home Adviсe Treatment methods for grade 3 scoliosis. Third degree scoliosis: danger, symptoms, methods of treatment and prevention. There should be four types of loads in exercise therapy

Treatment methods for grade 3 scoliosis. Third degree scoliosis: danger, symptoms, methods of treatment and prevention. There should be four types of loads in exercise therapy

According to statistics, more than 40% of people suffer from various forms of spinal curvature, with scoliosis in the first place. Every year the number of children who are diagnosed with this disease increases.

Scoliosis grade 3 is a significant curvature of the spine and requires mandatory treatment.

Scoliosis of the spine

What is scoliosis?

Almost everyone has an idea about scoliosis. This is a curvature of the spine to the right or left (in medicine they say in the frontal plane). In addition to the deviation of the spinal column, many changes occur in the human body associated with this condition.

The main criterion by which the degree of the disease is judged is the magnitude of the arc of curvature. It is measured in various ways after an x-ray. With grade 3 scoliosis, the arc angle is large and ranges from 26 to 50 degrees.

Scoliosis can also be simple with one arch (C-shaped) or complex with two arches along the entire length of the spine (S-shaped).

Types of scoliosis

Causes of scoliosis 3 degrees

Even today, scientists have not been able to find out the true cause of the disease. There are only theories of its origin.

Causes of grade 3 scoliosis:

incorrect or asymmetrical load on the spine;
disruption of vertebral growth during skeletal development;
diseases of the endocrine system, as a result of which the vertebrae become more susceptible to stress;
progressive diseases of the nervous system often lead to curvature of the spine;
imbalance in the growth of the skeleton and muscles, usually this occurs during the period of active development of the musculoskeletal system (from 6 to 7 years and from 10 to 14 years).

Incorrect posture can cause spinal curvature

Symptoms of scoliosis grade 3

Scoliosis of the 3rd degree is noticeable not only by external signs; as the disease develops, all internal organs suffer. Clinical manifestations depend on the person’s age, the causes of the disease, the location of the curvature and many other factors.

Conventionally, symptoms are divided into two types: external changes and damage to internal organs.

Symptoms of grade 3 scoliosis:

asymmetry of parts of the body, with a thoracic curvature of the spine, one shoulder is lowered, the head is shifted more to one side, when examined, the navel is not on the center line, one shoulder blade is lowered, the other is slightly raised;
lumbar scoliosis of the spine of the 3rd degree is characterized by an incorrect position of the iliac bones of the pelvis - one of them is raised, and due to the distortion of the pelvic bones, one leg is raised, that is, shortened;
during examination of a person, when the body is tilted forward, a hump or spinous processes of the vertebrae are noticeable;
internal organs suffer – the likelihood of developing diseases of the upper respiratory tract, heart and vascular diseases increases;
diseases of the digestive system appear: gastritis, peptic ulcer;
in addition to all the symptoms described, the person is bothered by back pain and constant weakness;
the muscles cease to function as a corset for the internal organs, protrusion of the abdomen occurs, and an abdominal hernia may occur.

Scoliosis grade 3 is easy to notice when bending forward

As the spine grows, constant changes occur in the human body, so some symptoms of scoliosis sometimes intensify.

Diagnosis of grade 3 scoliosis is not difficult. This disease is usually detected during preventive examinations.

Treatment of scoliosis 3 degrees

Treatment of scoliosis is a long process and requires patience. It consists of several stages:

regular massage, several sessions per year;
a set of exercises or therapeutic exercises;
drug therapy, including the prescription of anti-inflammatory, painkillers and chondroprotectors;
wearing a corset;
surgical intervention if necessary.

Unlike previous stages of the disease, treatment for grade 3 scoliosis is more difficult. In most cases, you have to use all available methods, but even the most effective ones do not always help. For example, massage is not used as one of the stages of treatment, but as supportive exercises after surgery. Physical therapy by itself will not bring the desired result, since it will not correct the deviation of the arc to a significant extent, by more than 40 degrees.

Corset for the spine

The program for correcting spinal curvature is selected individually and depends on the cause, extent of the lesion and concomitant diseases.

Therapeutic exercises

In an attempt to cure scoliosis, you need to resort to all possible treatment methods. After the examination, the person is referred for a consultation with a doctor for physical therapy. The set of exercises must be chosen carefully; excessive load can lead to irreparable consequences. There should be no forceful methods of influencing the affected spine, sudden movements, or somersaults.

you need to start the exercises by walking in place while maintaining posture for several minutes;
a child or adult slowly rises on his toes with his arms raised, then returns to the starting position;
in a position lying on the stomach, the right hand should be extended forward, the left hand should look with the palm at the floor and is laid to the side, while the right leg is gradually withdrawn to a slight angle of 20 degrees, in this position the adult or child remains for several seconds and returns to its original position position;
position - lying on your stomach, you need to raise your head up along with the shoulder girdle, then lower your head down;
the exercise resembles the previous one, but as you inhale, you need to raise your head, arms and right leg (more often it is used for S-shaped curvature).

This cycle of exercises begins every morning and must be repeated at least three to four times. Additionally, it is recommended to do special physical exercises in water, but only with the support of an instructor.

Gymnastics for scoliosis (example)

Other treatments

One of the conservative treatment methods is wearing a corset. This is the basis for the treatment of grade 3 scoliosis. It is recommended to wear it for 18 hours. With a curvature arc of 25 degrees or more, this method can become the main one. Sometimes it is possible to completely correct scoliosis, but you should not wear a corset for 24 hours, as it promotes muscle atrophy.

Surgery is a way to treat spinal curvature if other methods are not indicated or are ineffective. Using metal rods, the curvature of the spine is fixed to a certain angle.

When to resort to surgical methods:

with progressive scoliosis, if the condition worsens during the year, when the curvature of the arch increases by more than 10 degrees;
Some types of congenital scoliosis are recommended to be treated surgically;
in case of development of persistent severe pain syndrome;
visible serious spinal deformity and cosmetic defects.

Surgical treatment of curvature

In some cases, disability is issued for grade 3 scoliosis, when the disease progresses rapidly and treatment is ineffective. Most often they give the third disability group.

Scoliosis of the third degree is not a death sentence, but the disease can cause many problems. The main task of a person is to be observed by doctors in a timely manner and to follow all the instructions of specialists.

Aug 22 2019

During the third stage, not only the spinal column suffers from scoliosis (there is a change in the spatial arrangement of the vertebrae relative to each other, displacement in the lateral plane and their “twisting”), but also other elements of the human skeleton. As a result, persistent violations of posture occur, the progression of negative changes in the internal organs (correct location and functioning), the degree of their severity depends on the severity and characteristics of the spinal deformity.

Why does scoliosis progress?

No specialist at a scoliosis treatment center will be able to accurately determine the single cause of the onset and progression of the disease in a particular patient. Scientists have proven that in patients with identical indicators (age of diagnosis of the disease, physical activity, nutrition, lifestyle), the rate of progression of scoliosis can vary significantly.

For this reason, immediately after detecting any signs of spinal scoliosis in a patient, treatment begins immediately in order to stop and, if possible, reverse all negative changes, which is easier to do in the initial stages of the disease.

Many reasons can lead to the progression of changes in posture, both individually and in combination:

Long-term non-physiological loads on the spine: static, in which a person is constantly or often in a forced position, and dynamic, in which a person constantly lifts a load with an incorrect distribution of its weight.
Various metabolic disorders caused by diseases and pathologies of the endocrine glands, which leads to disruption of calcium metabolism in the body.
injuries of the spine as a whole or its individual components.
Violations of the correct tone of the back muscle corset.

Manifestations of grade 3 scoliosis

Even a person who is completely ignorant of medicine and in particular orthopedics will visually notice manifestations of scoliosis in himself or others.

First of all, this refers to the deviation of the spine from its vertical axis by 25-500C. The deviation inevitably affects the appearance of the chest - the formation of a costal hump begins, located at half of the maximum curvature. This change is accompanied by a simultaneous “compensatory” deformation - a visible distortion of the pelvis and shoulder girdle begins, they are especially noticeable in women, since the breasts also become asymmetrical.

Treatment of grade 3 scoliosis requires not only correction of posture, but also control of pathological functional and organic changes in the internal organs of the pelvis, abdominal cavity and chest.

Treatment of stage III scoliosis

Today, treatment of scoliosis, even in such an advanced stage, can be carried out either conservatively or by surgical intervention on the spine and adjacent anatomical formations. Surgical treatment is not indicated in all cases, but complex conservative therapy gives fairly good results if the patient fully and systematically follows all the doctor’s prescriptions.

Conservative remedies include:

Exercise therapy according to the Katharina Schroth method.
Wearing a custom made Chenault corset.
Massage treatments.
A variety of physical therapy (traction, acupuncture, etc.).
Wearing orthopedic devices in the form of insoles, etc. (does not give a very quick or noticeable result, but allows you to partially relieve tension from the spinal column and adjacent muscles), etc.

Schroth Katharina scoliosis treatment method

This is a system of therapeutic exercises developed in the 20s of the last century by Katharina Schroth and which over time became the standard of exercise therapy in the complex of conservative treatment of scoliosis, first in Germany and then in European countries. Over the past few decades, the Schroth method has been effectively practiced in Russia.

The main goal of exercise therapy according to Schroth is to stop the progress of spinal curvature, reduce the existing angle of deformation, correct muscle imbalance, and correct externally manifested cosmetic defects.

The complex is based on breathing, derotational, that is, aimed at turning the vertebrae into the correct position, isometric and other exercises that strengthen the muscle corset and eliminate its asymmetry. Thanks to the exercises, pain is significantly reduced, correct and full breathing is restored, deformity is corrected and the correct position of the spine is fixed in three planes.

Chenault corset

Non-surgical treatment of the spine in a hospital for scoliosis in advanced stages almost never takes place without the use of a custom-made orthotic design. The most effective of them is considered to be the Chenault corrective corset, developed in the 70s of the last century by the French doctor Jacques Chenault.

The principle of operation of the corset is to apply pressure to protruding areas of the body deformed by scoliosis, as well as to create zones of free space for the redistribution of retracted sections. The use of a Chenot corset can significantly reduce the manifestations of deformity in advanced stages of scoliosis, and in its initial stages even achieve complete reverse correction to a normal state.

The creator of the corset himself believes that its design is 75% active and 25% passive. This means that active influence corrects the spine based on physiological factors of the body - height, physique, breathing, body movements, etc. Passive impact is based on selective pressure on convex parts of the body, provoking their movement into empty areas allowed by the design.

The Chenot corset is used for childhood and youth scoliosis with a curvature angle of 200 and in adulthood with a progressive curvature of more than 200.

Results of using the Chenault corset:

Preventing the progression of spinal column deformation during the period of active childhood and adolescent growth.
Restoring the normal balance of the spine.
Correction of spinal column deformity arcs in three planes.
Consolidation of the progress achieved in correcting the deformity or its significant slowdown until the period of growth of the spinal bones has completely ended.
Reducing pain.
Improving the general posture and well-being of the patient.

Despite the high effectiveness of treatment, experts draw attention to the fact that long-term use of the Chenault corset leads to atrophy of the back muscle corset, which in the future can lead to relapses of the disease and even greater deformation. Therefore, the optimal tactics for non-surgical treatment is considered to be a combination of long-term wearing of a corset, intensive exercise therapy, visiting a chiropractor, physiotherapy, etc.

Surgical treatment of scoliosis

If the patient does not fully comply with the instructions of the attending physician or his disease rapidly progresses (the angle of curvature increases, deformities of the spine and adjacent structures appear), then conservative therapy will be of little benefit. In this case, surgical intervention in combination with intensive postoperative rehabilitation programs is necessary.

In each individual case, doctors decide on surgery individually after an in-depth examination of the internal organs and systems, assessing their condition and the degree of curvature of the spine from scoliosis.

Recently, age is no longer the main factor in recommending or prohibiting surgery. For example, even a small child will be indicated for surgery if there is an advanced stage of scoliosis, despite the fact that the period of active bone growth has not yet completed.

Indications for the operation are:

Progressive scoliosis with a deformation angle of 600 or more, since this condition negatively affects the functioning of the internal organs of the chest, especially the functioning of the lungs and cardiovascular system, causing pulmonary and cardiovascular failure.
Severe pain syndrome that is not relieved by taking non-steroidal anti-inflammatory drugs and other painkillers, but goes away after taking narcotic painkillers.

Relative indications are:

The deformation angle is about 400.
The appearance of noticeable defects in appearance that negatively affect the patient’s quality of life, self-esteem and performance.

Depending on the age of the patient (the starting point is the end of the period of active growth of the skeletal bones), various systems are used during the operation to stabilize the spine and perform reverse corrections.

For patients over 14 years of age and adults, decompression and stabilization systems are installed, which represent a fixed connection of several elements of the spinal column. However, in this case, not only the deformation, but also the growth and further development of the fixed part stops. Gradually, the deformation of the spine decreases due to the growth of other segments, and the risk of injuries to internal organs decreases.

For children under 14 years of age, in the surgical treatment of grade III scoliosis, the Luque or Cortel-Dubousset, Harrington systems are used, which do not limit further growth and development of the vertebrae after installation. However, for the first time after surgery, the same Chenot corset and active rehabilitation programs of exercise therapy and physiotherapy may be required.

Scoliosis and disability

Treatment of spinal diseases, in particular grade 3-4 scoliosis, is sometimes ineffective and ends with the patient being assigned one or another disability group. The decision on this is made by MSEC after an appropriate examination and assessment of the degree of disability due to the progression of lesions of internal organs.

To establish disability it is necessary:

diagnose the clinical and radiological degree of curvature of the spinal column;
characterize the course of the pathological process - scoliosis is progressing or not;
find out the frequency and duration of exacerbations of pain; it often accompanies, for example, S-shaped scoliosis of the 3rd degree in combination with neurological disorders;
conduct an assessment of respiratory and cardiovascular activity to identify disturbances in their work.

Most often, when treating postural disorders in the form of grade III scoliosis, the third (less often the second) disability group is established. After receiving it, an individual program is necessarily developed for each patient, which can be completed at spinal rehabilitation centers in your region of the country, including treatment in specialized sanatoriums, hospitals, etc.

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Scoliosis is an anomaly that can lead to serious consequences in the absence of adequate treatment.

It occurs both in childhood and in adults, and of the 10% of children with this problem, only 1% require treatment.

In older people, scoliosis may be associated with spinal problems. In the third stage of curvature, scoliosis is visible to the naked eye and difficult to treat.

The concept of degrees of development of curvature

There are four degrees of development of scoliosis depending on the angle of curvature:

First degree– deviation from the axis by no more than 10%. Considering that every person has a slight deviation, the first degree threatens a person with absolutely nothing. Often doctors, when making such a diagnosis to a schoolchild, intimidate with dire consequences, but in fact, if the stage of curvature is no more than the second, then it will not affect the health in any way, and even more so does not require any treatment.
– the problem is more complex and the percentage of deviation from the axis is already from 11 to 25 and requires correction. If you start the second degree, the disease will develop very quickly, so you should hurry with special gymnastics and.
Third degree– a deviation that is 25-50% to the left or right of the axis.
– deviation more than 50%.

Threats and dangers of the third stage of violation

Scoliosis of the 3rd degree is already a problem that not only disfigures a person’s figure, but also worsens the condition of internal organs and systems, discs, joints and vertebrae suffer, and there is a high probability of disability. This stage already brings psychological and physical discomfort.

The main task of doctors and the patient at this stage is to do everything possible to correct the position of the spine to. This work is quite difficult, but real (with adequate treatment, exercise therapy, proper nutrition).

If the doctor puts 2-3 degrees of scoliosis, and this is 25 percent deviation to the right or left, then the sooner treatment begins, the greater the likelihood that the condition can improve to 1 degree.

If the angle of curvature reaches 40, it is already pointless to treat with physical training and procedures, since at this stage surgical intervention is required.

An advanced stage of scoliotic disease can be a serious threat to human life and health:

a person, realizing his physical deviations from the norm and the visual perception of himself from the outside, often falls into depression, which also disrupts his general mental state, causing mental disorders to appear;
women with the third stage of scoliosis may face not only gynecological problems, but also infertility;
the higher the percentage of deviation from the norm, the greater problems will arise with the heart and blood vessels, kidneys, gastrointestinal tract, lungs;
a consequence of an advanced disease is atrophy of the muscles of the back, abdomen, and limbs;
prolonged severe pain.

Varieties, forms and locations

In the process of researching scoliosis, many different ones have appeared, based on the form and types of the disease.

According to V. Chaklin:

Scoliosis mild– deviation from the norm from 5 to 10 degrees. If the patient takes a horizontal position, it is practically invisible.
The next stage in the development of the disease, when the curvature is noticeable in any condition and position, rib humps may be observed due to improperly fused bones.
Curvature angle more than 30 degrees, which gives complications to the heart and lungs.
Cutting scoliosis - pronounced and accompanied by severe pain with sudden movements. At this stage, a hump is necessarily present and pathological changes in internal organs and systems occur.

Classification of scoliosis according to V. Chaklin

In medical practice, there are three types of scoliosis:

The localization of the curvature is any part of the spine from the thoracic region to the lower back. There are scoliosis and divisions.

There are also frequent cases when curvature occurs only in the upper or only in the lower part.

Before making a diagnosis and determining the stage of the disease, the doctor must clearly trace the shape of the curvature, direction, location, size and, ideally, the causes of its occurrence.

Causes and risk factors

According to the Cobb classification, the causes of scoliosis are divided into the following groups:

congenital, which was still laid in the womb during the development of tissues and organs;
traumatic: occurs as a result of untimely or poor-quality treatment of an injury;
neurotic– it can be caused by neurological disorders and diseases;
myopathic, which is caused by pathological changes and foci of inflammation of the back muscle tissue;
idiopathic– in this case it is impossible to establish the cause, since the process can be affected by several factors at once.

As for the causes of scoliosis, they can be divided into two points: congenital and acquired.

The impetus for acquired ones can be various injuries and diseases (inflammatory processes of muscles, neurology, etc.). Congenital ones can be diagnosed immediately after the baby is born and the causes can be pathology during the development of tissues and organs.

The first thing that can be determined in a baby is congenital: contraction of the neck muscles on one side, which can lead to scoliosis if treatment is not started. Also powerful The impetus for the development of curvature can be cerebral palsy, in which involuntary contractions of various muscles are observed.

In order to prevent the development of the disorder, it is necessary to know the risk factors, which will be the first step towards this problem:

ignoring the rules of correct posture and organization of the workplace, especially for school-age children;
inactive lifestyle;
abnormal carrying of heavy objects.

Features of the clinical picture

Symptoms of grade 3 scoliosis are characterized by pronounced deformation and persistence, with simultaneous deformation of the chest and the presence of a costal hump of significant size.

Based on X-ray studies, we can talk about the presence of wedge-shaped vertebrae in the curved areas and adjacent to them. As for the intervertebral discs, it is very difficult to trace them from the concave side.

Diagnostic approach

It is quite simple to identify stage 3 scoliosis and this can be done even visually and without having a medical education.

Naturally, it’s worth taking an x-ray to confirm, but still there are many bright signs that literally “catch the eye”:

there is a skew of the shoulder girdle;
pelvic distortion;
pathology of the chest (its deformation);
poor posture;
in female representatives there is a pronounced distortion of the mammary glands;
changes in the state of organs and systems;
painful sensations.

Complex of therapeutic measures

For the full treatment of grade 3 scoliosis, comprehensive measures are required, which include: physiotherapy, use and, with the only condition: the doctor must select the ideal special exercises in order not to aggravate the situation.

These methods are considered traditional (conservative). Often, only surgical intervention can correct such a difficult situation.

Selection of therapeutic exercises

When prescribing exercises for a patient with stage 3 scoliosis, specialists must be extremely careful in their choice, since any careless movement can lead to complications. Somersaults, running, squats, weight lifting, twisting, and outdoor games are prohibited.

It is important to perform all exercises from a lying position: this stage is characterized by the fact that the therapeutic effect is achieved precisely by the position, and not by force loads.

To perform this exercise at home, it is effective and safe: lying on the floor face down, stretch your right arm up and your left arm to the side. Move your right leg to the side. Breathe in. After this, as you exhale, raise your arms, right leg and head up. Go down. Repeat up to ten times, depending on the sensations.

Massage techniques

It should only be performed by a highly qualified specialist so as not to harm the already damaged spine. All movements should be gentle, and the massage should be asymmetrical, that is, on the curved side it is done longer and more intensely than on the concave side.

Surgery

To prescribe an operation, a doctor’s opinion on the more or less normal state of the internal organs and systems is necessary. The most effective intervention will be before the child begins to actively grow.

If the moment is missed and the child begins to grow, wearing a special corset is prescribed. It will also be effective after each exercise therapy session.

At home, you can repeat the exercises that were prescribed by your doctor or trainer, taking all precautions.

Be sure to follow the rules of a balanced diet. Sleep in a ventilated room and get a good night's sleep. Be sure to walk in the fresh air, preferring walking.

Advanced scoliosis is dangerous and unpredictable!

The worst thing about the development of the disease is that external manifestations are only the tip of the iceberg. There are many more serious consequences:

To neurological problems may cause compression of the spinal cord;
the nerve roots are pinched in the pinched area, which provokes drop in muscle tone, and this, in turn, leads to loss of ability to work;
leads to almost complete loss of innervation loss of flexibility and mobility of spinal segments;
joint pain;
for pregnant - insufficient oxygen supply to the fetus.

A patient with the third degree of scoliosis is given the third disability group (in especially difficult cases - the second).

Prevention - everything is simple, but many people forget it

In order to prevent the development of a disorder or stop it, you must follow the rules:

from childhood, monitor your posture;
Healthy food;
to walk outside;
relax on an orthopedic mattress;
perform the exercises correctly.

Your question is our answer

We answer questions from our readers.

My child is six years old, he was diagnosed with stage 3 scoliosis and was banned from attending. Will we do the right thing if we follow the advice?

Maria

A completely wrong decision: for diseases of the spine, physical exercise is required, but it should be calculated specifically for your age and the degree of the disease. Do not perform sudden movements under any circumstances, only smooth exercises from a lying position.

Orthopedist

Recently I was given a summons to the military registration and enlistment office. Will they be able to call me if the doctor has diagnosed scoliosis?

Andrey

Starting from the second stage, young people are released from conscription with the mark “B” - limited fit, or “D” - not fit, with the issuance of a military ID.

Orthopedist

My child was diagnosed with third degree scoliosis. Can he go to the pool?

Inna

Not only is it possible, but it is also necessary. – one of the most effective means of correction for scoliosis, as well as a measure of preparation for surgical intervention.

Orthopedist

In most cases, the condition of the spine is a consequence of a negligent attitude towards one’s health or the health of one’s children.

Be careful and follow preventive measures so that you do not have to wear corrective corsets and undergo surgical interventions.

Scoliosis of the 3rd degree is already a pronounced, disfiguring deformity with a large angle of curvature of the spinal column, in which both fragments of the spine (vertebrae, joints and discs) and internal organs are affected. It causes a person a lot of physical and mental suffering, and it is quite difficult to cure. In this case, we are talking about transferring this disease to a milder second degree, and stopping its further development. However, one should not be discouraged - treatment of such curvature is being carried out successfully today, and if the efforts of doctors are complemented by the will and determination of the patient himself, then any disease will eventually recede. In the photo below you can see for yourself that this is possible.

Doctors usually diagnose grade 2 - 3 scoliosis when the angle of deviation is equal to or slightly exceeds 25 °. If you begin to treat the disease in a timely manner with such angle values on radiography, the chances of cure, with a return even to the first degree, are still high.

The third degree of scoliosis according to the Chaklin method is in a wide range from 26 ° to 50 °.

Curvature approaching 40° is critical. It is almost impossible for an adult to cure with such a conservative method, but children under 11 years of age have a good chance. Exceeding the angle above 40° is a reason for surgery, since such a curvature poses serious health risks:

Severe long-term pain appears
The functioning of the heart, lungs, gastrointestinal tract, and kidneys is seriously impaired
Women are at risk of gynecological diseases and infertility
Muscular atrophy occurs not only in the back, abdomen, but also in the limbs
Mental disorders appear due to constant depression and inferiority complex

With scoliosis of 3 degrees, they usually give the third (and sometimes second) disability group.

In the photo you can see an x-ray of third-degree scoliosis in an 11-year-old child before and after surgery:

Causes and signs of grade 3 scoliosis

In addition to congenital, hereditary factors and severe bone diseases, which cause the disease to manifest itself at a very early age, the 3rd form can also arise for the following reasons:

Progressive scoliosis 2 degrees
Impaired metabolism, affecting the structure of bone tissue
Endocrine diseases - insufficient activity of the endocrine glands (endocrine glands): thyroid - leads to a slowdown of all processes in the body, increased weight, hormonal imbalance, parathyroid - to a decrease in the amount of calcium in the body, adrenal glands - to a lack of important minerals and trace elements (magnesium, sodium, zinc, etc.) and steroid hormones
A period of intense growth in adolescents
Bone loss in menopausal women caused by decreased estrogen
Severe physical injuries leading to a hip fracture, pelvic displacement, shortening of one leg

If a young or adult person suddenly experiences rapidly progressing scoliosis for no apparent reason, then you need to look for the cause within

With grade 3 scoliosis, the following external and internal signs are observed:

Clear asymmetry of the shoulders, shoulder blades, pelvis, waist triangles
Women experience breast asymmetry
There is a noticeable scapular hump and protrusion of the ribs on the convex side of the arch
Protrusion and depression of the ribs appear on the front of the chest
The extreme lower ribs with S-shaped scoliosis of the third degree almost touches the upper iliac bone of the pelvis. This increases the pelvic distortion and causes a limping gait due to the shortening of one leg
Increased rotation (twisting) of the spine) leads to wedge-shaped deformities of the vertebrae and frequent pain exacerbations
Depending on which department is affected more, the diseases of the internal organs described above begin

Treatment methods for third degree scoliosis

Treatment for this form of scoliosis can be either conservative or surgical.

First, the acute inflammatory process, if any, is removed. The scheme is the same as in the general recommendations for the treatment of scoliosis
Then x-rays are necessarily taken in two positions (horizontal and vertical) to determine the angle of deformation
The necessary examinations of cardiac, respiratory activity and the functioning of other organs are carried out

If the deviation angle is less than 40 ° and the general state of health does not cause alarm, then treatment will be carried out using a clearly conservative method.

Conservative treatment method

Conservative treatment follows the same scheme as for.

But there is some difference:

Therapeutic gymnastics should exclude twisting and sudden movements
Manual therapy and massage are done if there are no serious displacements or deviations in the functioning of internal organs
Corsets are worn much longer after exercise therapy and after almost every procedure

A little more about exercise therapy.

Therapeutic gymnastics consists of carefully selected asymmetrical exercises performed lying down

The specificity of each exercise is that they are selected differently for tense and relaxed muscles on both sides of the curvature arc.

The difficulty of exercise therapy for the third degree of scoliosis is that symmetrical exercises are not suitable here at all. Typically, grade 3 has a complex S-shape. For example: Left-sided thoracic and right-sided lumbar scoliosis.

Example exercise:

Lying on the floor face down, we take a correction pose: extend the right arm up, the left arm to the side with the palm facing the floor, and move the right leg to the side by about 20°. Let's take a breath. As you exhale, raise both arms, shoulders, head and right leg. We linger a little in this position and, clenching our fingers into a fist, inhale and return to the starting position. We perform the exercise 7 - 10 times.

Let's decipher this exercise:

The main tensile force here is done when lifting with the left arm and right leg, because it is the left pectoral muscle and the right lumbar muscle that are contracted
Inhalation, if you noticed, is done not while stretching, but in a correction pose: our task is to make the right side on the concavity side breathe more. Our left one already breathes in excess, so we combine the raising of the left arm with exhalation

Exercises are performed under the guidance of an orthopedist:

he must set the correct corrective posture
observe how rib and scapular deformities behave when performing the exercise
manually correct the exercise if necessary

Photo of corrective exercise for scoliosis:

Surgical treatment for scoliosis

Surgical treatment for scoliosis may be offered in the following cases:

If the deflection angle has reached 40 ° -
in this case, they do not insist on surgery, but can initially use all the possibilities of conservative treatment
If it is impossible to achieve a good result using conservative methods
Progressive scoliosis and threat of stage 4
Frequent painful exacerbations
In these cases, surgery is considered as the last opportunity to cure or at least stabilize scoliosis
If the deflection angle approaches 50°

In the latter case, surgery is prescribed clearly for health reasons and is the most preferred method of treatment, since due to such a large angle of deviation, the organs of the chest and pelvis are severely affected

Operation methods:

In adults, it is done using special fixed stabilizers, which are attached with clamps on the area “corrected” from scoliosis.
In children, other non-rigid systems are used, which change their length as the child grows,
For example, the system Harington or Quatrel-Debussy

The system can be seen in this photo:

The operation cannot permanently eliminate the problem. After this you need:

Compulsory wearing of corsets
Therapeutic and strengthening physical education

Remember that a lot depends on you. I wish you health and victory over the disease!
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Any disease, before it has time to gain a foothold in the body, can be cured using traditional methods. This situation fully characterizes dystrophic lesions of the skeleton, which, without timely assistance, cause serious deformations of bones and joints. One of them is scoliosis – curvature of the spinal column in the frontal plane. It can be found in people of any age, although the origins of the disease always lie in childhood.

Since in the early stages the disease occurs unnoticed by a person, it can only be caught in an advanced state. It is the 3rd degree of scoliosis that is characterized by the appearance of the first manifestations. Pain syndrome associated with the impact of deformed vertebrae on surrounding structures always comes first. Changes in the spine during this period vary somewhat, which leads to different tactics of assistance.

Is it possible? The complexity of the treatment lies in the fact that its result depends entirely on the actions of the patient, who must follow the doctor’s recommendations. The third period of the disease is already characterized by deformation of not only the joints, but also the bone tissue of the vertebrae. Therefore, without surgery it will not be possible to completely get rid of it - only its partial correction is possible.

Concept

Before describing the clinical signs of third degree scoliosis, it is necessary to describe the pathological mechanisms leading to spinal deformity. It is their consistent development that causes the patient’s condition to deteriorate during this period - the functions of not only the spinal column, but also neighboring structures are disrupted. The following factors contribute to this:

The first stages of the disease can be called compensated - the lateral displacement of the vertebrae is still controlled by the tension of the ligamentous and muscular apparatus. Therefore, the intervertebral joints still retain a relatively normal anatomical location.
At the third degree, subluxation develops in these joints, which leads to rotation of some vertebrae around their axis.
The maximum changes are always observed in the central part of the curvature arc, which experiences the greatest load.
Stretched muscles and ligaments are no longer able to prevent this process, so they shift along with the deformed bones. This is why pronounced changes in the shape of the chest, which is closely connected to the spine, develop.
In this case, the body responds with a rough, but still protective reaction - it triggers destruction mechanisms in the affected joints - arthrosis. In this way, it tries to achieve a state of stabilization, preventing further displacement.

At the third stage of scoliosis, the formation of two curvature arcs is always observed in the thoracic and lumbar region - true and compensatory.

Differences of the 3rd degree

It is in this period of the disease that the limit is found that determines the irreversibility of pathological changes. It contains the boundary between absolute and relative indications - it is assessed based on clinical signs and X-ray examination data.

Externally, it is quite difficult to distinguish grade 3 scoliosis from the previous stage, so additional tests are used for diagnosis. Based on these, further patient management tactics and prognosis are selected:

A common feature is the formation of a compensatory arch of curvature, which gives the spine. But at the third stage it becomes permanent and irreversible, which is confirmed by a traction test. In the prone position, the patient is gently pulled by the head - unlike the second degree, straightening of one of the arches is not observed.
The rib hump - a one-sided protrusion of the chest in the area of the scapula - sharply intensifies and becomes noticeable in three positions at once. It can be seen when standing at the side of the patient, as well as in the lying position and when bending over with the arms down.
There is a sharp deviation from the vertical axis of the body not only of the horizontal line drawn through the shoulders, but also of the plane of the pelvis. Moreover, the last two indicators are also not parallel to each other.
The x-ray shows an increase in the angle of the main arc of curvature from 31 to 60 degrees according to Chaklin. In addition to this indicator, characteristic deformations can be observed - subluxations (rotations) of the vertebral bodies, as well as their wedge-shaped shape at the apex of the arch.

When determining further tactics for patient management, doctors primarily rely on the patient’s age and severity of symptoms.

About the forecast

Typically, the boundary between indications for surgical and conservative treatment is an angle of deformation of more than 50 degrees, provided there are no complaints. Grade 3 scoliosis itself, accompanied by pain or other symptoms, also requires surgical correction. This is due to the high risk of complications:

Initially, the changes affect the chest - deformation of the ribs and surrounding soft tissues impairs its mobility. Respiratory dysfunctions associated with decreased ventilation and blood supply to the lungs gradually develop.
Impact on the branches of the celiac plexus leads to dysfunction of the gastrointestinal tract. Patients begin to worry about constant bloating, abdominal pain, and constipation. The situation is further complicated by a sharp weakening of the abdominal muscles.
In the most severe cases, problems occur associated with mechanical pressure on it, as well as a deterioration in its blood supply. In this case, neurological disorders are observed - disturbances in sensitivity and mobility of the lower extremities (up to complete paralysis), as well as urination - incontinence or retention.

Signs of any of these conditions are an absolute indication for emergency surgery to eliminate the pathological effect on the internal organ.

Features of assistance to adults

In children and adolescents, the processes of growth and development have not yet completed, so the use of certain treatment methods is difficult for them. Therefore, they are treated primarily with conservative measures. In adults, the tactics of assistance depend on many factors:

The choice of traditional measures is preferable only for patients without any clinical manifestations who do not have a wedge-shaped deformity of the vertebrae according to the image. Minor subluxations are not an obstacle to conservative therapy.
Another group consists of patients who have developed severe pain due to the use of non-surgical methods. If it interferes with the implementation of the further treatment plan, then preparations for the operation begin.
A similar situation is observed in the group of patients undergoing conservative treatment, in whom progression of the curvature is observed radiographically (increasing the angle of more than 50 degrees).
The combination of severe spinal deformity in combination with any clinical manifestation is an absolute indication for surgical correction of scoliosis.

To a greater extent, treatment in adults is aimed at eliminating a cosmetic defect - to prevent complications, it is carried out only with progressive variants of the disease.

Conservative treatment

All traditional methods of helping with scoliosis are long-term in nature - years of continuous training are required to achieve positive dynamics. Moreover, regular medical monitoring is carried out only at the first stage, when the main changes are eliminated:

Treatment begins with an artificial vertical impact on the spinal column, which ensures its traction. This promotes stretching of the soft tissues, as well as a gradual return of the vertebrae towards the median axis.
The second stage involves a combined effect, including holding the spine with the help, as well as the use of physical therapy and medications.
Treatment of grade 3 scoliosis with non-surgical methods at the final stage involves constant wearing of support bandages and regular exercise. This period has no time limits, since it is a simultaneous prevention of disease progression.

Conservative measures do not lead to complete relief from the curvature, but only transfer it to the previous stage with subsequent stabilization of the condition.

Correction

Although the third degree of scoliosis is characterized by irreversible changes in the soft tissues, it can still be corrected with traction. The goal of this method is to create a load on the spine that is opposite to the pathological displacement. The following procedures are used for this:

The traditional way is on a shield with the head end raised.
In this case, an axial force is exerted on the spinal column using a natural force - the weight of the body.
Lateral pressure is applied using several straps secured around the torso. Loads of various weights are fixed to them, the severity of which is adjusted over time. They allow artificial influence on the arcs of curvature, returning them to the central axis.
The procedures are carried out for at least 2 months, during which the effectiveness of the method is regularly assessed.
The absence of positive dynamics becomes an indication for surgery, and in the opposite case, the patient moves on to the second stage of treatment. It fixes the spine in the achieved position using a rigid corset.

Nowadays, underwater traction is actively used, which is distinguished by a more physiological effect of gravity on the musculoskeletal system.

Fixation

Previously, in this period, the only method of assistance was a continuous plaster corset, applied from the back of the head to the tailbone. It was necessary to wear it for several months without removing it in order to achieve adaptation of the soft tissues to the changes. Now the second stage has become more advanced:

Thanks to the use of modern orthopedic products, it was possible to improve the patient’s quality of life, as well as reduce the incidence of complications associated with improper fixation.
To support the spine, rigid or adjustable solid corsets are used, covering all its parts.
is selected individually - strict compliance of sizes is a condition for reliable fixation of the spinal column after traction.
When treating the third degree of scoliosis, they must be worn for at least 23 hours during the day, removing them only to perform hygiene procedures.

Gradually, the rigidity of the corset or the time it is worn is gradually reduced under constant monitoring of the condition of the curvature. If its re-progression is noted, then the issue of performing an operation is decided.
Additionally, the patient receives courses of medications that help correct pathological changes. These include muscle relaxants and painkillers that relax the muscles of the spine.

Simple fixation will not provide adaptation to everyday stress, so in parallel the patient begins to engage in therapeutic exercises with a gradual increase in load.

Strengthening

After achieving maximum correction of scoliosis, the last stage begins - preventive measures. They will allow the patient to adapt to life with the disease, eliminating the main risk factors. To do this, he is given the following recommendations:

Any load on the spine is excluded - lifting and carrying heavy objects, sitting for long periods of time, sleeping on a soft bed.
Constant wearing of a soft bandage is required; it can only be removed at night if you have a hard orthopedic bed.
Regular appointments are prescribed - her program includes strengthening not only the back muscles, but also the abdominals and shoulder girdle. It must be performed daily at least 3 times a day.
Over time, you can add breaststroke to your regular exercise routine. It has an excellent effect on the muscles of the torso, helping to maintain the normal position of the spine.

Surgery

In some cases mentioned above, stage 3 scoliosis can only be cured through surgery. Currently, there are several options for surgical care:

Surgeries on the posterior parts of the spine involve eliminating curvature using distractors - devices that create measured pressure on individual vertebrae.
Interventions on the anterior sections are usually of a plastic nature - for this purpose, the most changed areas are removed, with their subsequent replacement with a bone or metal prosthesis.
Combined operations involve a combination of the listed methods, and are usually used for complicated scoliosis.
Surgical treatment can also be cosmetic in nature, and be aimed at eliminating the rib hump and deformation of the shoulder blades.

Performing surgical intervention is not immediately accompanied by a complete return of lost functions. After it is completed, a long period of rehabilitation begins, which gives the spine the opportunity to again accept axial load.