Scoliosis Awareness Month is designed to shine a spotlight on the need for awareness, education and early detection of scoliosis. It also helps to educate about the diversity of individuals affected by scoliosis from children to adults, and highlight how to recognize the warning signs, and what options there are for help.

Scoliosis is an abnormal lateral curvature of the spine. It is most often diagnosed in childhood or early adolescence but can also be diagnosed in adulthood either existing since adolescence or as the development of a new scoliosis, usually as a result of spinal degeneration which is known as Degenerative De-Novo Scoliosis (DDS).

                                                             The First scary look at my own x’ray

In my case, I have known for some time that I had some scoliosis and attributed it to a leg length discrepancy identified in my 30’s when I was first fit for orthotics during a brief running stint. It never gave me too much trouble, and even when I occasionally suffered from some low back pain over the years, no one really mentioned scoliosis as the cause or recommended any specific treatments. Over the last 10 years or so, I began to notice more asymmetry in my hips and shoulders, which, again, I attributed to a leg length discrepancy and thought it inevitable as no one had ever recommended treatment specific to scoliosis.

Suddenly, last year, however, it seems, everyone including me was noticing my scoliosis including my new primary care physician and my massage therapist. But it was only when I experienced an episode of some unrelenting lower back pain did some serendipitous events begin to occur. Upon the recommendation of a local chiropractor I have seen from time to time I was sent for thoracic and lumbar x’rays. When I saw my x’rays and the significant curvature of my lower spine it was sobering, and by this time I had read enough about scoliosis to know that it is a progressive condition and in fact low back pain is often a common symptoms associated with scoliosis in adults and yet treatment approaches are often symptomatic without addressing the root cause.

Why is that Parkinson’s patient leaning to the side?

Recently, one of my patients with Parkinson’s who lives elsewhere, returned for a Speech Vive device programming visit. It had been several years since I saw her in person and when she came into the office I was struck by her posture which had clearly declined over the years, and she now walked and sat with a significant lateral trunk lean to the right. A year ago, another female patient of mine, also with PD returned after several years away, and she too, hunched over to the side, so much so, I had to bend down myself to see her face and communicate with her. Scoliosis and severe kyphosis coupled with neuromuscular changes from Parkinson’s had placed her in an untenable posture which not only increased her fall risk and limited her ability to perform ADLs, but it also made communication nearly impossible with her hard of hearing husband. When I asked her about her condition, she told me she was told “there is nothing they can do about it.” Is it true, I wondered, with my own situation in the back of my mind, that once spinal changes occur in adults there is nothing more that can be done?

According to an article in the Journal of Clinical Neurology published in 2009,scoliosis is more common in patients with Parkinson’s disease (PD) than in the general elderly population, and the authors concluded that neither L-dopa treatment nor the laterality of the initial symptoms of PD is related to the appearance of scoliosis.(i)

Patients with scoliosis were significantly older (72.8±7.3 years) than those without (66.5±9.2 years, p<0.001), and scoliosis was observed in women 7 times more frequently than in men (28 women vs. 4 men, p=0.006). There were no significant differences in any of the other clinical characteristics. In this study, at least, the presence of scoliosis was separate from dystonic postures associated with Carbidopa. 

Is there Treatment for Adults with Scoliosis?

When one reads about scoliosis you will learn that it is a progressive condition that is better identified and treated in childhood or adolescents when bracing and therapeutic exercises can actually influence spinal growth, reduce the impact of the abnormal curve, and hopefully eliminate the need for surgery later in life.

As an adult, I wasn’t sure my options, but last June, I made a 70 mile trip to Naples, Fl where I was evaluated and subsequently treated by Dr. T Foster Bryant at a Scoliocare Clinic. Dr. Bryant and his rehab therapist, Erin, are not only passionate about the care they but, in addition to treating children, they also have a special interest in taking care of older individuals with spinal deformities and collapsing postures, Frequently, these are the patients who have been told by other providers that their only options are surgery or that “there is nothing more that can be done.”

In my case, I’m lucky, because one year into wearing a special bracing (Scoliobrace) and specialized exercise, x’ray shows that I have had a modest improvement in the curvature of my spine. I’m hopeful that continued use of the brace will slow the progression of my scoliosis and reduce future episodes of low back pain.

When discussing adherence to exercise with my patients, I often lift up my shirt to partially expose my brace, letting them know, that I, too, am doing my best to follow a prescribed treatment plan that includes daily exercises in the hopes that it will reduce the symptoms of a progressive condition and let me continue to engage in the activities I enjoy for as many years as possible.

I am hoping that my “old muscles” can indeed be taught new tricks. I often tell patients that most of us, if we live long enough, will have something to deal with. But education is power, and the more you know about your disease or condition, the more you can self-advocate and continue to obtain the help you need.

                                             

Exercises and a ScolioBrace to help with muscle re-education and spine strengthening.

Have you been diagnosed with scoliosis or kyphosis worsened by the diagnosis of Parkinson’s disease? If so, please consider being evaluated by someone who specializes in spinal disease and function. If you would like to learn more visit: https://scolicare.com/

(i) Baik JS, Kim JY, Park JH, Han SW, Park JH, Lee MS. Scoliosis in patients with Parkinson’s disease. J Clin Neurol. 2009 Jun;5(2):91-4. doi: 10.3988/jcn.2009.5.2.91. Epub 2009 Jun 30. PMID: 19587816; PMCID: PMC2706417.

 

My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

Voice Aerobics the heART and Science of Voice Practice