Scoliosis Treatment in Singapore
Looking for an alternative to surgery or braces to treat scoliosis? Often confused with poor posture, scoliosis is an abnormal curvature of the spine due to genetic disposition. Detection should be done at a younger age for ease of treatment. If left untreated, scoliosis can lead to severe, long-term consequences.
Read more about how chiropractic can help before deciding.
Choosing the appropriate treatment for scoliosis can be a daunting task.
To help you make a more informed choice, here are some guiding questions:
- What is scoliosis?
- What causes scoliosis?
- Can you develop scoliosis later in life, or are you born with it?
- What are the effects of scoliosis?
- Will scoliosis affect pregnancy?
- When is surgery for scoliosis needed, and what are the risks involved?
- How do I check if I have scoliosis?
- Can exercise treat scoliosis?
- Can a chiropractor fix scoliosis without surgery?
- Can I receive chiropractic care if I have undergone a spinal surgery before?
- When should I do a scoliosis check up with a chiropractor?
What is scoliosis?
Scoliosis is an abnormal curvature of the spine that measures more than 10 degrees.
Often, scoliosis is confused with having poor posture. Scoliosis is mainly due to genetic factors causing uneven spinal growth, whereas poor posture is the result of bad postural habits over time.
People typically think of a “S”-shaped or “C”-shaped spine instead of a straight spine when you mention scoliosis. That’s correct! A curvature of more than 10 degrees in the spine is considered scoliosis. However, there are different protocols depending on the severity of the curvature.
The typical protocols for scoliosis are:
- Less than 25 degrees: Observation with regular exams and follow-up X-rays
- Between 25 to 40-50 degrees: Bracing to stop the progression of the curve
- More than 40-50 degrees: Surgery – typically a spinal fusion to straighten the curve
Scoliosis does not happen overnight. Typically, the curves worsen at a rate of 1 degree a month. However, this can speed up during the adolescent growth spurt. An extreme case of scoliosis can result in death while mild scoliosis can cause distortions in posture and appearance.
Should I be afraid of having scoliosis?
No, you shouldn’t. Here’s why!
First, most cases of scoliosis do not require spinal surgery. Next, time is a critical factor in play. It’s far easier to manage a mild case of scoliosis than an acute case. Thankfully, in Singapore, we have early detection measures in place.
Approximately 2% of adolescent children were diagnosed early before their scoliosis became worse.
For those who are diagnosed with scoliosis, what’s next? Well, there are 2 ways around this.
- “Wait and see” approach – typically, the doctor will order periodic x-ray screenings to see if the curve is worsening and whether more “invasive” treatments have to be used.
- Chiropractic care – regular spinal adjustments help to keep your spine in check and prevent scoliosis from getting worse.
There are no right or wrong approaches. It really depends on your risk appetite. While we have seen cases where people were relieved that their scoliosis does not seem to be worsening, we have also seen the flip side where people regret not taking action earlier.
What causes scoliosis?
The most prevalent type of scoliosis is ‘idiopathic’, meaning the cause of it is unknown. 80% of all cases are idiopathic. The remaining 20% are caused by neuromuscular, congenital, degenerative and traumatic reasons. While there have been many speculations on the causes, scoliosis is NOT caused by:
- Carrying heavy things on one side only
- Accidents or trauma
- Poor calcium intake
- Bad posture or sleeping position
- Any type of physical activities or sports
Can you develop scoliosis later in life? (Adult Scoliosis)
Yes, you can. It is not uncommon for idiopathic scoliosis to go unnoticed in their adolescent days. Most mild scoliosis do not have obvious symptoms and it can be really difficult to diagnose with a naked eye. When this type of scoliosis continues into adulthood, it’s called adult idiopathic scoliosis.
Another type of scoliosis commonly observed among adults is degenerative scoliosis/osteoarthritis/spondylosis. When subluxation is not treated early, this can be dangerous! Our bones start to degenerate and our spinal discs lose its height, further worsening the damage to our spine. When the damage is asymmetrical, this causes titling and slipping between the vertebrae, resulting in an abnormal curve.
What are the effects of scoliosis?
While there might be outward signs of scoliosis that might affect the appearance, the more worrying effect of scoliosis if left untreated (depending on severity) is the rib cage pressing against organs and causing complications. These complications can lead to:
- Persistent back pain
- Damage to heart and lungs
- Breathing problems
- Damage to nerves
- Death (in extremely rare cases)
Will scoliosis affect pregnancy?
No, it doesn’t.
Women with scoliosis are just as able to deliver healthy babies. While pregnancy isn’t pain-free for any mom, moms with scoliosis may experience increased rates of back pain or breathing difficulties.
When is surgery for scoliosis needed?
In most cases of scoliosis, a spinal-fusion surgery is not necessary. However, in the event that your scoliotic curve is greater than 40-45 degrees, more invasive treatment methods have to be implemented to control it.
Depending on the type and severity of your scoliosis, the surgeon will attach screws and rods parts of your spine to forcibly straighten and align it. Though effective, there are some things you should be aware of.
Risks of spinal fusion surgery
Every surgery has its risks. We recommend going to see a surgeon to understand all medical risks related to the surgery based on your condition. Besides medical risks, here are other considerations when thinking about a spinal surgery:
1. Financial Cost
Spinal-fusion surgery is a very complex surgery. Every case of scoliosis is different and there are many variables that can affect the cost of spinal-fusion surgery. In Singapore, the estimated price ranges between USD7,200 and USD10,500.
2. Emotional Cost
In a study by Mayo Clinic, patients who undergo spinal surgery have a higher risk for postoperative depression than patients treated for other surgical or medical conditions known to be associated with depression.
In Dr Subach words, “The likelihood of depression occurring in postoperative period has to do with two factors. The first is the duration of symptoms prior to treatment, and the second has to do with success relief of the pain. When the symptoms persist for a long period of time prior to surgery, the patient often comes in with some signs of depression and resignation to having the pain.”
3. Decreased range of motion
Inevitably, with the metal parts that are attached to your spine, patients who undergone spinal fusion will experience decreased range of motion. The question is how much?
Well this depends on how many levels of your spine were fused and at which level. Typically, the L4-5 and L5-S1 levels tend to provide the most motion in the low back.
How do I check for scoliosis?
Have you observed any of the following effects of scoliosis?
- Uneven shoulder level (e.g. T-shirt keeps slipping to one side)
- Uneven hip level (e.g. pants/skirt rides up higher on one side)
- Body leaning to one side
- Greater space between one arm and body on one side
- Head not centered
These may cause you to suspect if you or your child has scoliosis. In Singapore, the School Health Services (SHS) of the Youth Preventive Services Division (YPSD) visit schools annually to provide health screenings, which include screening for scoliosis.
If your child has not been screened but you are concerned, we strongly recommend bringing your child for a check-up.
Can exercise treat scoliosis?
Just like crooked teeth, physical misalignments require physical interventions to correct them. Brushing your teeth everyday will not straighten your teeth.
Exercise cannot treat scoliosis and the physical misalignment of the spine. Exercise may help improve posture and range of motion, but itself cannot change the curvature.
Can a chiropractor fix scoliosis without surgery?
Scoliosis is a progressive condition. The key to treating a progressive condition is to stay ahead of its progression. Chiropractic is a proactive treatment that focuses on physical adjustments to correct misalignments in the spine. With regular adjustments, we have seen positive results from our practice members with scoliosis during their duration of care, but results really depend on:
- The severity of your condition
- How your body responds to adjustments
- Stage of growth (child or adult)
Chiropractic is a non-invasive and drug-free approach towards correction and prevention of the spinal curvature from getting worse.
Can I receive chiropractic care if I have undergone a spinal surgery before?
Yes, we have practice members who have undergone a spinal surgery before and continue to benefit from chiropractic care.
Having a previous spinal surgery can limit your range of motion, and affect your overall spinal health. It is important to let our chiropractors know that you have gone through surgery before, and details of the surgery.
During the adjustment, the chiropractor will take note not to adjust the area affected by the surgery.
When should I do a scoliosis check-up?
In Singapore, the School Health Services (SHS) of the Youth Preventive Services Division (YPSD) visit schools annually to provide health screenings, which include screening for scoliosis.
This is when your child may discover that they have scoliosis.
However, if your child or you notice symptoms of scoliosis before the health screening, you should get a check-up as soon as possible to understand if you have, and the severity of your scoliosis.
At Chiropractic Singapore, we will require X-rays to assess the degree of the spinal curve and stage of growth of the spine (for children). Our chiropractors are trained to diagnose scoliosis and recommend if and how chiropractic can help.
Note: The above information is not a substitute for a diagnosis or any form of medical care. Symptoms and treatments differ from person to person, and one should consult a chiropractor for an accurate diagnosis and recommendation.
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