Scoliosis-New Ideas for Etiology and Treatment

Scoliosis is a spinal curvature that develops in children during their growing years. It results in a three-dimensional deformity that leaves the developing spine growing into a spiral. Curves of more than 25º occur in about one out of 1000 U.S. children. Also, about 70% of pediatric cases are idiopathic, meaning they don’t have a discernable cause.

A variety of treatment possibilities exist. They include bracing, chiropractic therapy, myofascial release, and spinal surgery with instrumentation. While non-surgical treatments may reduce associated pain, none have been shown to reduce or stop scoliosis progression.

At Blatman Health and Wellness Center, we’ve pioneered an alternative to scoliosis treatment. Our methods are based on the theory that fascia restriction is what interferes with a child’s vertical growth.

Fascia: The Key to Idiopathic Scoliosis

Fascia is a fibrous tissue that is continuous throughout the body. It holds muscles to bone, muscles to other muscles, and bones to joints. It also keeps organs like the heart, lungs, uterus, and bladder where they belong in the body so that they do not flop around or fall due to gravity.

Fascia consists of tough sheets and cords that, through dissection, are demonstrated to go from head to foot as one piece of tissue. Indeed, a technique called “fascia sparing dissection” has revealed shallow and deep lines of continuous fascia in the body’s front, back, and sides. There are also spiral lines of fascia through the abdomen and chest.

Fascia has been shown to contain contractile fibers and has contracting properties as a result. Sometimes, these fibers cause pathological reduction of fascia, as seen in Dupuytren’s contracture, a condition that causes the hand and fingers to bend or contract due to a tightening of the fascia under the skin of the palm.

Scoliosis from this type of fascia contraction would be idiopathic or different in each child and relatively unpredictable in its progression over time. The fascia restriction prevents vertical growth of the spine. As the child develops, their spine growth follows a path of least resistance, resulting in the characteristic spiral deformity.

This theory pointing to fascia contraction also posits that the greatest progression of scoliosis occurs during more rapid growth in childhood, with very little progression after age 18. In addition, this possible etiology would also mean that bracing, physical therapy, muscle balancing, and chiropractic would have little effect on reducing the condition’s progression. Also, fascia tension would define scoliosis as coming from inside the body, making external treatments such as bracing ineffective.

In addition, if scoliosis is caused by fascia restriction, a skilled examiner should be able to palpate and discover the tightest contracting fascia cords in the trunk of the body. Through collaboration with David Lesondak, we’ve learned that we can indeed feel many of these restricted fascia cords in both children and adults with scoliosis. The cords we cannot palpate are deep and sometimes anterior to the spinal column in the chest and lower back.

Fascia-Based Treatment of Idiopathic Scoliosis

As we have learned to feel the tight cords, we’ve been able to treat children with percutaneous (i.e., through the skin) needling that releases the fascia, much like what has been used to treat Dupuytren’s contracture.

Children in the program have included boys and girls, ranging in age from 10–18 years. Every child has gained vertical and shoulder height with each treatment. We have found this percutaneous technique to be less successful in areas of tight thoracic curves. In these cases, the fascia restriction may be best released with surgery as it requires access through the chest and lungs. The most dramatic success has been with a 10-year-old child whose curve was no longer noticeable one year after four consecutive days of treatment.

As children age with this progressive scoliosis, their vertebrae transform into an oblique trapezoid shape that is difficult to reverse. Therefore, the sooner a practitioner can release the fascia cords, the better the chances of minimizing scoliosis progression.

Keep in mind that a child undergoing treatment needs to be able to lie still and tolerate the discomfort of the treatment, which is similar to a trigger point injection. Nevertheless, the team at Blatman Health and Wellness Center treats patients of all ages with compassion and care. They’ll explain all stages of the procedure, making sure the patient understands what’s happening every step of the way.

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