By: Dr. Tony Nalda
Scoliosis is a complex spinal condition with the potential to cause a number of effects felt throughout the body, particularly if left untreated. If left to progress, a scoliotic curve increases in size, and the uneven forces introduced to the body also increase, and this doesn’t just affect the spine, but also its surrounding muscles and nerves.
Although scoliosis is a spinal condition, it can affect the body in many ways. As the brain and spine work in tandem to form the body’s central nervous system (CNS), nerve involvement is a common feature of spinal conditions like scoliosis, which are associated with numbness and/or neuropathy.
Before exploring the nature of neuropathy and how scoliosis can affect the body, let’s first define the condition and the parameters that have to be met in order to reach a diagnosis of scoliosis.
What is Scoliosis?
Scoliosis is a highly-prevalent structural spinal condition, with current estimates at between 6 and 9 million people living with the condition in the United States alone, and it is the leading spinal condition amongst school-aged children.
Scoliosis is the development of an unnatural sideways spinal curve, with rotation, and a minimum Cobb angle of 10 degrees. It’s the rotational component that makes scoliosis a 3-dimensional condition as the spine doesn’t just bend unnaturally to the side, but also twists. Cobb angle is known as the orthopedic gold standard in the assessment of scoliosis: a measurement taken during X-ray that involves drawing intersecting lines from the tops and bottoms of the most-tilted vertebrae at the curve’s apex.
The resulting angle is expressed in degrees and places conditions on a severity scale: Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees Severe scoliosis: Cobb angle measurement of 40+ degrees
Scoliosis is highly variable. What one patient experiences as a symptom, another might not, and as a progressive condition, where a scoliosis is at the time of diagnosis is not indicative of where it will stay.
The higher the Cobb angle, the more severe the condition, and the more rotation there is, the more likely it is to cause noticeable symptoms like pain, postural deviation, radicular pain, and/or neuropathy. So now that we’ve defined the condition and the parameters that have to be met to reach a diagnosis of scoliosis, let’s talk about how scoliosis can affect the body in general.
How Scoliosis Affects the Body
As mentioned, scoliosis can affect the body in a number of ways from pain and postural deviation to muscle imbalance and nerve involvement. When left untreated, scoliosis is virtually guaranteed to progress at some point, and the more severe a condition gets, the more likely it is to cause related complications such as digestive issues, lung impairment, and/or migraines. When it comes to back and/or radicular pain, this is determined by key patient/condition variables such as patient age, condition type (causation), the angle of trunk rotation (ATR), curvature location, and condition severity. When mild, scoliosis isn’t known to cause noticeable functional deficits and pain, particularly in young patients, and neuropathy is less likely to become an issue in children and adolescents because the condition is not yet compressive.
Scoliosis becomes compressive in adulthood once skeletal maturity has been reached; prior to that, growing spines are experiencing a constant lengthening motion that counteracts the compressive force of an unnatural spinal curve. It’s compression of the spine and its surrounding muscles and nerves that causes the majority of condition-related pain.
In addition, as muscles struggle to support an unnaturally-curved spine, they are exposed to adverse tension, strain, and uneven wear, often becoming tight, sore, imbalanced, and painful as a result. The spinal canal is home to the spinal nerves, which are mixed nerves, containing both sensory and motor fibers, and if the spine is unnaturally curved, the uneven forces introduced by the condition can expose the spinal nerves to uneven pressure (compression) and cause a variety of symptoms.
Can Scoliosis Cause Neuropathy?
First of all, let’s define neuropathy: damage/impairment to one or more nerves that can cause a variety of symptoms including muscle weakness, tingling, and/or numbness in the affected area.
Nerves are like branches on a tree, fanning off in multiple directions, so when a spinal nerve is exposed to uneven pressure, either at its root, or anywhere along its pathway, the effects can be felt far from its site of origin.
In fact, it's common for the first effects of neuropathy to be felt in the hands and feet.
The brain and spine work together to form the body’s central nervous system (CNS), which facilitates brain-body communication.
The nervous system is a vast network of cells and nerves that connect the spinal cord and brain to the rest of the body; this is done by facilitating communication via the sending/receiving of signals to the hands and feet, legs and arms, mouth and face, internal organs, and muscles.
When nerves aren’t functioning properly because they are damaged, this is neuropathy and commonly involves the sending of incorrect messages/signals.
When nerves aren’t sending reliable signals, the following issues can arise: nerves can send pain signals where there is no pain, or no pain signal when there is pain, and this is why neuropathy can be such a complex and unpredictable condition to live with.
There are also different types of neuropathy such as sensory, autonomic, and motor, and scoliosis is most closely linked to motor neuropathy as the motor nerves control movement and muscles.
Scoliosis and Neuropathy
Scoliosis, like any condition that affects the function of the central nervous system, can cause neuropathy. The central nervous system includes the brain and spinal cord, while the peripheral nervous system (PNS) refers to the nerves that branch out from the CNS and extend to other organs, muscles, and parts of the body.
While scoliosis is more closely linked to the function of the central nervous system, when severe, it can also affect the connection between the nerves of the CNS and PNS.
Scoliosis is closely connected to the motor nerves because it’s not just the spine that maintains its natural curves and alignment, but also its surrounding muscles that provide it with support and stabilization, and of course, the spine’s very design is based on movement.
Although the spine is one long structure, it consists of many complex moving parts, and if the communication between the brain and body is disrupted, this includes the muscles that support the spine; if an unnatural spinal curve is compressing the spine and its surrounding nerves and muscles, affected nerves can become irritated, inflamed, pinched, and/or impinged.
As scoliosis can affect the spine’s overall health and function, it can cause numbness and neuropathy by impacting the spinal nerves.
In addition, as scoliosis can disrupt the spine’s overall biomechanics, it can also lead to neuropathy by making the spine more vulnerable to a number of spinal conditions with the potential to disrupt nervous-system activity.
Conclusion
Scoliosis can affect the body in many ways, and each patient’s experience of life with the condition will be as unique as the patient themselves, which is why there is no one-size-fits-all approach to scoliosis treatment.
The complex nature of scoliosis necessitates a customized treatment approach, and as a progressive condition, being proactive with treatment is key to minimizing the condition’s effects and managing its symptoms.
Neuropathy happens when one or more nerves are damaged to the point that their function is impaired, and as a spinal condition, scoliosis can directly impact the spinal nerves by exposing them to uneven pressure and compression.
When neuropathy is caused by an underlying condition like scoliosis, here at the CLEAR Scoliosis Institute, we treat the neuropathy by addressing its underlying cause: the scoliosis itself. By working towards a curvature reduction on a structural level, we reduce the uneven forces and pressure on the spine, and its surrounding muscles and nerves, and by working to increase core strength, the spine is optimally supported by its surrounding muscles.
Reducing pressure on affected nerves means giving them the space they need to function optimally within, and this can improve their ability to send/receive reliable signals between the brain and the rest of the body: improving brain-body communication. In addition, custom-prescribed home exercises can be key to establishing a home-rehabilitation program for stainable long-term results.
So can scoliosis cause numbness or neuropathy? Yes, it can, but it doesn’t have to, particularly if a diagnosis is responded to with proactive treatment that works towards preventing progression and minimizing the condition’s effects.
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