This case is an example of a 51 year old adult male with Scoliosis. He was able to reduce his Cobb angle from 28 degrees to 16 degrees, improve his visual appearance, and return to hobbies he enjoyed (e.g. tennis).
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This patient is a 51 year-old illustrator who enjoys his work, gym and tennis. His scoliosis was measured at 28˚ 11 years prior to entering St Jude’s. He was leaning even further in the direction of his scoliosis to reduce pain, which served to further exacerbate his existing curve.
The condition at this time prevented him from work, walking, sitting and any recreation or exercise (yoga). He attempted to relieve this pain through massage and acupuncture before turning to professional care at St Jude’s Clinic where he reported having back pain a steady 75% of the time. The pain was worse after sitting for long periods and was gradually changing and worsening with time. The patient reported that his father, and quite possibly his sister, also had the condition.
The pain, in addition to the Scoliosis, was the patient’s main concern now and was thought to be related to recent renovations during the past 5 months. The first episode occurred in 2002, the next 3 months ago and the last episode 3 weeks ago. The Scoliosis was never treated prior to attending St Jude’s Clinic. The client was also diagnosed with an acute right sided disc bulge.
Specific behavioral techniques were employed to return the bulging disc to a more central location.
A combination of exercises were suggested in an attempt to:
1. Straighten as much of the spine as is possible.
2. Restore neck curvature and decrease forward head posture/translation.
Bracing was excluded from all therapy. No heel raises / lifts were used to achieve the straightened spine.
Exercises were performed in the clinic and at home with clinic sessions lasting 2 hours on a 3-weekly basis. The frequency was then reduced after re-evaluating, to twice a week for 6 weeks and then weekly throughout Dec 2013. Home exercises were encouraged for two 30 minutes sessions per day.
Visual Improvement over 5 weeks
- The gentleman was able to touch his toes by his 3rd visit and perform a confidence-building sit-up by the 5th visit.
- The patient’s curve was reduced from 28˚ to 16˚, though at this curve our patient still suffered from debilitating lower back pain which restricted his mobility.
- The inclination of his bottom vertebra (L3) initially measured 14˚ from the horizontal. One month later from his initial consultation at St Jude’s, the L3 was now at 12˚. As the next few days progressed, cosmetic improvements appeared. Notice that the left side of the body regains its crease (similar to the right side), and the body became more midline.
- 2 months after his initial consultation the bottom tilted vertebra was reduced to 4˚ from horizontal and the spine appears “straight”. This improvement has been maintained since 4th October 2013.
Disc pain and the irregular postures it can cause, are created by bulging discs and muscle spasms. The body attempts to remain upright but off centre to compensate for this pain, thus creating an irregular position, which gradually becomes a natural posture to the person concerned.
Relapse is quite common, even after treatment, especially in the hotter months, which is why it is important to continue the prescribed exercises with consistency and persistence to maintain improvements.
Our patient’s lopsided presentation is due to a right-sided disc bulge, and a supposed pre-existing scoliosis adding to the asymmetry. His previous episode of sciatica in 2002 was avoided, as this case was caught early. Home renovations and the hotter weather were the likely aggravating factors. Surgery in repeated cases of sciatica is a last resort option and can frequently be avoided.
Given factors such as the man’s age and muscle build, mobility was able to be achieved and reduction of antalgic scoliosis (as opposed to adolescent idiopathic scoliosis) was also possible – creases appearing on either side of the waist now. The patient has now returned to the tennis court with key behavioural factors in place as his guide to safe and enjoyable playing. These behavioural factors are vitally important in creating a more symmetrical appearance and are required to maintain improvements or even achieve further reduction of the scoliosis (to 4˚) where possible. Stabilisation may be all that is achieved in some cases while a reduction possible is easily within reach for others.
Factors such as age and body-type are thought to hinder correction due to rigidity and chronic changes. In this particular case of acute induced scoliosis a reduction was achieved. The 1st and 3rd x-ray reveal a structural short leg of 13mm. Spinal alignment was achieved without the use of any foot orthoses (heel lift). When a heel lift is introduced the 4 degree L3 inclination is reduced to 2 degrees.
Results vary from case to case. Our commitment is to make a break-through for large curves and to prevent smaller curves from getting bigger. Where reduction is possible it is often seen within months. This man received treatment and from us and saw results in only 3 months.
If you are interested in seeing whether we can help change your Scoliosis today, please phone us on 02 8005 6561. We would love to help.