Neck and Back Pain, Neck and Back, Self Care
“You need to walk straight,” Randy said. “You walk like this. He lowered his right shoulder and collapsed his rib cage to his hip. "Why don’t you stand up straight!” Randy did not understand that a spinal deformity, not slouching habit, caused Kate’s uneven gait. Since her spinal curvature didn’t cause pain, Kate was unaware her body listed to the left when she walked. Now, it was a concern.
When viewed from the side, the healthy spine has three c-shaped curves that create a slight “s” shape.
The first curvature includes the seven vertebrae extending from the base of the skull to the shoulders to create the cervical spine. The next 12 vertebrae connect to the rib cage and protect the heart and lungs. The reversed c-curve in this section is called the thoracic spine. The five vertebrae at the base of the spine form the lumbar region. The vertebrae in this third section c-shaped section are the strongest and carry most the body’s weight.
Below the lumbar spine are the sacrum and the coccyx which creates the tailbone. The tailbone curves toward the inside of the body.
The c-curves stack in a vertical line. When viewing the backbone from the back of the body, it has a straight appearance.
With three interdependent c-curves in the spine, it’s impossible to stand with a straight spine.
When people “stand up straight,” it means they are standing tall with proper posture. In this position, you can draw an imaginary straight line from the ears to the ankles. If a person stood tall with correct posture and backed up against a wall, the base of thoracic spine and tailbone would touch the wall. But the lumbar spine would curve a finger’s width away from the wall.
The gentle c-curves of the spine allow free movement and support throughout the body.
Spinal curvatures become problematic when they grow sideways and create a horizontal s-shape when viewed from the back.
Scoliosis causes curvature of the spine. The onset of scoliosis usually occurs between 10 and 16 years of age. The condition causes the vertebrae to turn and rotate making the hips, waist, and shoulders appear uneven. More common in girls and young women than in males, there is no definitive cause for scoliosis. In fact, over 90 percent of scoliosis cases have no known cause. Poor posture, pregnancy, and environmental factors may be factors in some abnormal curvatures.
There are a few causes of abnormal spine curvatures that orthopedic specialists have been able to diagnose.
The Dowager’s Hump or hunchback is another form of curvature. The condition known as kyphosis increases the curve of the upper section of the thoracic spine, pushing the head forward and rounding the back at the shoulders and base of the neck. Poor posture and osteoporosis are significant causes of the dowager’s hump.
People who suffer from a dowager’s hump or hunchback walk and stand in a stooped position. The condition prevents them from standing upright.
Another area affected by irregular curvature is the lumbar spine. Besides curving sideways, the lumbar is susceptible to too much or not enough angle in its curvature. Both conditions can cause debilitating pain.
The recent explosion in smartphones, tablets, and laptops has a direct correlation to the number of abnormal spinal curvatures affecting the cervical spine.
Texting, typing, and scrolling cause people to bend their necks to view the screens in their hands or on their laps. This positioning has caused a condition known as Tech Neck or Text Neck. In moderate cases, the natural c-shaped curve in the neck straightens. In severe cases, the c-curve reverses. These abnormal curvatures cause pain and limited movement.
Treatment for the pain and mobility issues associated with spinal curvatures that are not caused by arthritis or disc-related problems vary based on the severity of the condition.
Back pain is the most common symptom of a moderate to severe curvatures of the spine.
Since the spine supports the entire body, abnormal curves interrupt the weight-bearing design of the spine to create pressure points and uneven weight distribution. Some people report muscle fatigue when they use the muscles surrounding the curvature.
Spinal curvatures can interfere with spinal cord function. The spinal cord transmits messages between the brain and the rest of the body through an intricate neurological system. As the backbone curves to side, it can pinch the spinal cord and cause pain, pressure, or loss of sensation as it compresses the nerves.
In severe cases, the spinal curvatures constrict the chest and reduce lung capacity. Left untreated, an abnormal curve in the thoracic area can cause restrictive lung disease.
Treatment for vertical curvatures may include core-strengthening exercises or braces. The lateral or sideways spinal bends, such as scoliosis, often require physical therapy, therapeutic braces, or in severe cases, surgery.
An orthopedic specialist should watch curve angles less than 20 degrees in young patients every 6 months.
Curve angles 25 to 45 degrees often need braces, which may stabilize the curves and force the spine to straighten. Braces are an effective treatment for children whose bones are still growing. Most surgeons prefer to treat the symptoms of moderate scoliosis with braces, exercises, and physical therapy, which can strengthen and retrain supporting muscles and relieve pain. Sometimes, physical therapy minimizes the appearance of the condition, improves function, and eases breathing.
Patients who have curvatures greater than 45 degrees may need surgical correction. During surgery, the surgeon uses bone grafts and orthopedic hardware to straighten the spine. The surgeon may place rods, hooks, screws, or wires in the bones to hold the spine in the correct position. After the spine heals, most people walk and move normally.
If there is too much damage to the vertebrae, the surgical team may recommend spinal fusion to keep the vertebrae in place. This surgical option is often the last treatment choice
Like other medical conditions, treatment of scoliosis and other abnormal curvatures is more successful when found early. Many times, treatment can prevent the curvature from getting worse.
Early scoliosis detection takes commitment to screening.
In the beginning stages, curvatures do not cause pain. Often, the condition remains undetected until later stages when it’s harder to correct. If you have children who are 10 years old and older, conduct scoliosis screenings every few months to detect abnormal spinal changes early.
Symptoms of abnormal curvatures include:
In addition to a visual assessment, parents can do a quick, painless scoliosis screening at home.
Ask the young person to bend over in front of you as if he or she is touching her toes. Run your hand down the backbone. Do the vertebrae appear straight or do they curve to the side?
If the spine curves to either side, contact your primary care provider, pediatrician, or an orthopedic specialist. Your medical provider will order an X-ray to diagnosis the condition before recommending treatment.
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