Lumbar Scoliosis: What is it? Causes, Symptoms, Diagnosis and Treatments

Most cases are mild, but they can be serious if the curvature begins to affect the heart and lungs.

Lumbar scoliosis is a disorder of the spine (within the five lumbar vertebrae) in which the lower part of the back, or the lumbar area of ​​the spine, curves to the left or to the right. This form of scoliosis is known as thoracolumbar scoliosis.

Although some people develop lumbar scoliosis at a very young age, it usually begins just before puberty, during the outbreaks of growth that occur during this time.

Severe cases of lumbar scoliosis can be disabling, and affect a person’s ability to walk, run or even breathe.

Scoliosis can also cause misalignment in the bones of the body and chronic pain in the back. Scoliosis is monitored closely to avoid serious complications. Treatments for scoliosis involve controlling pain or correcting the curvature if necessary.

Lumbar scoliosis can make one hip look taller than the other or one leg look longer than the other. In milder cases, corrective exercises are performed. These involve strengthening the abdominal muscles that support the spine.

In some cases, lumbar scoliosis is degenerative, develops after age 50 due to a rupture of the spine, as opposed to the most common adolescent idiopathic form, which has no known cause.

People with degenerative lumbar scoliosis may have no symptoms or may be severely disabled.

Although this form of curvature can be linked to congenital scoliosis at birth, and can also occur as a result of a neuromuscular condition in adulthood, it is more frequently identified in patients with idiopathic scoliosis.

Although this form of scoliosis is less common than the curvature within the thoracic region (posterior middle), it is common for the curvature to include the upper lumbar vertebrae and the lower thoracic vertebrae.

The most commonly affected by the lumbar curvature are people with degenerative conditions of the spine in the lower back, where years of bending and twisting and bearing the weight of the upper body can have a cost.

Degenerative conditions that cause lumbar scoliosis

While lumbar scoliosis may be present at birth (congenital scoliosis) or develop early in life (adolescent idiopathic scoliosis), it is more prevalent in middle-aged or older people.

At this stage of life, the anatomy of the spine has generally begun to wear out.

The intervertebral discs begin to lose water content and become brittle, the cartilage of the vertebral joints begins to fray and bone spurs begin to form (osteophytes).

If the degenerative condition of the spine progresses, or if there is a simultaneous neuromuscular condition, such as cerebral palsy, a lateral curvature (to the right or to the left) of the spine may occur.

Symptoms of lumbar scoliosis

In most cases, the symptoms of lumbar scoliosis will be distinguished during early and middle childhood, although in cases of adult degenerative scoliosis, it can also be associated with a number of corresponding conditions, including lumbar spinal stenosis and osteoporosis.

Some visual symptoms of lumbar scoliosis include:

  • Uneven shoulders
  • Unusually high hips.
  • Uneven alignment of the rib cage.
  • Uneven waist.
  • Body tilted to the side.

These anatomical abnormalities can begin to affect or irritate the spinal nerve roots, producing many non-visual symptoms, which include:

  • Localized pain.
  • Pain that moves along the nerve.
  • Tingling or numbness in the lower extremities.
  • Loss of muscle strength in the arms and legs.

Back pain from lumbar scoliosis is usually due to muscle imbalances created by misaligned vertebrae. The muscles on one side of your body will be squeezed in comparison to the other side.

If you do not stretch and strengthen your spinal muscles, these imbalances will get worse, causing more pain.

Spinal malformation

The characteristic symptom of scoliosis is a C curve shape (or S when combined with scoliosis of the upper back) rather than a straight line from the neck to the hip.

The curve may be noted during a chest radiograph due to lung infection or injury, or may be observed during a flexion test.

For this test, a person touches the floor or fingers and the spinal form can be identified by a doctor to determine in which direction the curve is formed.

Mild curves less than 20 degrees from a specialized angle measurement are usually treated only with periodic observation; Bracing and surgery are reserved for curves of 25 to 50 degrees.

Muscle and back pain

Mild scoliosis is mainly painless during childhood and adolescence. However, scoliosis that develops in adulthood, or scoliosis of the adolescent who is not treated with braces or surgery, can cause symptoms of chronic pain.

Bone pain can occur due to secondary arthritis. Muscle pain in the lower back is common, because the muscles that are attached to the curved spine are pushed or pushed out of their normal positions and tensed continuously.

Uneven alignment of the body

The sides of the body that appear unequal may be the first sign or symptom of scoliosis in a child or adolescent without pain. With lumbar scoliosis, the legs may have different lengths, or one hip may appear higher than the other.

This symptom is more noticeable in the placement of clothing; clothes will appear longer or shorter or will warp and stretch to adapt to the irregular alignment of the body.

Diagnosis

Lumbar scoliosis can be visually identified by an X-ray test or Adam’s forward bend, and is characterized by the distinctive C-shaped curve in the lower section of the spine and the apex of the curve should be a of the lumbar vertebrae.

It differs from thoracolumbar scoliosis, which is when a single curve extends between the few lower vertebrae of the thoracic spine and the first vertebrae of the lumbar spine and the apex of a thoracolumbar curve should be at T12 (twelfth thoracic vertebra) or L1 ( first lumbar vertebra).

A lumbar scoliosis may occur in combination with a thoracic scoliosis to form an “S” shaped curve, with the thoracic curve in one direction (left or right) and the lumbar curve in the other (right or left).

What are the treatments for lumbar scoliosis?

The recommended treatment for lumbar scoliosis can vary depending on a variety of factors, from the patient’s age and health to the severity of the spinal curve and its long-term implications.

For those who experience pain and inflammation as a result of lumbar scoliosis, anti-inflammatory medications such as ibuprofen may be prescribed in an attempt to reduce discomfort for the patient.

In other cases, doctors can recommend a course of injections of corticosteroids in the spine, which are done under X-rays, and can receive no more than four times in a period of 6-12 months.

In the most severe cases, where the curvature is seen to progress and may affect the health and general well-being of the patient, a physician will often recommend that the patient undergo a corrective surgical procedure.

This is known as spinal fusion surgery and involves inserting rods and screws into the spine, which prevents the spine from curving.

Medicines

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ibuprofen, can be used to reduce the pain and inflammation associated with lumbar scoliosis.

These medications should be taken under the supervision of a doctor, as they can cause significant side effects that affect the heart, liver, kidneys and stomach.

A doctor may also recommend an injection of corticosteroids into the lumbar spine. Corticosteroids are strong anti-inflammatory medications that can reduce the pain and inflammation caused by lumbar scoliosis.

These injections are done under live X-rays, called flouroscopy. A patient can not have more than four injections in a period of six to 12 months.

Exercises

Regular back exercises can help lumbar scoliosis. A doctor may prescribe physiotherapy to treat the condition.

A physiotherapist can help the patient stretch the back muscles, which can help correct the curvature of the spine. Once flexibility is achieved, exercises can be performed to strengthen the muscles of the back.

This will prevent the lumbar spine from curving in the long term. The exercises must be done regularly to be effective.

Surgery

The pain, tingling and numbness often associated with lumbar scoliosis in adults could be addressed with innovative minimally invasive stabilization procedures performed using advanced techniques.

An intervention may be inevitable in severe lumbar scoliosis. In particular, a surgeon will probably suggest a spinal fusion. A spinal fusion involves inserting rods and screws into the spine to fuse the spine together.

This prevents the spine from arching. Although a spinal fusion is an appropriate treatment for severe scoliosis, complications include bleeding, infection, pain, nerve damage, or inadequate bone healing.

In addition, a future surgery may be required years later to remove the rods and screws if they cause pain in the patient.

Therefore, a patient should maintain close contact with his doctor and let him know if he begins to experience complications from scoliosis surgery.

Procedures such as lateral lumbar interbody fusion and transforaminal lumbar interbody fusion are alternatives to traditional open fusion surgery.

Clamps

The reinforcement of full-time lumbar scoliosis is an obsolete treatment that must end. Orthodontic treatment for scoliosis has existed for more than 450 years, but its success is still debatable.

Full-time reinforcements often cause more problems for the person who uses them, such as pain that did not exist before, trouble breathing and weakened muscles. Neither has consistently been proven to avoid lumbar scoliosis surgery.

Bracing is generally recommended for children aged 10 to 15 years with a scoliotic curve between 25 and 45 degrees. The hope is that the reinforcement will delay or stop the progression of the curve, since the condition is progressive.

One of the main problems with braces, including hard plastic braces, metal braces, and softer braces, is that they weaken muscles.

When you do not use your muscles, they atrophy. For example, when your arm is broken and in a cast, the muscles inside the cast become small and weak. This is what happens when your child uses an orthopedic device for scoliosis during the recommended 18-23 hours per day.

It also explains why the curve gets worse quickly once the corset is removed. In a clamp, your child’s spine stiffens. The joints have no necessary movement and often develop more degenerative problems.

The reinforcement of the lumbar scoliosis also puts pressure on the ribs and usually causes a hump. Doctors almost always recommend removing the orthopedic device when they see this negative change using 3D X-rays, but additional damage may already have occurred.

Are there viable alternatives to medications and surgery for lumbar scoliosis?

An increasingly popular method to treat scoliosis is the use of physiotherapy and exercises, which is the treatment approach we employ.

By performing a variety of movements, a physiotherapist will work to correct the existing spinal curve and strengthen the back muscles of the patient, for continued maintenance and progress.

Stretches and exercises for a lumbar curvature to the left

Exercises can help control or, to some extent, reverse the effects of scoliosis. However, check with your health care provider about the best way to treat your lumbar scoliosis.

Lumbar rotation lying down I

The stretch of lying lumbar rotation has multiple progressions from a light stretch to a more intense stretch. The exercise is done lying down on the convex side of your body with a pillow under your head.

Bend the hips so that the angle of the hip joints is approximately 135 degrees and the knees are almost 90 degrees.

You should rest on the shoulder closest to the floor with the opposite shoulder slightly tilted back, slightly stretching the lumbar spine. Your forearm is on your chest.

Lumbar rotation lying down II

To do the second level of stretch, bring the knee of the upper leg forward so that the hip is at 90 degrees and the knee is bent at less than 90 degrees.

Release your upper shoulder to the floor with your hand on the side edge of your belly, stretching the lumbar spine. If you want to increase the intensity of the stretch, straighten the leg in front of you and drop your upper shoulder to the floor behind you.

Lying on the lateral curvature

This stretch should be done on a table so that your arm can hang over your head with you lying on the convex side of your spine. If you bend your hips and knees slightly in front of your body, it will keep you balanced on your side.

Place a folded towel under the concave area of ​​your spine and then cover your upper arm over your head. You can increase the stretch by increasing the size of the roll below the lumbar spine.

Oblique abs

Strong abdominal and lower back exercises are essential for the entire lumbar area, especially for the concave side of the lumbar spine.

Make oblique abdominals lying on the convex side of your body, keeping your knees bent in front of you. Look up and contract the obliques to draw the hip and rib cage on the concave side towards each other.

Hyperextensions aside

The hyperextension will strengthen the lumbar muscles on the concave side of the spine. Begin this exercise lying on your stomach. Straighten both arms above you so that your limbs are in line with your body.

Simultaneously, raise the arm on the convex side of your body and the leg on the concave side of your body, holding the contraction for three seconds.

Lateral stretch

Stand with your feet shoulder-width apart. Rest one hand on your hip and raise the other arm above your head. Bend your waist with your arm raised curving over your head.

Do not bounce, just stretch and return to the upright position. Repeat ten to 20 times on each side. Be careful not to twist while bending so as not to aggravate your spinal pain. Once you feel confident with the lateral stretch, add hand weights to the routine.

Keep a weight by your side instead of putting your hand on your hip. Keep the other weight on the arm raised.

ABS

Lie on your back and bend your knees. Raise your arms above your head and slightly tilt your pelvis up. Bring your arms forward and raise your upper torso while your arms extend forward over your knees.

Keep your elbows straight while continuing to roll up and touch your knees. Lie down slowly and repeat. Inhale as you raise your arms on the floor and release your breath when you get up.

Perform the exercise slowly to develop the muscles in the lower back.

Lizards

Lie on the floor face down and place your hands approximately shoulder-height below your shoulders. Raise the upper part of your body by straightening your arms.

Keep your knees firmly plated, and point to a straight alignment on your back as much as possible. Tilt your pelvis forward while you get up. Hold for a count of five, release and lower again.

Straightening of the wall

Stand against the wall with your head, shoulders and buttocks firmly against the wall and your feet about 8 or 12 inches from the wall. Press your lower back into the wall to fit the wall.

Take some deep breaths and let go. Repeat ten times.

The same exercise can be done lying on your back with your knees bent. Raise your arms above your head and press your back against the floor.

Take a deep breath while you extend your arms and exhale while applying the pressure. Repeat ten times.

Standing movements

Perform some strength training movements while standing. For example, stand with your hands on your hips and your feet shoulder-width apart. Reach your right arm over your head to the other side of the body until you feel a stretch.

Do a total of 12 repetitions per side. If you have the ability, you can hold a small set of weights during this exercise.

Stretching

You can stretch to relieve back pain related to scoliosis and keep your joints loose and flexible. To stretch your lower back, lie down on a comfortable exercise mat.

Pull your knees towards your chest and wrap your hands around your legs. Hold the stretch for 10 to 15 seconds before returning the legs to the floor. Perform six to eight repetitions. Stretch each day before doing any other physical activity.

Seated exercises

Sitting exercises can be part of your exercise program when you have scoliosis. You can rotate the trunk by sitting on a chair with your spine resting against your back.

Keep your feet planted on the ground while twisting your torso to the right of your body. Your left arm should be able to grab the chair; Your head should be on your right shoulder.

Arch and extension

There are three positions for this exercise, which combine a cat and camel stretch with an extension of the back.

Extends the flexor muscles of the spine, the spinal extensors, the muscles of the middle part of the back and the obliques, which reduces stiffness and pain.

First, get on your hands and knees forming angles close to 90 degrees in your hips, shoulders and knees. Then, draw your navel toward your spine, arching your back up; Hold the stretch for five seconds.

Then, sit back on your calves, keeping your arms and hands in place to stretch the middle part of the back and the oblique muscles; keep for five seconds.

Finally, lie down, straighten your legs and place your pelvis on the floor. Keep the arms in position to keep the upper part of the body upright, extending the spine; keep for five seconds. Repeat this series of steps for four more repetitions.

Lateral curved dumbbells

The lateral curves with dumbbells strengthen the weaker muscles on the side of the trunk. Do this exercise only on the side where the scoliosis curve separates the shoulder and the hip on the same side.

Once you have more strength and muscle tone on this side and more flexibility on the other side, start doing side bends on both sides. This will reduce muscle fatigue on the stretched side, decreasing back pain.

First, maintain a 5 lb weight dumbbell with the opposite hand to the stretched side; Place your feet slightly wider than the width of your shoulders and bend your knees. Then, fold as comfortably as possible towards the side where you are holding the dumbbell.

Next, contract the muscles of the overextended side to raise your trunk to a vertical position.

Swim as an exercise for lumbar scoliosis

Advantages of swimming

Swimming is a beneficial exercise for someone with lumbar scoliosis because the movements are not discordant and there is less pressure on the lower spine. Swimming creates buoyancy, which reduces the forces of body weight that act on the body.

Water also provides resistance, which can work your muscles and improve endurance and flexibility. Swimming with scoliosis can help develop the muscles of the arms, legs and back, which could improve overall balance and muscle strength.

Back pain

Lumbar scoliosis can cause chronic back pain if left untreated. Swimming benefits those with lumbar scoliosis because it provides cooling water that improves the circulation of body tissues.

In addition, swimming provides a form of stress relief and can help release tension, possibly reducing some chronic pain.

The person with lumbar scoliosis who wants to try to swim can find renewed energy and vigor, as well as a positive attitude and feelings of achievement.

Difficulty

Depending on how severe the case of lumbar scoliosis is, swimming can be a challenge. Most people with lumbar scoliosis can participate in sports, although some movements can be difficult due to the affected muscles.

In addition, for those with severe lumbar scoliosis that affects the lungs, swimming competitively or for long distances can be difficult due to reduced lung capacity.

Some types of swimming strokes can be difficult initially when using the back and arm muscles, but most people with lumbar scoliosis can swim, even with modified movements.

Considerations

Although swimming may be good for you if you have lumbar scoliosis, it does not change the shape of the spine. Treatments such as braces or surgery can help prevent further curvature of the spine and worsening of the condition.

If you must use a clamp for the spine, you must remove it to go swimming. Also, if you have back pain associated with scoliosis, using your back muscles while swimming may or may not help relieve some discomfort. Talk to your doctor or physiotherapist about the benefits of swimming for your condition.