Scoliosis is probably the most common spinal deformity encountered in clinical practice. But, if you look up scoliosis in the index of renowned child and adolescent neurology textbooks, and other neurology texts, it is surprising to find nothing under that heading. This is because traditionally, scoliosis is thought of as an orthopaedic condition, more related to bone structure and not neurological control over the musculoskeletal system.
Scoliosis is not only a 3-dimensional deformation of the spinal column, it is a condition of the neuromusculoskeletal system. In fact, it is almost certainly much more related to neurology than biomechanical.
💢 As for the seriousness of scoliosis, it has been associated with a lower quality of life (1-3), lower scores on health questionnaires (4),and a greater likelihood of developing chronic pain more often than the general population (5). The average curvature progression in idiopathic scoliosis is more than 7 degrees per year (6).
💢 From the mechanical viewpoint, most chiropractors, osteopaths and physiotherapists are quite comfortable with the idea that a short leg may contribute to a scoliosis. But is this all there is to it?
Is it solely the result of a short leg?
Or carrying a schoolbag over the same shoulder?
As chiropractor Matthew Long recently said on a blog – it might be time to move on from the idea of schoolbags causing scoliosis – and for good reason.
💢 Many of the proposed etiologies of idiopathic scoliosis are neurological in origin, including brain asymmetry (7), neural axis deformities (8), and central nervous system processing errors (9) and integrative problems (10,11). So, how might poor sensory input from muscles, ligaments and spinal joints to our brain contribute to scoliosis? Remember, that we have 100 billion neurons in our brain and up to 80,000 connections between each neuron. The question is, can a failure in communication between our sensory system, which perceives where we are in space, and our motor system, which coordinates our response to that position in space, be responsible for scoliosis?
