and Thrombosis. Retrieved February 2, 2022, from https://www.karger.com/Article/Abstract/21468

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18. Coric, D., Bullard, D. E., Patel, V. V., Ryaby, J. T., Atkinson, B. L., He, D., & Guyer, R. D. (2018). Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations. Bone & joint research, 7(2), 124–130. https://doi.org/10.1302/2046-3758.72.BJR-2017-0221.R1

19. Morningstar M. W. (2011). Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis. Journal of chiropractic medicine, 10(3), 179–184. https://doi.org/10.1016/j.jcm.2011.01.006