Adult Spinal Deformity

The Silent Menace

How Adult Spinal Deformity Outweighs other Chronic Conditions in the Health Drama of Life.

When you think of health-related quality of life (HRQL) concerns, chronic conditions like arthritis, lung disease, diabetes, and congestive heart failure probably top your list.

But hold onto your lumbar support because Adult Spinal Deformity (ASD) is here to steal the spotlight.

A study spearheaded by Ferran Pellisé and his team from the European Spine Study Group has shed light on just how impactful ASD is compared to these well-known chronic conditions. Spoiler alert: ASD is the unsung heavyweight champion.

Prepare yourself for a deep dive into the world of ASD, where we uncover its dramatic effects and explore a scientific and practical path to relief through Chiropractic BioPhysics (CBP) care.

ASD: The Heavyweight Champion of HRQL

The study conducted by Pellisé et al. compared HRQL scores of individuals with ASD to those with arthritis, chronic lung disease, diabetes, and congestive heart failure. Using data from the International Quality of Life Assessment project, which included 24,936 individuals from eight industrialised countries, the study employed the SF-36 health survey to measure HRQL across various domains.

For those of you really paying attention – yes these are the same testing protocols we use in the Clinic.

To qualify for the ASD group, participants had to meet strict criteria: age over 18, scoliosis curve greater than 20°, sagittal vertical axis over 50 mm (also known as sagittal balance), pelvic tilt beyond 25°, or thoracic kyphosis exceeding 60°. This meticulous selection ensured that only those with significant spinal deformities were included, resulting in 766 participants. We shall get back to the selection criteria a little later as it quite important for all patients.

Numbers That Speak Volumes

The results were striking. Across all SF-36 domains, ASD patients scored significantly lower than those with any other chronic condition. For instance, while individuals without chronic conditions scored between -2.5 to -14.1, ASD patients’ scores ranged from -10.9 to a jaw-dropping -45.0.

Physical function, role physical, and pain domains were particularly affected. Surgical candidates for ASD displayed the worst HRQL scores, ranging from -17.4 to -45.0. Even those who had undergone surgery fared poorly, with scores lingering between -10.9 and -33.3, still worse than those with other chronic conditions.

The Silent Struggle of Adult Spinal Deformity

Adult Spinal Deformity (ASD) is an increasingly common structural condition we encounter in practice. It is characterised by abnormal curvature of the spine in adults and encompasses several types of spinal irregularities, including scoliosis, kyphosis, and lordosis:

• Scoliosis involves a lateral, or side-to-side, rotation and curvature of the spine. This condition is more common in young girls and women.
• Kyphosis is characterised by an excessive forward curvature of the spine, resulting in a hunched back. Think of your elderly mother, irritating uncle, or crusty old grandfather who spent most of their time looking at the ground. The kyphotic changes of ASD are very common in the mid-back (thoracic spine) and, as it becomes more severe, the neck (cervical spine).
• Lordosis refers to an excessive posterior curvature, typically in the lower back (lumbar spine), sometimes resulting in a ‘sway back’. The increased lordosis is often in response to the kyphotic changes occurring above. In ASD, your lower back has to work really hard, desperately trying to hold the body up. Eventually, no matter how ‘tuff’ you are, your lower back and hips give out, and you start to collapse forward. In time, you give in to using a walking stick or frame just to stay upright. It’s hard to fight gravity.

These deformities can develop due to various reasons, including degenerative changes in the spine due to incorrect ageing, chronic misalignment or subluxation, previous spinal surgery, congenital defects, or conditions like osteoporosis that weaken the bones and create more kyphotic changes.  Unlike spinal deformities in children, which are often idiopathic (of unknown cause), adult spinal deformities are frequently associated with these underlying conditions.

ASD leads to significant physical and functional impairments. The abnormal curvatures can cause severe back and leg pain, stiffness, and muscle weakness, greatly limiting mobility and the ability to perform everyday activities. Individuals with ASD may experience difficulty walking, standing, or sitting for extended periods. The condition can also lead to balance issues, increasing the risk of falls and further injury.

Moreover, the chronic pain and disability associated with ASD can lead to psychological issues such as depression, anxiety, and social isolation, severely affecting overall quality of life.  The emotional toll, coupled with physical limitations, makes managing ASD particularly challenging.

Hope on the Horizon: Chiropractic BioPhysics Care

Adult Spinal Deformity (ASD) is a complex and often debilitating condition that can severely impact one’s quality of life. Fortunately, Chiropractic BioPhysics (CBP) offers a non-invasive, effective approach to managing and alleviating the symptoms associated with ASD.

Chiropractic BioPhysics is a scientific and research-based advanced chiropractic technique that focuses on restoring and maintaining proper spinal alignment. By correcting spinal misalignments, CBP aims to improve overall health and function. This method integrates principles of biology, physics, geometry, and physiology to create a comprehensive approach to spinal care.

The protocols we use are those developed by the CBP worldwide community and regularly published in some of the top journals in the world.

The CBP Approach

CBP care begins with a thorough assessment, including detailed x-rays and postural analysis, to understand the specific nature and extent of the spinal deformity. By pinpointing the exact areas of misalignment, Corrective Chiropractors can develop a personalised treatment plan tailored to each patient’s unique needs.

CBP employs a combination of mirror-image exercises, spinal adjustments, and traction to correct spinal alignment:

• Mirror-image exercises involve movements that counteract the abnormal curves, promoting proper posture.
• Spinal adjustments help realign the vertebrae, reducing nerve interference and pain.
• Traction applies sustained pressure to specific spinal segments, encouraging structural correction over time.

Benefits of CBP for ASD

Patients undergoing CBP care often experience significant improvements in pain levels, mobility, and overall function. By addressing the root cause of the deformity rather than just the symptoms, CBP provides long-term relief and typically helps prevent or slow progression of the condition. Additionally, the non-invasive nature of CBP makes it a safer alternative to surgery, with minimal risks and side effects.

A Brighter Future with The Spinal Centre

In Practice we often talk about being trapped in a body that does not work. We all know someone that embodies this concept. An aunty, an uncle, a grandmother, or even our parents may be deteriorating before our eyes. It is not really about ‘life span’ it is about ‘health span’.

Or to put it another way; How much life you have in your years. Not how many years you have in your life. It is hard to change life span. But we can affect health span.

This study really hits home on the concept of ensuring your body works now and into the future. The fact that Adult Spinal Deformity affects your health related quality of life more than chronic conditions like diabetes and heart failure is mind blowing.

The bigger issue though, is that significant structural and postural problems (or ‘deformity’ as the study defines) are getting worse within the population – not better. Just wander around a shopping centre for the afternoon and observe people’s posture, movement and deportment. To be blunt, we are a mess. You can see the results of this study in real time.

Tragically, the inclusion criteria of degenerative scoliosis, sagittal balance, pelvic tilt and thoracic kyphosis are disconcertingly evident in the border public. I suspect many of these people are not under high quality Corrective Chiropractic care, but are just using drugs to try and manage their symptoms. It’s like rearranging the deck chairs on the Titanic – she is still going down!

Remember you cannot drug yourself out of structural problem, any more than you can use a fuel additive to fix your wheel alignment.

Let’s unpack it a bit:

• Degenerative Scoliosis with curve greater than 20°. We see about 60% of women over 60 now have some type of degenerative scoliosis. It is very important to stabilise the scoliotic change to manage and reduce progression. As the study shows, the worse the scoliotic changes, the greater the sagittal imbalance and the worse the thoracic kyphosis (hunching of the mid back) the greater pain and disability suffered by the patient.
• Sagittal Balance – off centre from the Vertical Axis over 50 mm. Your head, neck, shoulders, back and pelvis should all basically line up. If they don’t you have a sagittal balance issue. Usually most people go forward. They hunch down and forward driving the loss of height as we age. The measure of 50 mm translation spread over the entire spine is quite a lot. However, we now see teenagers with 40 mm of forward head translation in their neck alone! Text neck anyone?  The use of phones and technology, while making our life a little more comfortable, is literally destroying our health.
• Pelvic Tilt beyond 25°. It is not normal to have leg length anomalies and pelvic rotation patterns. They are becoming more common and often ignored from a medical viewpoint as irrelevant. Not so as the study shows. Perhaps if hip replacements were not so popular and profitable for everyone except patients we might address pelvic tilt before it hits 25 degrees.
• Thoracic Kyphosis exceeding 60°. An increased thoracic kyphosis – or hunching of your mid back – is a big deal. Not only does it look unsightly and is embarrassing, it significantly impacts on your quality of life. We now see very strong evidence it is associated with many health conditions, disability, chronic pain, organ issues, reduced lung capacity, increased pressure on the heart and fibromyalgia.

Your thoracic spine should have a forward facing curve called a kyphosis of about 44°. If the thoracic kyphosis increases above 60° then you are considered to be ‘kyphotic’ and you may actually fall within the parameters of this study. For those that speak human, you are developing the ‘old lady hunch’.

The issue is that if you are tall, reasonably muscled, or other areas of the spine are good at compensating for it you may not notice the kyphosis. Interestingly, it’s often your lower back that ‘notices’ the kyphotic changes in your mid back, and you ‘notice’ your lower back because it starts to get stiff and painful from years of overwork. You know you are not right – you are just trying to put up with it. To assess this area properly, in terms of the kyphosis and any type of translation, your Chiropractor will have to measure it on X-rays.

We would contend that all patients under care should know the numbers relating to the three curves of the spine. You should also know if you translate in each section of the spine forward, backward or to the side.  If you don’t, chat to your chiropractor. If your chiropractor doesn’t know, or you don’t have a current set of X-rays, then you may want to get a second opinion.

We would argue you cannot address your spinal health, or effectively self manage your posture, if you are not aware of these basic numbers. A little like a diabetic who does not know what their blood sugar levels are. Or a heart patient who has no idea what their blood pressure or pulse should be. You don’t have to know – but you would probably get a better health outcome if you did.

Shining a Light on Adult Spinal Deformity

The impact of Adult Spinal Deformity on health-related quality of life is profound and far-reaching. This condition, often overshadowed by more commonly known chronic diseases, deserves our attention and action. By recognising the significant burden of ASD, we can advocate for better research, improved treatments, and more supportive policies that enhance the lives of those affected by this condition.

Adult Spinal Deformity is not just a physical ailment; it is a life-altering condition that affects every aspect of a person’s existence. Conditions like scoliosis, kyphosis, and lordosis, which fall under the ASD umbrella, involve abnormal curvature of the spine. These deformities lead to severe pain, reduced mobility, and difficulties in performing everyday tasks. Imagine struggling with basic activities like walking, sitting, or even sleeping, constantly battling pain and discomfort.

The psychological toll of ASD is equally significant. Chronic pain and physical limitations can lead to depression, anxiety, and social isolation. The constant struggle to manage the condition can drain an individual’s emotional and mental resources, further diminishing their quality of life.

For those suffering from ASD, Corrective Chiropractic offers a pathway to better health and improved quality of life. By realigning the spine and promoting proper posture, CBP can help patients regain mobility, reduce pain, and enhance their overall well-being. If you or someone you know is struggling with ASD, consider exploring CBP care as a hopeful and effective solution.

Adult Spinal Deformity is a formidable adversary in the realm of chronic conditions, significantly impacting health-related quality of life. However, through research and innovative treatments like Chiropractic BioPhysics, there is hope for those affected. By shining a light on ASD and advocating for comprehensive whole body care, we can help individuals reclaim their lives and look forward to a brighter future with less pain and disability.

Adult Spinal Deformity is Not just a Spinal issue – It is a Life issue.

As we move forward, let us strive to bring more awareness, understanding, and compassion to the silent struggle faced by individuals with Adult Spinal Deformity. Together, we can make a difference in their journey towards better health and quality of life.

The Spinal Centre – Neuro-Musculoskeletal SolutionsThe Spinal Centre provides the Best Natural Medicines, Health Products and Nutritional Solutions to Free You of Pain and Improve Your Spinal Health.The Spinal Centre is a leader in the management and treatment of spinal pain and disability including:

• Chronic Back and Neck Pain
• Cervical and Lumbar Disc Injuries with or without neruological changes
• All forms of arthritis including rheumatoid arthritis, psoriatic arthritis and osteoarthritis
• Neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease
• Neuromuscular problems such as chronic back pain, headaches, migraines, neck or spinal pains
• Myofascial pain syndromes such as fibromyalgia, diffuse muscular or joint pains
• Austistic spectrum disorders including ADD, ADHD, learning difficulties and autism
• Fatigue, energy and mood disorders including chronic fatigue and depression

The Spinal Centre focuses on resolution with the development of individualised treatment programs using Conservative and Integrative Medicine; combining genetic, metabolic and nutritional testing with specific natural medicines to enhance your health and achieve your genetic potential.We have helped thousands – Why Not You?