Scoliosis: Curvature of the Spine

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Etymology

The word Scoliosis, also known as kyphosis, spinal curve, back curve, structural scoliosis, functional scoliosis, and spinal muscle atrophy (abbreviated as SMA) is a word from both Latin and Ancient Greek literally meaning  “twisting, torsion“.

scoliosis-vertebral-column      scoliosis-vertebral-column

Definition

Scoliosis is a medical condition regarding the deviation of the spine’s curvature. The biomechanical deformity, which most often originates during the prepubertal development of a person’s body, can also be caused by cerebral palsy, muscular dystrophy, Marfan syndrome, neurofibromatosis (a type of tumor), environmental, genetic, and unknown reasons. It affects about 3% of the population, mostly females between the ages of ten and twenty. There are different cases of scoliosis, some are mild and can be minded regularly, others are severe and require bracing or surgery for they might cause disability, respiratory problems and other complications within the chest area.

Anatomy of the vertebral column

The vertebral column is a flexible column composed of a series of bones, the vertebrae. The main function of the vertebrae is the protection of the spinal cord. Its other functions are:

Each vertebra has a central part or centrum, and a “Y” shaped neutral arch. The vertebra creates a cylindrical space (the vertebral foramen) for the spinal cord. They are separated by a cartilaginous disc that offers flexibility to the vertebral column and amortizes the shock in locomotion.

The vertebral column is characterized by a variable number of curves:

  • A sacral curve, in which the sacrum curves rearward and supports the ventral organs
  • An anterior cervical curve, which evolves soon after delivery as the head is lifted
  • A lumbar curve, also anterior, which evolves as the child rests and walks. The lumbar curve is a perpetual characteristic only of humans and their bipedal ancestors.

It is important to understand the structure of the vertebral column for it is the part of the body that is affected by this condition.

Signs and Symptoms

Most symptoms are noticeable just by observing one’s bodily structure:

  • Uneven hips (one might lower than the other)
  • Asymmetrical shoulder blades
  • Uneven shoulders (one might be higher than the other)
  • Irregular waist
  • One side of the ribcage is more prominent than the other
  • Disproportionate musculature on one side of the back and spine area
  • The body tilts on one side

Other symptoms include:

Some symptoms may be more severe in some individuals than in others for every scoliosis case is different.

In some cases of structural scoliosis, along with other symptoms mentioned above, the individual may experience constipation and painful menstruations due to the curvature of the spine which can compress the stomach and other organs in the lower abdomen area. A mild kyphosis could even be overlooked by untrained eyes. Nonetheless, if the spinal curve advances the symptoms can become obvious.

 

Types of scoliosis and causes

Idiopathic

65% of all cases of scoliosis are idiopathic which means that they are caused by unknown reasons.  Idiopathic kyphosis affects mostly individuals who go through adolescence when the individual’s skeleton is developing rapidly. Studies have shown that this type of SMA could potentially be heritable, therefore it could run in one’s family. Specific genes have not been clearly identified, although the CHD7 gene has been linked to idiopathic scoliosis as well as genes figuring bone metabolism and formation and the structure of connective tissue. Idiopathic scoliosis is cataloged by the age of the conditions’ development:

  • Infantile idiopathic scoliosis which evolves from birth to 3 years old (referred to as early onset scoliosis EOS)
  • Juvenile idiopathic scoliosis evolving from 4 to 9 years old (referred to as early onset scoliosis EOS)
  • Adolescent idiopathic scoliosis (referred to as AIS) evolving from 10 to 18 years old

A very wide-spread misconception is that carrying heavy objects and/or sleeping in certain positions might cause scoliosis.

Congenital scoliosis

Fifteen percent of all scoliosis cases are attributed to malconformations, such as abnormal formation and segmentation of the spine, during the first couple of weeks in utero, resulting in deformed vertebrae, fused vertebrae and leading to a sideways curvature of the spine.

Secondary scoliosis

A tenth of the scoliosis cases, known as secondary scoliosis, are caused by neuropathic and myopathic conditions such as poliomyelitis, cerebral palsy, spinal cord trauma, muscular dystrophy, spinal muscular atrophy, and myotonia. Secondary scoliosis can cause some muscle mass loss, especially in the back area and can lead to limited muscular support of the spine. As a consequence, the spine is drawn to unusual directions.

Degenerative scoliosis

There is also a type of scoliosis that is due to aging and other changes which evolve in an advanced stage of life: degenerative scoliosis. It is due to the disintegration of the vertebral column.

Functional scoliosis

There is another type of scoliosis, the functional or nonstructural scoliosis, that is caused by temporary causes that affect the lateral curvature of the spine. A difference in leg heights could cause this type of scoliosis and could easily be corrected.

Syndromic scoliosis

Some scoliosis (“syndromic scoliosis”) are linked to conditions, less or more related to bones, the skeleton and its muscles, such as Loeys-Dietz syndrome, Marfan’s syndrome, nail–patella syndrome, neurofibromatosis, osteogenesis imperfecta, Prader–Willi syndrome, proteus syndrome, spina bifida, muscular dystrophy, familial dysautonomia, CHARGE syndrome, Ehlers–Danlos syndrome, hemihypertrophy,amniotic band syndrome, Arnold–Chiari malformation, Charcot–Marie–Tooth disease, cerebral palsy, congenital diaphragmatic hernia, fragile X syndrome, Friedreich’s ataxia, and syringomyelia.

Some of these conditions can cause kyphosis (from Ancient Greek “hump”, also known as round back or Kelso’s hunchback) which is an unnatural and extreme convex curvature of the spine in the cervical, thoracic and sacral regions.

Furthermore, other conditions could lead to Lumbar hyperlordosis is also called hollow back, saddle back, and swayback. It is an eccentric lordosis, an unnatural inward curvature of the lower spine.

Scoliosis is known to be ruled by an orthopedic law, the  “Hueter-Volkmann Law” (created by two orthopedics Carl Hueter and Richard von Volkmann) which states that the development of bones is inhibited by compression forces and stimulated by tensile forces. This rule has been understood by cause of clinical observations and animal experiments. Some developing animals’ plates have been loaded. The effect of the weight was significant: the development of the plates has been inhibited by more than 40%. These studies could validate the law indeed.

The scoliosis curvature of the spine has a “C” or an “S” shape and it can present:

  • A right thoracic curve is the bending of the vertical curve in the center of the back to the right side of the upper back, in the thoracic area
  • A right thoracolumbar curve bending from the right upper back side to the lumbar region, in the lower back.
  • A right lumbar curve bending from the right side of the lower back to the same lower back region
  • A double major curve that involves a right thoracic curve and left lumbar curve. These two curves might counteract each other making scoliosis less obvious
  • A triple curve that is quite rare.

Diagnosing scoliosis and medical examinations

If one presents the signs and symptoms that have been mentioned above, one should seek medical help and assistance because even mild scoliosis can progress and cause trouble. Adolescents and young people, especially females, have a higher risk of developing this condition than the rest of the population. Periodical exams and check-ups are advised, specifically for young individuals still growing and developing their bodily structure.

Physical examination

During a typical exam, the doctor will need to know the detailed medical history and will ask about the recent growth of the patient. The patient might be asked to bend forward as far as possible ( the Adam’s Forward Bend Test). The orthopedic pediatrician will look for asymmetrical physical traits such as a more prominent shoulder blade, uneven hips, and waist. Along with that, there could be a neurological exam to identify possible numbness, unusual reflexes, and muscle weakness.

Scoliometer to Measure Spine Rotation

While the patient is bending forward the doctor might use a scoliometer, also known as  “inclinometer”, to determine the exact angle of trunk rotation (ATR).

X-ray and the Cobb angle measurement

If the orthopedic doctor suspects the patient of having scoliosis, a plain X-ray of the spine may be necessary in order to confirm the condition’s presence. Using the X-ray, the Cobb angle measurements follow. The Cobb angle is found by drawing two perpendicular lines: one is traced from the spine’s most tilted vertebra above the sideways curve’s apex, the other is traced from the most tilted vertebra beneath the apex. If t6he Cobb angle, found between the two perpendicular lines, is of at least 10 degrees, the patient shall be diagnosed with scoliosis.

cobb-angle-measurement-scoliosis-vertebral-column

Further exams, such as MRI, are required if the confirmed scoliosis is suspected to be caused by a tumor or other hidden conditions. As mentioned before, some types of scoliosis, known as syndromic scoliosis, are caused in fact by syndromes and could require other types of treatments.

There are some aspects to be taken into consideration to diagnose a patient with scoliosis:

  • Lateral curvature of the spine (measured by the Cobb angle)
  • Axial rotation, wich is the unusual vertical rotation of the spine could be added to the lateral curvature
  • Skeletal maturity is critical, specifically for teens and children, for deciding the scoliosis treatment.

The case of scoliosis which has nothing to do with congenital, secondary, degenerative, neuromuscular, syndromic and functional scoliosis is called idiopathic scoliosis. A patient can be diagnosed with idiopathic scoliosis only if the other types of scoliosis are excluded.

Risk factors

Some people have a higher risk of developing scoliosis:

  • Females are more prone to develop the condition than males, even though boys and girls develop scoliosis at the same rate.
  • Adolescents. The signs and symptoms usually reveal in the prepubertal phase when the adolescent structure grows more rapidly.

adolescents-girls-women-scoliosis

  • Individuals with a family history of scoliosis. Even though the studies have not yet identified the exact genes that are linked to scoliosis, it tends to be a hereditary condition

Those who have reached skeletal maturity have a lower risk of developing the condition, although some cases such as degenerative scoliosis, functional scoliosis, and syndromic scoliosis do not depend on the skeletal maturity and can evolve later in life. In some cases, if scoliosis is not treated and it becomes severe, it could cause a cardiac and respiratory difficulty and limited mobility.

The most common type of scoliosis, idiopathic scoliosis, causes little to moderate pain, physical disability, and cosmetic concerns.

Treatment

Before deciding the remedy for scoliosis, some aspects must be taken into consideration:

  • The severity of the curve is quite important to determine the remedy for scoliosis since some cases (90% of the scoliosis cases) might require just periodical checkups every four to six months to monitor the scoliosis progression while in other cases the spine’s curvature could be larger, therefore it could be more likely to progress.
  • The curve pattern such as the “S” shaped curvature is more likely to progress than the “C” curve pattern.
  • The location of the curve is important because curvatures in the thoracic area are more likely to progress than the curves located in the lower or upper areas of the back.
  • Gender is relevant, for girls are more likely to have a progression of the curvature than boys.
  • The skeletal maturity- The younger the patient is, the more they have potential further growth of the spine and therefore the spine’s deviation is more likely to progress, so early identification of the problem and intervention offers the best results. If the skeletal growth of the patient has stopped, there is a low risk of the evolution of the deformity.

Every treatment is specific for every patient, even though there are standard treatments for severe, moderate, and mild scoliosis.

Noninvasive treatment and self-management

Mild scoliosis can simply be monitored and treated with physical activity. Exercising can help strengthen the muscles of the back and helps the spine to become more flexible.

Although there are very few studies to prove the efficiency of physical therapy and manual manipulation to stop the progression of scoliosis, exercise and physical activities are known to only do good to the body.

Some Physiotherapeutic Specific Exercises (PSE) have proven to be useful in reducing scoliosis progression, but their efficiency depends on the amount therapeutic sessions and the patient’s cooperation with the caregivers.

Diet is also very important to prevent and cure scoliosis. All bone conditions require an adequate diet, scoliosis is one of them. The average American diet does not provide one with the necessary amount of vitamin D and calcium. Vitamin D is a vitamin that is produced by the human body as a consequence of the exposure to the Sun. Calcium is a mineral that the human body needs to maintain strong bones and to carry on many important functions. The vitamin D and/or calcium deficiency can lead to conditions and diseases such as osteoporosis, kidney disease, osteomalacia (bone softening in adults), psoriasis (disorder causing skin redness and irritation), rickets (bone weakening in children), thyroid conditions, muscle weakness/pain, renal osteodystrophy (bone problems due to chronic kidney failure), cancer, high blood pressure, cardiovascular disease, kidney stones.

Bracing

If mild scoliosis progresses (becomes moderate scoliosis) and the Cobb angle surpasses 25 or 30 degrees in addition to the fact that the individual has a long period of skeletal growth remaining, the next step is bracing. The same goes for mild scoliosis that has a Cobb angle 5-degree progression in the period of observation (four to six months).

bracing-scoliosis-vertebral-columnbrace-scoliosis-vertebral-column

Bracing is the only noninvasive, nonsurgical practice that has been proven to reduce the progression of scoliosis and to reduce the pain caused by scoliosis when the patient is an adult. Braces apply pressure on the curves in the spine and, in most cases, effectively prevent its progression. A plastic (or made from fiberglass) corset-like custom device is applied to one’s torso and sometimes, the one-piece brace, extends to the neck. Braces are usually prescribed to still growing individuals because they give better results. If the brace is well designed and it fits the patient’s body perfectly, then, the chances of the successful prevention of scoliosis’ additional progression increase and the brace can even be comfortable. The brace’s effectiveness increases with the number of hours a day it’s worn. The brace has to be worn for most of the day(full-time bracing from 16 to 23 hours) excluding bathing, skin care, and some physical activities. In some cases, only nighttime bracing (for at least eight hours) is required. Braces are discontinued:

  • When boys grow significant facial hair
  • About two years after girls begin to menstruate
  • When there are no further changes in height.

Recommendations

If you are considering the brace treatment for scoliosis here are some recommendations regarding bracing.

First of all, the orthopedist who is responsible for the treatment should have:

  • a previous master (MD with at least 5 years of experience in bracing) for at least 2 years
  • training by a previous master
  • a continuous practice in scoliosis bracing for at least 2 years
  • prescription of 45 braces at least a year over the last 2 years
  • evaluation of at least 150 patients per year over the last 2 years

The CPO constructing braces should have:

  • continuous working experience with and MD for at least 2 years
  • a continuous practice in scoliosis bracing for at least 2 years
  • at least 100 braces manufactured a year over the last 2 years.

Both the MD and the CPO will have to work together while consulting the patients and their case.

The brace should be built by the certified CPO with the indications of the MD and has to be checked by the CPO and MD accurately to fit the patient’s body and make sure the brace is tolerable and that it allows the patient to move. The check-ups (every 3 to 6 months) have to be regular to monitor the efficiency of the brace which has to be replaced as the patient develops.

Surgery

scoliosis-surgery-rodsscoliosis-surgery-spinal-manipulation

In cases of severe scoliosis, bracing usually fails and scoliosis needs to be treated surgically. Orthopedists encourage the patient to have surgical treatment if their curve is cosmetically unacceptable, if they have bone related conditions and syndromes, if the Cobb angle of their curvature is more than 45 degrees, if their curvature affects physiological functions like breathing. In the United States, the average hospital cost was $30,000 to $60,000 per patient in 2010 (for the cases that required surgical procedures)

The operation is performed by a surgeon specialized in spine surgery. In most cases, the surgery brings significant corrections, although it does not completely correct the deformity. There is a risk (20% chance of all surgeries) that after the surgery the lower back pain symptoms won’t be alleviated (“failed back surgery syndrome”). People who smoke have a lower rate of successful spine fusion. In some cases, another surgery is required to fix the screws that might have become loose or broken.

The objectives of the scoliosis surgery are:

  • Stopping the curvature’s progression. In most scoliosis cases, surgery is needed because of the unceasing progression of scoliosis. The procedure has to prevent the further evolution of the condition at the very least.
  • To reduce the deformity of the curve. In some cases, scoliosis includes the twisting of the spine and surgery might help with one’s posture while correcting the deformity.
  • Maintain trunk balance – the surgeon will try to maintain the natural curvature of the spine and the even hips and legs while correcting the deformity.

There are three main types of scoliosis surgery: the fusion surgery, the growing systems, and the fusionless surgery.

1. The fusion surgery

The fusion surgery is the safest and most efficient type of surgery which perpetually fuses two or more juxtaposed vertebrae to create a fixed solid bone while they grow together. The surgery involves the usage of rods, screws, hooks, and/or wires placed in the spine. The downside of the procedure is that the fused vertebrae lose mobility and can limit one’s spine flexibility. This type of surgery is not recommended for very young individuals as it can cause complications: it can take too much space in one’s chest, not allowing the lungs and other organs to grow normally. In this case, the growing systems are a valid alternative up until the patient is old enough to have the spinal fusion done.

These are the types of spinal fusion procedure:

  • The Posterior lumbar interbody fusion (PLIF) – the operation is completed from the posterior side of the trunk(the chest) and it removes the disc between two vertebrae and it inserts bone between the two
  • The Anterior lumbar interbody fusion (ALIF) – the operation is completed from the anterior part of the trunk(the chest) and it removes the disc between two vertebrae and it inserts bone between the two
  • The Transforaminal lumbar interbody fusion (TLIF) analogous to the PLIF
  • The Extreme Lateral Interbody Fusion (XLIF) – an interbody fusion in which the approach is from the side
  • The posterior fusion is a surgical approach through an incision on the back and involves the use of metal instrumentation to correct the curve
  • The anterior fusion is a surgical approach through an incision at the side of the chest wall and involves the use of metal instrumentation to correct the curve.
  • The duration of the operation (takes four to eight hours) depends on whether it is composed of both of these two surgical procedures.

There is a risk of pseudoarthrosis (5% to 10% of spine fusion surgeries) when the vertebrae don’t fuse together. Spinal fusion complications occur quite rarely nevertheless there are some possible difficulties such as:

  • Those that are related to most surgeries (infection, anesthetic complication, and bleeding)
  • Nerve damage -reduced sensibility and strength in arms and legs, reduced control over the bowel and bladder
  • Difficulties with ejaculation -there are some nerves that control ejaculation in front of the L5-S1 disc space. If those nerves are damaged a valve will not close. The sperm will then go on easiest track through the bladder. The most significant result would be the problematic conception. The sensation of sex remains mostly unchanged.

2. The growing systems

The growing systems, mostly for young patients,  involve the periodical anchoring of rods to the spine to maintain and correct the spine’s curvature. It is a periodical procedure because the rods have to be replaced as the patient grows(every 6 to 12 months) until he reaches skeletal maturity and can get a spinal fusion, therefore is a procedure to delay the fusion surgery. This method guides a growing spine and prevents the further deformation of one’s curvature. The surgery might cause pain, nerve damage, bleeding, and infections. In some cases, the patient might need a follow-up surgery if the bone has failed to heal.

3. The fusionless surgery

The fusionless surgery. In this procedure, pressure is applied to the outer side of a spinal curve to slow or stop its development while letting the inner side of the curve to develop normally, correcting the scoliosis curvature.  After the insertion of screws on the outer side of the scoliosis curve, the screws are pulled to correct the deformity. This procedure allows more spinal mobility, although it is a new procedure that has to be perfected. The method is based on the theory which states that a constantly pressured bone could grow slower and denser. This theory could be the “Hueter-Volkmann Law” (demonstrated by some studies) which states that the development of bones is inhibited by compression forces and stimulated by tensile forces.

 

Rehabilitation

The next step after surgery is rehabilitation since the patient must heal and start to return to daily normal life and normal activities. The rehabilitation can consist in exercising, such as stabilizing postural and respiratory exercises, for 5 1/2 to 7 hours every day. Along with that, there can be pain treatment such as pain physiotherapy, physical therapy, acupuncture, manual medicine, and psychological intervention and pain treatment by medication. With these methods, the postoperative pain can be reduced significantly in a lot of cases along with pain frequency, while chronic pain as a late result of surgery can be reduced although there aren’t any studies to prove their effectiveness. Every clinic has its own postoperative scoliosis rehabilitation program, it might differ from one to another. The rehabilitation is completed under the supervision of a physical therapist. In the following paragraphs,   the different means to reduce pain that the PT might utilize will be described.

Ice

The most common way to reduce pain and inflammation is to apply some ice on the affected area: the cold ice numbs the nerve receptors and minimizes pain.

ice-scoliosis-pain

Movements and positions

In some cases, the patient will feel less pain while standing in a certain position and/or while doing something. The PT will help the patient find his/her position or movement to minimize pain.

Electrical devices

The PT might use electrical devices that produce vibrations: if applied on the affected area, the vibrations will loosen up the muscles and nerves relaxing the area and minimizing pain. Some devices actually use electrical currents to relax the muscles and to stimulate the nerves. Electrodes, rubber suction cups or wires are placed over the skin of the body part that has to be stimulated. The patient only feels some tingling in the stimulated areas. The side effects include skin irritation and redness under the electrodes, chemical burns or cardiac fibrillation caused by electrical current and muscle soreness or spasm due to excessive stimulation.

Painkillers

scoliosis-drugs-painkiller

Glucosamine and nonsteroidal anti-inflammatory drugs (NSAIDs) of the propionic acid class:

  • Ibuprofen aka. Brufen, Advil, Motrin, and Nurofen etc.

Eating a fiber-rich meal is recommended before taking since Ibuprofen might cause, in some cases, bleeding of the gastrointestinal apparatus. Carefully check the leaflet.

  • Naproxen aka. Aleve, Anaprox, Flanax, Naprelan, Naprosyn etc.

Naproxen can raise the probability of stomach ulcers.  This is why it is often prescribed with a proton-pump inhibitor which is a medication that reduces stomach acid production). Thoughtfully read the package insert and avoid if you have gastric or duodenal ulcer.

Steroid medication and local anesthetic: if the pain progresses your doctor may prescribe you some injections to reduce inflammation.

Methyl salicylate-based analgesic heat rub gels: Methyl salicylate aka. oil of wintergreen or wintergreen oil is an organic ester, naturally produced by many species of plants, particularly wintergreens. It is also synthetically produced and can be found in different brands such as Ben-gay, Tiger Balm, Heat Rub, IcyHot, Deep Heat, Flexpower, RUB A535 etc.

Exercises

The PT develops a personal program for every patient and usually focuses on muscle facilitation to strengthen the muscles in the area of the incision, weak muscles, small muscles that are helpful to stabilize the spine. In some cases, the therapy helps the patient regain the mobility and flexibility in their hips, shoulders, joints. Patients can learn the exercises with the PT and then do them at home on their own. The exercises are usually slow and of low intensity because the patient’s body has to gradually regain its flexibility.

Prevention

A healthy lifestyle can help prevent scoliosis. Here are some things doctors recommend to prevent the condition.

Diet

A plant-based diet helps you healthy and strong, reduces inflammation and prevents all kinds of diseases such as heart disease, kidney failure, cancer, osteoporosis, high blood pressure, bone-related conditions, etc.

B12

B12 in micrograms (μg) is important for growth and brain functions. Its deficiency can really damage your body in numerous ways. Below there is a table with the daily recommended intake for adults and young people.

Age                            RDA (μg)

0-6 months……………….0.4

7-12 months……………..0.5

1-3 years…………………..0.9

4-8 years…………………..1.2

9-13 years…………………1.8

14+ years………………….2.4

pregnant women………2.6

lactating women……….2.8

Sunlight and water

Get your daily hour of sunlight. Drink 8 cups of water every day ( 2L a day).

Exercise

It helps you fit and strengthens your muscles, including the back muscles. Activities such as yoga, pilates, CrossFit, weight lifting, and competitive sports are recommended. For Crossfit and pilates, there are plenty of videos to help you exercise and to guide you through your fitness journey.

Yoga

It is an ancient oriental practice that combines awareness with light physical activity and relaxation. Here are some basic moves.

1. Mountain pose: stand tall with your feet altogether, raise your arms to the sky and inhale. This is a basic yoga pose that stretches muscles and invigorates the body.

2.Downward dog: start on all fours, spread your palms on the mat then press the hips towards the ceiling. Your body should resemble a boomerang. While you inhale and exhale, you will stretch your calves, your arms and your back muscles.

3. Warrior pose: Stand with feet 3 or 4 legs apart, bend one leg to the side, your arms should be away from your shoulder forming a straight horizontal line. Inhale and exhale. This pose will help you stretch your leg muscles and will force you to work on your stability.

4. Tree pose: stand tall and lift one leg with your knee to the outer side then rest your foot on your thigh; your arms should be away from your hips and they should be lifted. Don’t forget to inhale and exhale. This pose is very good for stability and it helps you to stretch your back muscles.

5. Cobra: Lay down on your belly. Your palms should be underneath your shoulders. Press into your palms and lift up. Inhale and exhale. This is a pose that will stretch your ab muscles and your back.

6. Child’s pose: sit on your knees, then on your the back of your feet. Try to touch the floor with your chest while elongating your arms in front of you.

7. Cat and cow: on all fours, while breathing, hunch your back and then press it down in the shape of a rounded “U”. This simple pose stretches your back like no other.

Going to the gym

Here are some simple exercises to do with weights. Only perform under the advice of your doctor and under a supervision of a trained medical professional.

1. Bicep curls: hold some dumbells or some water bottles in your hands, place your arms on the sides, then, palms facing the ceiling, lift the weights to your shoulders then bring them into the same starting position ( 3 sets of 15 each). This is an exercise that will work your biceps, triceps, shoulders and other back muscles.

2. Squats: stand tall, hold some weights on your shoulders, then feet apart (hips wide) lower yourself while keeping your back straight. Come back to the initial position(repeat for 3 sets of 10-15 each). This is an exercise that will work your whole body.

3. Deadlifts: stand tall, with feet apart, hold your weights down, below the hips, try to reach the floor with your weights while you keep your back straight (3 sets of 10-15 each). Return to your initial position. This exercise targets the back muscles and glutes.

4. Russian twist: on the floor with your back upright, knees bent and feet hovering, hold some weights on your chest and twist your torso to the sides (repeat until you feel the burn in your muscles). This is an exercise that targets the core, including the back muscles.

5. Lunges: stand tall while holding weights in your hands then step forward with one leg until both legs for a 90 degrees angle. Return to the initial position and repeat with the other leg. Do this for 3 sets of 20 lunges(10 lunges per leg).

6. Calf raises: stand tall with your weight and hands to the sides then lift your ankles off the ground and come back in the initial position. This exercise is meant to burn your legs so repeat until you can’t go on.

7. Lying press: stand on your back on the mat then start with your upper arms perpendicular with your torso then push the weights towards the ceiling and come back. Repeat for 3 sets of 10-15 repetitions.

Conclusion

Scoliosis is a condition that does not typically affect the quality of life if mild or moderate. Young people and females are more prone to develop the condition, but genes seem to play a significant part. If you have the symptoms mentioned before, schedule a check-up with your doctor. There are plenty of safe ways to treat it, even in its most severe cases. Nonetheless, preventing it is better than treating it, so make sure you have a proper lifestyle: plenty of exercise, a good nutrition, and proper sleep patterns.

This article utilized credible sources and is for information purposes only.  Please consult a healthcare provider for diagnosis, treatment, and additional information.

 

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