Not all cases of adolescent idiopathic scoliosis could be due to ACEs or the repressing of emotions. Sometimes the underlying cause could be functional which may often be overlooked.
Functional scoliosis, also known as non-structural scoliosis could be compensatory, postural, or pathologic. Compensatory is when the body is compensating for something else like a difference in leg length, an unlevel pelvis, pain, infection/inflammation, or physical trauma. Postural could be when one persists in staying in maladaptive positions or consistently carrying weight on one side. Yes, carrying heavy bags can distort spinal curvature. Pathologic when there could be a spinal tumor.
However, the majority of adolescent scoliosis is termed as ‘idiopathic’ – reasons unknown. It is expedient to have an in-depth assessment to ascertain the contributing factors.
Functional scoliosis is usually much milder in curve size than structural scoliosis. Functional scoliosis can be more easily treated by correcting the underlying problem – with a few aids, changes in living practices, and physiotherapy. The spine itself needs no treatment unlike, structural scoliosis which has more extenuating factors precipitating spinal distortions.
Differentiating Functional Scoliosis From Idiopathic
One key way to differentiate between true idiopathic scoliosis also known as structural scoliosis and functional scoliosis is by the rotation of the spine.
In functional scoliosis, the curvature is just lateral. This can usually be detected by asking a patient to bend forward or lay down, the scoliosis curve would likely disappear. This does not happen when it’s true idiopathic scoliosis – the spinal deformity is fixed and does not disappear.
One important fact in treating both types of scoliosis – the earlier the better. Thus, less likely a patient’s condition will progress to the point where surgery is needed. Getting to the root cause by ascertaining whether the spinal changes are compensatory, pathological, or protective.
Some common causes of functional scoliosis are:
1) Eye Problems
The visual system controls 70% of postural coordination and movements. One of the signs of scoliosis is a tilted eye-line. The question is: ‘Was scoliosis due to a misaligned eye line or was a misaligned the reason for scoliosis?’
It is better to investigate thoroughly to rule out any serious issues like horizontal gaze palsy that may be caused by lesions in the cerebral hemispheres. (HGPPS) is a disorder that affects vision and also causes an abnormal curvature of the spine (scoliosis ). People with this condition are unable to move their eyes side-to-side (horizontally).
2)Jaw/Teeth/Tongue
Misaligned Jaw
A misaligned jaw affects more than just your bite. When your jaw is out of balance it changes the posture of your head and spine.
Research shows that scoliosis and malocclusion are often related. If you have scoliosis, often a deviation of the alignment of the jaw will be present. This also shows that the spine will be affected if you realign the jaw. If a deviation of both the spine (scoliosis) and the jaw (malocclusion) is present, and you fix the alignment of the jaw, sometimes scoliosis does get better.
Our jawbone has a sliding hinge called the temporomandibular joint (TMJ). There is one on each side which connects the jawbone to the skull. Via the cervical spine, namely, C1(called the atlas as it holds our head up). And C2 (called the axis since it allows us to move our head freely).
Since the brain stem extends through the C1 and C2, the TMJ is extremely important to the neurological system. Any TMJ disorder could be an important factor contributing to the collapse of spine structure and disruption of the nervous system.
Crooked Teeth
There is a link between kids with crooked teeth who need braces and scoliosis. Malocclusions, such as crossbites, gaps between teeth, crowded teeth, and missing teeth.
Here again, it is the chicken and dilemma, whether malocclusion causes scoliosis or if scoliosis causes malocclusion. However, proceed with caution, in some cases, scoliosis has improved with orthodontic intervention. While in other cases orthodontic braces were cited as having caused scoliosis.
Also, do note there have been cases that indicate that dental implants may cause scoliosis.
Tongue-tie
A tongue tie is when the tongue is tethered to the bottom of the mouth and isn’t free to move around as it should. This impacts the way your upper palette develops which in turn impacts the way your skull develops which in turn impacts the way your spine develops.
Mouth-Breathing and Tongue
Mouth breathing could be a possible cause of postural abnormalities involving the head and cervical spine. As long as nasal breathing has not been achieved, the tongue cannot occupy a good position. The tongue is the rudder of the human body when it comes to posture, breathing, and facial development. When it is out of alignment other parts of the body go out of whack and cause issues that may seem unrelated. So check how you are breathing.
3) Leg /Feet Issues
Our feet and legs are directly connected to our spinal posture. The skin of the sole provides data to the brain so that motor areas can stabilize and move the body. Remember the nursery rhyme, t
the foot bone’s connected to the ankle bone,
The ankle bone’s connected to the leg bone. The leg bone’s connected to the knee bone …
Dem Bones Skeleton Dance Dry Dancing Bones
Our whole body is one inter-connection biodynamic system. Sometimes even something as simple as foot corn can have far-reaching consequences on our spine. Most importantly, kindly wear good comfortable shoes to avoid spinal issues. This is critical when children are developing. Barefoot is the best when a child is learning to walk.
Leg Discrepancy
Leg discrepancy causes pelvic asymmetry and lumbar scoliosis. This could be congenital or could be due to diseases like polio not common these days though.
Flat Feet
Flat feet can lead to spinal imbalances and compensatory adaptations. The theory goes as follows: as the midfoot collapses, to keep the gaze aligned on the horizon, the shoulders need to hunch or twist.
4) Physical Trauma
Accidents /Falls
Though most cases of idiopathic scoliosis have no specific causes, a car accident or a fall could cause spinal issues eventually leading to scoliosis. This type of scoliosis is also known as traumatic scoliosis where spinal curvature is negatively impacted by a traumatic event like a car accident. Trauma to the spine can affect the vertebrae and can cause misalignment.
Car accidents, on-the-job injuries, or a simple unexpected jerk can cause what is known as whiplash. Whiplash causes tightened muscles that originate from muscle tears or excessive movement of joints. Sometimes, symptoms of this neck injury may develop immediately, while oftentimes the effects are felt days, weeks, and even months later.
High-Impact Sports and Injuries
Even high-impact contact sports like football, boxing, and baseball could lead to spinal misalignments and inflammation which initially one tends to overlook. However, over time to avoid pain and discomfort, one tends to twist the body to deal with it which could lead to spinal distortions.
There is a term for scoliosis athletes who are young teens involved in an acrobatic type of sports – gymnasts, swimmers, and dancers who are prone to developing scoliosis. That’s because these kinds of athletes are the ones who routinely lengthen their thoracic spines for all sorts of reasons. The backbend is an example of a move that involves thoracic spine lengthening. If this often during one’s growing phase, then it can make the vertebrae turn and move down deep into the opening that is a part of the scoliosis curve.
5) Psoas – Tight Muscles of the Hip Joint Cause a Scoliosis
There is a definite correlation between the psoas and scoliosis. The psoas is the muscle around the hip and groin area. A chronically constricted psoas restricts movement and pulls on the pelvic bones compromising not only pelvic integrity but also spinal alignment. Moreover, any tension within the pelvis will be reflected in the jaw and vice versa.
Now, a tightened psoas could be due to stress/emotional trauma but it could also be due to lifestyle choices. Like the propensity to sit for long hours could result in tight psoas which in turn could develop into scoliosis.
6) Prolonged neck bending
Prolonged smartphone usage causes upper cervical instability leading to faulty postures such as forward neck posture, slouched posture, or rounded shoulders. Sustained forward neck posture can cause injury to the structure of the cervical spine, as well as ligaments.
In some professions like dentistry where continuous bending is a job requirement, one could be predisposed to spinal misalignment. Continuously bending down could lead to functional scoliosis.
7) Tethered cord
According to neuroscientist Prof. Milan Roth, a tight spinal cord or tethered cord is the cause of most Adolescent Idiopathic Scoliosis (AIS). However, this spinal nerve tension is not diagnosed early on, and as one grows the more our spine is constricted and twisted.
Tethered cord happens when something catches hold of the spinal cord and does not let it move freely. Normally, the spinal cord hangs loose in the canal, freely bending stretching, and moving up and down as the body grows. However, a tethered spinal cord does not move; it is pulled tightly at the end. This reduces blood flow to the spinal nerves and damages the spinal cord from the stretching and the decreased blood supply.
It most often occurs in the lower (lumbar) level of the spine. Some tethering can happen before or after birth in children and adults with Spina Bífida.
8) Filum Disease
Recently, on Reddit, I came across filum disease as to be the underlying cause of scoliosis. The filum terminale is the nonfunctional continuation of the end of the spinal cord. It usually consists of fibrous tissue without functional nervous tissue.
When the lower part, or filum terminale externum, closely adheres to the dura mater it does not allow for free movement of the spine. This could lead to a stiff coccyx and hips which could lead to scoliosis.
Chiari Malformation
Now Chiari malformation (CM) is a serious condition. It is a neurological condition in which the brain, cerebellum (that which controls balance), and brain stem(which regulates heart rate, breathing, sleeping, and eating), is squished out of the bottom of the skull because the skull is too small to hold all the brain.
CM can go undiagnosed for many, many years. However, symptoms usually appear between the ages of 10 and 20 years. Although many people with Chiari are born with the malformation, most patients don’t know they have it until symptoms appear in later childhood or early adulthood, as the skull and tissues of the neck mature with skeletal growth.
Get To The Root Cause
Our spine is called our backbone because is our body’s central support structure. It not only holds us upright but it is the interface connecting our mind and body – allowing for the smooth functioning of the entire system. You simply cannot treat scoliosis as just a spine issue.
Sadly, that is often the case and most treatment is focused on forcefully pushing the spine into position without considering other factors. Sometimes, bracing and spinal manipulations work, while often they don’t. And the patient is left feeling frustrated and in intense pain.
Most doctors don’t have the time to make an in-depth assessment. They tend to be fixated on their mode of treatment and tend not to look at all aspects. It is up to the patient to do their research and seek second or third opinions about scoliosis. Also, developing self-awareness and self-knowledge does help in understanding how our minds and body work. Attention to our sitting, and sleeping positions, where is my tongue? Are my shoes comfortable? There are so many aspects one needs to pay attention to get to the root cause of a dis-ease.
Corrective Measures – Nip It In The Bud
Sometimes, the reason for our spinal curvature could be physical while oftentimes, it could be emotional. The key is finding the causative factors and nipping them early. In some instances, it could be something seemingly simple but overlooked factor. Always, look at all aspects, do your research, and find the right solution. And it does not always have to be surgery, that should always be the last resort.
Image Source: Pixabay
Further Reading:
Myofascial Release ~ Ruth Duncan
