Severe Scoliosis in Adults: One of the first things to understand about scoliosis is that different degrees of scoliosis exist. For instance, surgery is recommended as an option to treat scoliosis only if the spinal curvature crosses an angle of about 40-45 degrees, also termed as the Cobb angle in young adults. In adults, it is usually recommended when the spinal curvature progresses to a bend of about 50-55 degrees. One of the principal reasons as to why surgery is usually suggested when the angle of the scoliosis is this high is to halt any further progression of the spinal bend. Unfortunately, what many people are unaware about is that if the spinal bend continues to progress, apart from causing pain, it can also cause significant problems such as putting pressure on vital organs such as the lung or the heart – impairing their function and causing a serious threat to life. Due to these reasons, even if a person is able to bear the pain from scoliosis, it is recommended that they get it checked out as soon as possible.
While it is not always possible to judge whether a person has scoliosis just by looking at them, for most people with scoliosis at this degree, postural changes and changes in the symmetry of the body are quite evident. Surgery is sometimes helpful in treating these conditions, but sometimes it is not. While it might be distressing to hear that this is a condition that can actually impact your quality of life, it helps to be aware of the facts to take the right decision.
How Serious is Scoliosis in Adults:
Unfortunately, when it comes to severe curvatures, such curves or scoliosis has a higher chance of progression, which may not be treatable even with surgery. Despite the Cobb angle used to describe younger individuals with scoliosis, this angle can continue to increase for those with severe scoliosis even after they reach adulthood if the condition is that severe.
While surgery may not always be effective in treating scoliosis, the alternatives for treating severe scoliosis are not great or quite effective either. For instance, braces are often prescribed by doctors to treat scoliosis, but even when it comes to moderate levels of scoliosis, the effectiveness that braces provide is questionable. This is even more so if your condition is severe. CLEAR guidelines do not suggest traditional (non-CLEAR) chiropractic treatments for severe scoliosis, in the case of children or teenagers. If you are adult, you could try out alternative treatments such as aqua therapy, physiotherapy, braces, and other types of treatment, but the clinical evidence or scientific evidence is not sufficient to demonstrate that they actually make a good or a positive difference in the lives of those suffering from this conditions. If you are wondering about treatment options for children or teenagers with severe scoliosis, ensure that you thoroughly check out all possibilities prior to selecting a treatment plan, and discuss surgery with your physician in from a holistic outlook.
If you do decide to forgo surgery and instead choose to stick to the CLEAR guidelines, it is not a one-week finish all sort of treatment – you will be required to do those exercises and follow the protocols probably for the rest of your life. This includes aspects such as monitoring, regular follow-ups, intervention in case of any worsening of the condition, etc.
If you are an adult with scoliosis and have not been diagnosed with either degenerative or de novo scoliosis, but just want a treatment plan to treat the pain that occurs from the bending of the spine, you could discuss that with your physician as well. In such a scenario, a more symptomatic approach towards treating scoliosis that mainly focuses on pain management may be suggested. However, even in this scenario, it will be tremendously helpful for you to ensure regular follow-ups for your condition.
Apart from all that has been discussed above, there are certainly other factors that one must keep in mind while deciding to opt for the CLEAR protocol for children and young adults.
It is important to note that CLEAR has a policy that requires all children and adolescents to also be under the care of an orthopaedic surgeon prior to starting with the CLEAR protocol. This includes the requirement for approval from an orthopaedic surgeon prior to beginning the treatment plan. This is to ensure that if the CLEAR protocol does not prove to be very effective or if the spinal curvature degenerates rapidly, (whether due to biological or organic factors or due to the patient not following the CLEAR protocol), that there is a backup option in the form of a surgery that is available.
Another important thing to keep in mind is that the success of the clear protocol depends on your ability and willingness to follow it properly. If you do not keep up with your appointments, do not perform your exercises, or violate the terms of the CLEAR protocol in any way, the Certified Doctor associated with the CLEAR program can send a patient away and choose not to work with them anymore. While you could still consult your orthopaedic surgeon should this happen, you will not be considered a part of the CLEAR treatment protocol anymore. This is because one of the hallmarks that make CLEAR treatment so effective is actually following it effectively, and doing what the protocol mandates or requires you to do. If you are unwilling to stick to the protocol, it is likely that you will neither see that the conditions improve and in some cases, may even worsen.
Given that younger children and teenagers are less likely to follow CLEAR protocols in a structured manner with dedication as compared to an adult, it is usually not recommended for younger individuals who have a problem with complying with the guidelines. If such a patient continues to demand that the be associated with the CLEAR program, usually a waiver indicating that the individual is aware of their own non-compliance and the consequences thereof, may be required to be signed by the person taking the treatment.