479- Chiropractic's Role in Scoliosis Care and Quality of Life

Welcome to the Evidence Based Chiropractor, where each week we deliver the latest chiropractic research and marketing strategies, all in the time it takes to get to your office. Now, here's your host, Dr. Jeff Langman.

Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Lengmaid. On today's episode, we are back with more research. We're gonna highlight a brand new study that examined the effects of spinal adjusting on scoliosis and specifically how it affects movement mechanics and overall stability. Now, before we get started, I'll say a few words about neck care. The best objective assessment tool, the cervical spine on the market. Reliable assessments and exercises for neuromuscular control, proprioception, range of motion and sensory motor integration. If you haven't checked out my demo, please head over to YouTube and check it out. Or if you just would like to connect with their team and bring this awesome tool into your practice, neckcare.com I will drop that link also down in the show. Notes. So today's topic is scoliosis, and it affects up to 12% of adolescents. And there are of course, traditional treatments like bracing and surgical intervention, but conservative approaches like spinal adjusting have proven to be very effective and continue to gain more and more traction. And this study is pretty exciting because it's not only about pain relief, it's about how we as chiropractors can help improve movement and function. So the study is titled Analysis of Kinematic and and Kinetic Changes in Scoliosis following Spinal Manipulation. And this came out in 2025. It's a brand new trial and here was how this was set UP. They had 35 participants aged 18 to 20. Every single one of them was diagnosed with idiopathic scoliosis. Their cob angles ranged from 10 degrees to 30 degrees, meaning they had mild to moderate scoliosis. Nothing 45, 50, 60 that could affect the heart and lungs. But. But 10 to 30 is meaningful enough that it can create real lifestyle challenges for these people. And what did they get? Well, they received spinal adjustments three times a week for six weeks. And the adjustments, of course, focused on the thoracic and the lumbar spine. And basically, the researchers utilized some 3D motion analysis to see if there were any changes in walking patterns, stair climbing and overall movement and function. And the goal was to determine could spinal adjustments not only improve, not only improve spinal curvature, but also enhance movement and stability. And the answer is going to be yes. Spoiler alert. But here are the details, because the details really matter. And when we talk about the details and the statistics. I'm gonna encourage you always to think about this, from how can I communicate this to my community and with my patient base, my people? Right. So, number one key finding in this study was that spinal adjustments did significantly improve cob angle. And one of the most clinically important measurements in scoliosis is the Cobb angle because it reflects basically the severity of that curvature. Again, zero degrees, zero curve. You start getting above 45, 50, 60, these can become potentially surgical challenges. But the middle ground there is exactly what they looked at, which was that 10 to 30 degrees. It might not be enough to have a surgeon ready to do surgery, thankfully, but it can still be a challenge and a problem, and you can help solve that problem. So before treatment for the individuals in this study, the average Cobb angle was about 15 and a half degrees. And after just six weeks of chiropractic, their Cobb angle was reduced to just under 9 degrees. So that's a 5% reduction, which is definitely in the realm of what they call clinically significant. Love to see those two words. And again, the average improvement was nearly 7 degrees. So this is really, really impactful. It's really important. I want to unpack this briefly because the alternatives might be, as mentioned earlier, bracing. Bracing is like a whole thing. I'm not an expert in it, but I know people have to wear the brace long hours every single day and hope for some improvement. And hey, many people have had improvement with that path. But you think about the care that you deliver and how non invasive it is, not only in terms of the delivery of the care, but in terms of you don't have to wear a brace 24, 7 to be able to receive a chiropractic adjustment. So to be able to make that impact and not dramatically negatively affect the lifestyle of the individual while receiving the treatment is a really, really meaningful aspect of the care you provide that should not go unnoticed. And here's a direct quote from the study. Quote. A reduction in the Cobb angle exceeding 5 degrees is considered clear, clinically meaningful. So for us, this continues to reinforce the concept and idea that spinal adjustments are an effective tool for scoliosis management. Not just in terms of comfort, as we just talked about, but also in terms of actual structural change. So big time findings, in my opinion, with this study, number two, is they found improved lower limb kinematics and stability. And it's easy to think of scoliosis as it is a spinal issue. But don't forget about the fact that when there is a spinal issue, often there's an effect on the entire body's movement patterns. So this study confirms that spinal adjustments can lead to better biomechanics and stability. So before care, patients had reduced hip and knee mobility on at least one side of their body. And they also showed bilateral asymmetry in walking, which forced them into all these compensatory movement patterns, which we know can add up over time. Now, remember, the people in this study were 18 to 20 years old. So you can get away with those compensatory movement patterns usually when you're younger, but that stacks up as days become weeks, weeks become months, months become years, and years become decades. Compensatory movement pattern, you're going to pay the piper one way or the other. So being able to affect asymmetrical movement patterns and compensatory movement patterns is again, really meaningful long term. So aftercare, they showed increased stability, less unnecessary movements, leading to smoother overall motion, better symmetry between both sides of the body, and more efficient gait mechanics. And that means they weren't expending a ton of excess energy while walking. And here's another direct quote from the study. Spinal manipulation reduced lower limb sagittal joint mobility and increased stability in individuals with idiopathic scoliosis. And this is big because movement dysfunction is a major issue with scoliosis, and up to 85%, 85% of patients experience abnormal gait patterns. So as a chiropractor, being able to influence those biomechanics in a positive way can again have really meaningful impact on quality of life and life effect. Again, now we stacked two things. I'll go back and, and catch us up. These individuals, 10 to 30 degrees of Cobb angle, reduce that curve 5 to 7 degrees and also improve the kinematics in the lower extremities, leading to less asymmetry, less compensatory movement. Now, number three was enhanced biomechanics in stair climbing. Remember, that was number three that they looked at. So stair climbing, as is the case, it's a daily activity. And for scoliosis patients, it can be a major, major challenge due to balance and coordination issues, proprioceptive issues, et cetera. So before care and treatment, there was more joint movement than necessary, and this led to instability and inefficiency. And there was also greater than normal ground reaction forces, as they called them, meaning their joints were absorbing more stress. Again, think about the undefeated nature of time and gravity. While 18 and 20 year olds might be able to tolerate that as they go through that over the course of their lifetime, it can really have a big life impact as they get older. So after care and treatment, less excessive motion in the hip and knee joints, better distributions of body weights were noted and a lower grf, meaning less strain on the joints and spine. So all positive findings. Here's a direct quote. Relative to that, idiopathic scoliosis patients exhibited significant changes in lower limb kinematics and kinetics following spinal manipulation. We which may serve as a potential mechanism underlying the alteration of the Cobb angle. So your spinal adjustments, they're not just quote unquote strength, you know, straightening the spine, it's really teaching the body to move more efficiently. And this ties back to the mechanisms of action that we've highlighted throughout the years on this podcast and on this show, which are so great and varied. Sometimes it can be difficult to really keep your, you know, keep it, keep it in mind. However, it's important to be mindful of the fact of you are, when you're delivering that adjustment, you're affecting the joint itself. You're affecting that segmental motion unit, you're affecting the peripheral nervous system, you're affecting the central nervous system. All of those things are happening. And there is cause and effect, there's give and take. So when you are doing that, when you're inputting that force and delivering that adjustment, when what you're doing is impacting far beyond just the. It's impacting the joint, yes, but also far beyond that. And communicating that in an effective way to patients is difficult. Clearly, us as chiropractors, over 125 plus years have not done historically the best job doing it. But it's important for us to continue to refine that messaging, continue to get a deeper understanding of how what we do positively affects our patients. And most importantly, not only just them as an entity, their life and lifestyle, and when we can impact their lifestyle and reduce the life effect of the reason they came in, we're in a beautiful position to really deliver the care and treatment that a chiropractor, a doctor, a teacher, an educator should, which is doing the best thing we can for that individual. So this study confirms what probably you listening to have observed firsthand that spinal adjustments is about more than just pain relief. You can enhance and improve movement patterns, you can decrease cob angles, you can increase joint stability and control, you can reduce the stress on the lower limb. And if you're taking care of scoliosis patients, which pretty much all of us are, it's important to consider, make sure you're assessing those gait and movement patterns, not just those X rays, but really take a with a fine tooth comb, look at the walking patterns, understand the balance in joint mobility. It could matter just as much, if not more than the cob angle itself. Keep in mind that the adjustments you deliver can retrain movement. It's not just all about the joint position, it's also about resetting motor patterns which can lead to better long term function for every one of those individuals coming into your practice and encouraging movement based care. I always say we're movement based healthcare professionals at our core. Regardless of how you approach the technique in your practice and when you can combine the adjustments that you provide with guidance on exercises, whether the patient's doing it at home or in your practice, this can help reinforce improving stability and symmetry over time. So this study, in my opinion, a massive win for us as chiropractors, continuing to show that spinal adjustments really are about optimizing function. And this is a really great study on the intersection of structure and function. And by improving the stability, balance and the efficiency of movement in our patients, the chiropractic adjustments that we deliver can really change the way that people with scoliosis experience life daily. So final quote from this study was quote this research confirms that spinal manipulation is a powerful tool in the conservative treatment of scoliosis, improving both structure and and function. End quote. And that is a great one to wrap up with. So how do you put this into practice in your practice? In my opinion, this goes both directions. This goes B2B and B2C. I can guarantee you almost nobody in your community, other healthcare providers, are aware of this study or the impacts you can make with scoliosis. And if they are, they probably believe the impacts you make are far less than what they actually are. So getting this out there, B2B business to business to other healthcare providers is a great way to build referral relationships on the other side of that coin. B2C business to consumer. Make sure you're getting this information out there. I can guarantee you again right now there are people in your community struggling with life effects related to scoliosis that have no concept that you might be the exact answer that they need to help them improve their quality of life, get back on track, move better, feel better, potentially even reduce that angle. So take this study, take the clinical pearls, get that messaging out there in your community and have some fun with it as well. Being able to help people in a meaningful way without having to do advanced interventions is just, it's awesome. So don't become blinded to that over time, but really celebrate it each and every day in your practice. And as we wrap up, I wanna say a few words about turncloud minimalist design without being sparse. They've stripped away anything that's not essential, making everyday functions in your practice simpler. They've created an awesome intuitive application where no one needs a user manual. You can learn more@TurnCloud.com Again, that's TurnCloud.com they support this podcast. I'll ask you to support them. Have a conversation with their team. I will drop that link below. And if you have not left a rating or review for this podcast, I would deeply appreciate it if you took a moment out of your day to do so. You can scroll on down, tap how many stars, leave me a note, and if you ever have questions, you can of course reach out to me at Jeff the Evidence basedchiropractor thank you so much for being a chiropractor. Thank you for tuning into this podcast. Have a fantastic day in practice and I will talk to you soon.

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