COMMENTARY ON SCOLIOSIS

     Scoliosis is a curvature of the spinal column. Many cases involve little or no pain, and they result in only a mild deformity, which may not even be visible to the untrained eye. However, severe cases can involve a substantial deformity, and they may seriously endanger the individual's overall health because of direct pressure on vital organs such as the lungs and heart.

 Modern Medical, Osteopathic and Chiropractic Explanations of Scoliosis

      While the term scoliosis is specifically defined as any lateral (sideward) deviation from straight spinal alignment, the term is most commonly used to refer to severe cases of spinal curvature, which substantially unbalance the trunk and the body as a whole. The classic picture of a scoliosis sufferer includes a humped back, with major imbalances between the muscles on the right and left sides of the trunk. It should also be noted that the curvature of scoliosis does not occur just in the left-right plane, but also from back to front. In some cases the most serious aspect of the curvature is the rotational twisting of the spinal column toward the front of the body, in which the organs of the chest and/or abdomen may be affected.

      The cases of scoliosis which cause doctors greatest concern are those which begin in childhood, before the spinal bones have fully formed and hardened. If a curvature begins at this time, and progresses (worsens) unchecked, structural changes can be permanent and deforming. Therefore, while medical doctors, osteopaths and chiropractors may at times differ from each other (and among themselves) as to what therapy is best, all agree that progression of the curve must be well-monitored to assure that the situation is not worsening. They also agree that cases which continue to worsen despite treatment may require the use of braces or, in the most extreme cases, surgery.

      Scoliosis is not among the better understood medical conditions. Most cases are considered "idiopathic," which means that the cause is unknown. This does not mean that health practitioners are totally in the dark - it means that although some treatments are effective, the deeper causes of the condition remain unclear.

      Among the causes of non-idiopathic scoliosis are:

       1. Congenital spine deformity - where the spinal bones are deformed at birth;
       2. Muscle Disorders - where severe muscle imbalances are caused by damage to the nerves that supply them, as in cerebral palsy and other conditions;
       3. Trauma - where the fracture of a vertebra or deep scarring  in muscles (as in burn victims) has caused the curvature to form.

      In evaluating spinal curvature, it is important to determine whether structural factors elsewhere in the body may be causing the spine to curve as a compensation. For example, if one leg is shorter than the other, this creates a situation where the spine must form a scoliosis in order to create overall equilibrium in the body. Usually this involves the formation of one curve in the lower back and another in the upper back. In such cases, it is of great value to place a lift in the shoe on the short leg side, so that the body will not need to compensate for the leg inequality by forming the spinal curvature.

      Similarly, if there is a pelvic tilt causing the body to form a compensatory curvature, then chiropractic or osteopathic manipulation of the pelvic area is needed to create the necessary, balanced foundation.

     Research has shown that in growing children and adolescents the degree of pressure on the different parts of the epiphyseal plate (the surface where bone growth takes place) determines the pace of bone growth. If pressure on all parts of the growth plate is relatively equal and balanced, the bone of the vertebral body will grow symmetrically. If pressure is unequal, the bone will likely become malformed. A malformed spinal bone anywhere in the spine can force the rest of the bones to compensate and form a curvature.

     Therefore, in cases of juvenile scoliosis, any measures which serve to equalize the pressure on the various parts of the growth plate will lessen the likelihood of severe permanent curvature. This can include structural aids such as lifts and braces, where appropriate, as well as spinal adjustments and manipulations. Electrical stimulation of muscles at the side of the trunk has also been shown to decrease scoliosis in some cases, but only when applied on a consistent basis for a period of months.

The Cayce Readings Approach to Scoliosis

     The scoliosis Circulating File includes readings given for both children and adults. They make it clear that it is far better to deal with the condition early rather than waiting until permanent changes have occurred.

     The treatments recommended in the readings place strong emphasis on the value of spinal manipulation and massage. Depending on the specific case, manipulation is to be done by a chiropractor, osteopath or neuropath. (Neuropathy was an early twentieth century hands-on treatment method which involved tracing by hand the paths of the major nerves of the body). Cayce sometimes advises manual adjustments at particular levels of the spine (generally referring to these as "corrections"); while in other instances, he calls for more general relaxing forms of manipulation and massage.

     The spinal levels in need of adjustment vary according the individual case, but there is a recurrent focus on the lower back (the coccyx, sacral and lumbar areas). If these readings are representative of scoliosis cases, one might conclude from the readings that, at least from a structural point of view, imbalances in the lower back are crucial in the development of scoliosis. However, manual treatments called for in the readings are by no means limited to the lower back. Frequently, there are recommendations to adjust areas in the middle and upper back (dorsal spine) and the neck. In addition, Cayce often notes the need to "coordinate" the function of the lower spine with areas higher up the column.

     It is significant that in discussing the use of osteopathic or chiropractic manipulation for many of the patients with scoliosis, the readings advise an extended series of treatments, recognizing that the desired structural shifts could occur only gradually. There are, for example, treatment plans involving 2-4 visits per week for periods of six weeks at a time. In some cases, more than one of these six week periods is necessary. Patience and persistence are required in cases such as these.

     Massage therapy also plays a key role in these readings, often in combination with chiropractic or osteopathic treatment. Several different massage oil mixtures are recommended, each formulated to meet the needs of the individual for whom the reading was given. Among these are:

1. Olive oil and grain alcohol
2. Olive oil and myrrh
3. Peanut oil
4. Mutton tallow with spirits of turpentine and spirits of camphor
5. Gasoline with oils of cedar, mustard and sassafras
6. Cocoa butter, which followed glycothymoline packs applied to the spine

     Other treatment methods recommended in certain cases are:

1. Low-power electrical stimulation with the Wet Cell Appliance and the Radioactive Appliance. Unlike most conventional forms of electrical stimulation, the purpose of these appliances relates to balancing the body's overall energetic field, rather than strengthening specific muscles.
2. Exercise - stretching exercises done with caution and moderation
3. Laxatives - senna, syrup of figs, Castoria.
4. Bed rest
5. Wearing a support belt for lifting
6. Electrical stimulation with the Violet Ray
7. Manual manipulation of the pelvic organs to counteract the formation of adhesions, which could lead to spinal curvature.
8. Hot vapor baths
9. Spinal surgery (as an option in one case)

     One of the most interesting readings on scoliosis is 4529-1, in which Edgar Cayce elaborates on the process whereby scoliosis develops. Since the modern medical professions still consider this process to be idiopathic (cause unknown), the Cayce theory may offer fruitful ideas for later research, in addition to offering avenues of treatment not currently in use.

     In 4529-1, the readings attribute the origin of the condition first to poor eliminations, and soon thereafter to unbalanced nerve impulses in the lower back. A reflex arc is set up between the organs of elimination and detoxification (kidney, liver and bowel) and the lower spine. This is called a viscero-somatic reflex. This nerve reflex  in turn causes muscular contractions in the legs and elsewhere, which eventually lead to the curvature in the lower back.

     This is consistent with the basic theories of osteopathy and chiropractic, which place strong emphasis on the interplay between the spine and the internal organs. It offers a reminder to both doctor and patient that the cause of structural curvature may involve more than just imbalances in the structure itself. Diet and eliminations are also worth considering. Since a healthy diet and normal eliminations are widely recognized as good for the health of every body, this approach should do no harm, and may have beneficial effects beyond the initial presenting condition of the spinal curvature.

[NOTE: The above commentary was written by Daniel Redwood, D.C. and is included in the Circulating File for Scoliosis.]