QuestionI am 26-years-old with a severe case of pectus excavatum (sucken chest) and associated scoliosis. My sunken chest and curved spine is pressing on my heart and lungs causing mitral valve prolapse and difficulty breathing, shortness of breath, exercise intolerance (I have yet to get a pulmonary function test). Over the past 3-4 months my back and hip pain (the scoliosis has also caused noticeable hip misalignment) has gotten progressively worse. I was under the impression that by reconstructing my sternum it would help re-align the rest of my body to help with the pain and avoid any problems in the future. However, I recently saw a thoracic surgeon and he did not believe it would help with the scoliosis and back pain. Do you have any experience or advice that you could give me? Any belief it could help my back in any way? I'm very confused about what to do and ANY info you have would help tremendously. Thank you for your time!
Answerscoliosis, pectus excavatum, curved spine, mitral valve prolapse, hip misalignment,
Hello Kara,
Sorry to hear of your complicated condition.
In chiropractic, there are often two slightly different schools of thought. One says that the upper spine, cervical spine is paramount, and as the c-spine goes- so goes the rest of the spine: diagnose and treat the c-spine and the rest will be fine. A second school of thought says the lower spine, the pelvis, lumbosacral area is most important because it is the base or foundation of the structure- diagnose and treat the lumbosacral spine and the rest will be fine.
The Thoracic spine is between these two sections. The thoracic spine is the structure that the ribs (chest) 'hang off' of. Your chest peculiarities (pectus excavatum) may be connected to spinal imbalance, or may be INTRINSIC to the chest (rib) structure. Your chest abnormalities probably did NOT cause the spinal changes.
In biology, in anatomy, there is a saying: find one idiosyncrasy, you will find others. I do not think that your spinal changes caused the pes excavatum, I do not think your chest problem caused your spinal problems. They are independent of each other, although they are often found together.
I prefer to use words like 'peculiarity', or 'idosyncrasy' rather than 'abnormality'. Abnormalities abound in anatomy. We ALL have abnormalities, but the lay public has such a bad feeling about the word 'abnormality' I use other words to help provide comfort and confidence to the patient. Even I have a spina bifida occulta, no one is perfect.
Unfortunately your structure will probably need surgery. Your rib structure is compromising your heart and lungs. We have to have good heart/ lung function or it impacts our entire life. I do not know of an alternative to surgery when the heart/ lung is compromised. Alteration of the structure of your chest is probably necessary to restore better function to your heart/lungs.
I also agree with your surgeon that the chest surgery will not affect your spinal structure much if any at all. IF, IF there were a connection, I would lean that the spine caused the thorax, rather than the chest causing the spine problems.
My advice: Follow through on the Thoracic surgeon's recommendations. Always get a second opinion. See an orthopedic surgeon (or two) for input on both the chest and spinal problems. Different specialties may offer different viewpoints and information for you to think on and decide upon.
My advice: See a local Doctor of Chiropractic as well. Perhaps a DC with additional education in orthopedics, rehab, and/or neurology. The public is often unaware that Chiropractors also have 'specialties'. I am a DACBSP (diplomat, american chiropractic board of sport physicians see http://www.ACBSP.com). There are additional specialties in neuro, ortho, xray, nutrition, pediatric, etc. See a Doctor of Chiropractic in your area, and if possible with additional education.
There are many techniques within chiropractic, from vigorous forceful manipulations- to mild low force (even no force) specific adjustment approaches. Before and or after surgery- there is a type of chiropractic applicable to your case of spinal misalignment.
I think you need surgical and chiropractic consults and treatment. I hope I gave you some information, wish I could do more. You are young- 26 y/o. You WILL heal. Have patience. You are going to have to have patience and work at this yourself, not just lay your conditions at the doctors feet.
A healthy lifestyle will help you recover from procedures. You are young, it will take time, you have time.
I utilize an informational handout in my Staten Island Chiropractic office, this does not touch upon pectus excavatum , but does cover scoliosis, I hope you find it helpful:
+++++++++++++++++++++++++++++++++++++++++++++
Scoliosis
Everyone's spine has a natural front-to-back curve -- that's what produces the normal rounding of the shoulders and the sway of the lower back. However, some people suffer from "Scoliosis" ?an abnormal curvature of the spine, especially one characterized by a rotational side-to-side deformity.
In simple terms, what this means is that the spine is twisted side-to-side, often taking on an "S" shaped appearance and even resembling a corkscrew in some cases.
Almost three out of every 100 people have some degree of abnormal spinal curvature, and for some it never becomes a serious problem. But for many others, the curve gets worse over time and can cause considerable pain, frustration, and limitations on normal activities. Severe scoliosis can even complicate breathing and circulation.
The current medical approach to scoliosis is to react to symptoms of curve progression, not to prevent potential progression. It is mainly a "wait and see" attitude - yes, you have it, but we'll just watch it for a while and when it starts to get worse, we'll do something!" However, according to the Journal of American Family Physicians, 1999, underarm thoroco-lumbar-sacral orthosis (TLSO) braces have a 74 percent success rate in slowing curve progression.
According to the AAOS figures, almost all cases of juvenile scoliosis (in children ages 3-10) progress. This group accounts for 15 percent of the scoliosis cases. Fifty percent of the cases progress to a point of surgical intervention. Adolescence scoliosis (in children older than age 10) comprises 80 percent of scoliosis in children, and 5 percent to 25 percent of these cases progress. The AAOS further states that if the curve is greater than 20 degrees at 10-12 years of age, there is a 68 percent chance it will progress. The AOS also concurs that even after bone maturity, especially in curves greater than 30 degrees, some progression occurs.
Who suffers from scoliosis?
The most common form of scoliosis is called idiopathic scoliosis, which basically means that the cause is unknown. Anyone can suffer from scoliosis; the condition usually begins in childhood, although too often it is not identified until the teenage years or later.
Scoliosis tends to run in families, and it affects many more girls than boys. In fact, research indicates that girls are nearly eight times more likely than boys to have scoliosis and five times more likely to require some form of treatment for their condition than boys, and the curvature of their spine is more likely to worsen over time, especially if left unattended.
What are some of the symptoms of scoliosis?
Sometimes curvature of the spine is visible (the body tilts to the left or the right, or one shoulder blade is raised higher than the other. Some of the actual physical symptoms of scoliosis can include back pain, fatigue (especially postural fatigue -- feeling tired when standing, sitting, etc.), and in more severe cases, problems with circulation and breathing.
What can chiropractic do?
Doctors of chiropractic are trained to identify and manage problems relating to the spine and the back. An initial visit to the chiropractor will include a thorough physical and diagnostic examination (including range-of-motion tests and spinal x-rays) to identify any problems you may be having, including whether you or your children may be suffering from abnormal or dangerous curvature of the spine.
If you do show signs of scoliosis, your chiropractor can provide a variety of techniques to help your condition, including spinal adjustments to increase movement and biomechanical function, and advice on posture and exercise to help prevent further increase in the problem.+++++++++++++++++++++++++++++++++++++++++++
Scoliosis and the Chiropractic Approach http://www.planetc1.com/chiropractic-articles/scoliosis-chiropractic.html
By Matthew Trull
Analysis of Findings
Scoliosis can be very serious. If detected early, the chances for stabilization and reduction of the curves are very good. In my family alone, we have two examples. My sister抯 Scoliosis was diagnosed when both her curves had already progressed to 45 degrees. She had Spinal Fusion surgery in Atlanta at Scottish Rites Children抯 Hospital. The surgery was successful; her curves were reduced to 20 degrees each. However, it was very dangerous, painful, expensive, and changed her life dramatically. My Scoliosis was diagnosed early, while I had only one curve that was 21 degrees. Following six months of Chiropractic care, I have been completely cured of Scoliosis. The approach was painless, inexpensive, and did not alter my life in any way. I believe Chiropractic care should be the first-line approach for all patients diagnosed with Scoliosis. My research has proven it has a very high success rate: 70% achieving stabilization and reduction, and 15% obtaining total correction!
Typical Treatment Options
Bracing: For curves 30-degrees or less, a Milwaukee brace is typically worn. It is a rigid brace that exerts pressure against the spine, in hopes of achieving stabilization. The brace is uncomfortable, unsightly, and is usually worn 20-24 hours per day, until the patient stops growing. It offers no correction, and is only marginally effective for stabilization. Surgery: An orthopedic surgeon performs Spinal Fusion surgery. The patient is placed on a spinal cord monitor to prevent paralysis. After performing an incision, the surgeon manually reduces the curves as much as possible, and inserts metal rods on each side of the spine, attaching them with special hardware. Bone splinters (either removed from the hip area, or donor bone) are applied between the vertebrae. Over time, these fragments grow together to create a solid bone. Surgery is very expensive, painful, dangerous, and requires the patient to alter their lifestyle forever. Surgery is very effective for reducing curves. Surgery should be considered a last resort.
Signs of Scoliosis
Most obvious signs of Scoliosis are: shoulders of unequal height, a 憆ib hump? which is caused by the ribcage on the back protruding more on one side than the other, and hips that appear unequal in height. Scoliosis clinics are conducted free of charge by health Departments and Chiropractors. A school or Health Department nurse or Physical Education teacher routinely screens students during the middle school years. It is extremely important to diagnosis and treat Scoliosis as early as possible.
Special Thank-You
I want to thank Dr. Marc Schnobrich, of Rincon Chiropractic, for all the many ways he has helped my family and me. He diagnosed my Scoliosis while treating me for an elbow injury. During the following months, he treated me weekly, always explaining what he was going to do. He provided excellent chiropractic care in many other areas, as well. Dr. Marc checked my spine often for progress. After six months of care, I was completely cured!
Dr. Marc has always been very kind, caring and helpful. He has been my friend as well as my doctor! During my research for this project, he loaned me books and other research materials. He patiently answered questions, and was never too busy to talk to me on the telephone between visits. He also answered my emails promptly and accurately. Thanks to Dr. Marc抯 care, I will be able to continue my normal lifestyle, which includes baseball and many other physical activities.
Thank you, Dr. Marc!
Conclusion
Spinal Fusion surgery is very painful, expensive, and will alter the lifestyle of the patient forever. Surgery should be considered the last alternative in treating Scoliosis. Wearing a Milwaukee Brace is uncomfortable, limits physical activity, offers no correction, and is mostly ineffective in stabilizing the spine. The Chiropractic approach is very effective at stabilizing the spine, preventing the curve from progressing. At least 70% of the patients achieve some degree of reduction in the size of the curves. Approximately 15% of Scoliosis patients achieve total correction, like I did! That means at least fifteen out of 100 patients will not have to face surgery, take medications, and change their lifestyle forever! All of this is done with a minimum of cost and no pain! Research and experience have proven Chiropractic care is definitely effective in the stabilization and reduction of Scoliosis! Chiropractic care should be the first-line approach for all Scoliosis patients.
Chiropractic Facts
The first Chiropractic adjustment performed on the North American Continent was in 1895, by Dr. Daniel David Palmer. His first patient experienced deafness following a back injury. Following care, the patient reported improved hearing. Dr. Palmer founded the Palmer School of Chiropractic in Davenport, Iowa, which continues to train Chiropractors today.
Spinal manipulation has been practiced since the beginning of recorded time. Over 2700 years ago the Chinese documented this form of treatment. Records indicate that ancient Japanese, Indians, Egyptians, Babylonians, Syrians, Tibetans, and Native Americans practiced a hands on approach to health.
An estimated 19.5 million Americans visit a Chiropractor each year.
There are over 50,000 licensed Chiropractors in the United States, and another 30,000 worldwide.
Chiropractic is the world's second largest health care profession. It promotes the body抯 own ability to heal itself. Chiropractic uses no drugs or surgery, and is all-natural.
Evaluation of Work
I believe whole-heartedly in Chiropractic Care for Scoliosis. I am living proof that it works! I thoroughly enjoyed researching this project. I was eager to find if others had similar success. I was delighted to find that more than 2/3 of the Scoliosis patients seeking Chiropractic care had very good results. It was fascinating to speak with Chiropractors who treat Scoliosis on a regular basis. I found them to be very caring, dedicated professionals. I accompanied my sister to Atlanta for her Spinal Fusion surgery, and remember the excruciating pain she suffered. I see her daily life changed. I wish my parents had been aware of Chiropractic when my sister was diagnosed with Scoliosis. Maybe next year I抣l research why more health care professionals don抰 offer Chiropractic care as an option to their Scoliosis patients. More public education is definitely needed in this area!
Scoliosis- is an OBVIOUS Misalignment of the spine. The spine compensates- like dominoes - - - one falls here, and the final domino may be far distant !, Like the old song- the toe bones connected to the foot bone, the foot bone to the ankle bone, the ankle bone is connected to the leg bone, the leg bone is connected to the knee bone, etc etc etc. the body is all interconnected and interdependent. A misalignment (subluxation) in the spine can cause a compensation elsewhere contributing to an abnormal curvature- known as a SCOLIOSIS.
Scoliosis: a misalignment of the SPINE often contributed to by:
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
The kinesiopathology of the subluxation (misalignment, improper movement pattern) is often involved with scoliosis, and can sometimes be the cause of the curvature.
A subluxation interferes with the proper functioning of joints, and can cause scoliosis, osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body- i.e.: muscles) and may cause various other conditions, symptoms and problems.
Subluxation is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Inflammed Discs can easily bulge, herniate, tear, or degenerate. Other soft tissues may also suffer permanent damage.
Pathophysiology:
The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Vertebral Subluxation may cause Spinal Scoliosis, Arthritis, Disk Herniation, Disk Degeneration, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment by Doctor of Chiropractic. Scoliosis??- nothing better then the CHIROPRACTIC Adjustment. Plus- do your at home exercise (ie 慼anging? as instructed.
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
++++++++++++++++++++++++++++++++++++++++++++++++++
I hope this information helps. You do not have an easy road ahead, but you can travel this road and come out the other side in much better shape. Get second opinions, but I do not disagree with your thoracic surgeon. See a Chiropractor as well.
Good luck, I wish you good health naturally, your Staten Island Chiropractor signing off,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
