What is curvature of the spine, and can it be treated?

The spine is a column of small bones, or vertebrae, that support the entire upper body. The cervical vertebrae are the five spinal bones that support the neck. The thoracic vertebrae are the twelve spinal bones that connect to the rib cage. The lumbar vertebrae are the five lowest and largest bones of the spinal column. Most of the body=s weight and stress falls on the lumbar vertebrae.Everyone's spine has natural curves. The upper trunk has a contour called kyphosis and the lower trunk has a reverse direction of the rounded contour called lordosis. A certain amount of curvature is needed to maintain appropriate trunk balance over the pelvis. Some people have spines that curve abnormally in any of the three planes: back-to-front; side-to-side; or top-to-bottom, called scoliosis. On an x-ray the spine may have an S or C shape that is abnormal. Some of the bones in a scoiotic spine also may have rotated slightly, making the person=s waist or shoulders appear uneven. Men and women in their later years may notice that they are shrinking, they cannot look straight up anymore, or their waist is getting bigger even though their weight has not changed. They may have a hump on their upper back called a Dowagers hump (exaggerated kyphosis). This condition is best prevented and treated by maintaining and building upper body strength through proper exercise to help strengthen the muscles supporting the vertebral column. Proper resistance exercise (i.e., weight training) also helps prevent osteoporosis, a common cause of Dowager=s hump. This problem of abnormal curvature of youth and adults may cause trouble with balance, back pain and even breathing. Unlike poor posture, these curves can=t be corrected simply by learning to stand up straight. Scoliosis does not come from carrying heavy things, athletic involvement, sleeping/standing postures, or minor lower limb length inequality.

Recognizing the problem is the first step. It is usually painless. Scoliosis can run in families. Health care providers should screen children and youth for this problem. The Adam's forward bend test is done by bending forward with arms extended and knees straight. This test is used during school csreening for scoliosis. Mild deformities are unlikely to progress. The proportion of youth with significant curvature is 0.5% with females who are tall more likely to have progression. Adults as part of their routine evaluation should have an annual height measurement.

A search is made for the cause of the abnormal curvature, which may involve x-rays. Examination of muscle strength and nerve function is also important as the change in the spine structure may put pressure on spinal nerves. Conditions known to cause spinal deformity are congenital spinal column abnormalities, neurological disorders, genetic conditions and osteoporosis. By identifying spinal deformities early, a search can be made for the cause, and treatment can be undertaken to stop progression and alleviate untoward affects of abnormal spinal curvatures.