Treatment for Mild to Severe Dextroscoliosis

Updated on 2024-05-16 15:02:13 0 0

By Lindsay Curtis

Medically reviewed by Kashif J. Piracha, MD

Dextroscoliosis is a form of scoliosis that causes the spine to curve to the right, forming a backward "C" or "S" shape. Though abnormal spinal curvature can occur anywhere on the spine, dextroscoliosis is usually found in the middle to upper portion of the back (thoracic spine). Depending on the degree of the curve, dextroscoliosis can range from mild to more pronounced.

About 2% to 3% of the population has some form of scoliosis, affecting children and adults.1

This article explores dextroscoliosis symptoms, causes, and treatment.

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Dextroscoliosis: Symptoms of Right Spine Curvature

Dextroscoliosis symptoms vary, depending on the degree and location of the spinal curvature. With mild dextroscoliosis, the spinal curve is less than 25 degrees, and there may be no noticeable symptoms.1 If the curvature is more pronounced (25 degrees or higher), signs and symptoms can include:2

A visible curve in the spine, appearing curved or twisted to the right
The body leaning or tilting to the left
Uneven shoulder, rib, and hip height, with the left side appearing higher than the right
The left shoulder blade sticking out more than the right
Asymmetrical waistline
Muscle imbalance and fatigue

If the spinal curve progresses, symptoms may become more severe and can include the following:

Back pain
Limited range of motion in the spine
Breathing difficulties

Dextroscoliosis vs. Levoscoliosis

Scoliosis is a spinal condition characterized by a sideways curvature of the spine. Dextroscoliosis refers to a curvature that bends to the right, while levoscoliosis refers to a curvature that bends to the left. The main difference between the two is the direction of the curve, but the causes, symptoms, and treatments may be similar for both types.

What Causes Dextroscoliosis?

In about 80% of cases, the exact cause of dextroscoliosis is unknown (idiopathic). The term “idiopathic” refers to a condition for which there is no known cause.

In the case of idiopathic dextroscoliosis, the spine develops an abnormal curvature without any identifiable underlying condition or structural abnormality causing the spinal curve. Genetic factors likely play a role in idiopathic dextroscoliosis, as the condition often runs in families.3

Sometimes other medical conditions can contribute to the development of dextroscoliosis, such as:2

Congenital (present at birth) conditions: Congenital dextroscoliosis occurs when one or more spinal vertebrae are not properly formed during an embryo’s development.
Neuromuscular conditions: Conditions that affect how nerves send signals to the muscles or how muscles function can cause muscle imbalances or weakness that lead to dextroscoliosis. Examples include cerebral palsy, spina bifida, and muscular dystrophy.
Degenerative conditions: Conditions that cause the spine to break down over time, such as osteoarthritis or degenerative disc disease, can lead to dextroscoliosis in older adults.

Other causes of dextroscoliosis include:4

Spinal trauma: A spinal cord injury that causes nerve damage in the spine can lead to the loss of control of the muscles in the back and cause dextroscoliosis.
Functional abnormalities: Sometimes, a problem in another part of the body, such as differences in leg height, pulled back muscles, or muscle inflammation, can cause the spine to curve in one direction.

Dextroscoliosis Risk Factors

Anyone can be affected by dextroscoliosis, but factors such as the following can increase the likelihood of developing a spinal curve:

Family history: About 30% of people with idiopathic scoliosis have a family member with the condition.5
Age: Signs and symptoms of scoliosis often begin during childhood or adolescence, especially between ages 10 and 18.
Sex: People assigned female at birth are more likely to develop scoliosis and tend to have more severe curves than those assigned male at birth.6

Does Everyone Need Dextroscoliosis Treatment?

Not everyone with dextroscoliosis requires treatment. The decision to treat dextroscoliosis depends on several factors, including your age, the curvature’s severity, and whether you have symptoms or functional limitations. In general, mild cases of dextroscoliosis usually do not require treatment beyond periodic monitoring to ensure that the curvature does not progress over time.

More severe cases of dextroscoliosis may require treatment to prevent curvature progression and manage symptoms. Curves between 20 to 40 degrees may require bracing to help prevent curve progression. Bracing is most effective during childhood and adolescence when the spine is still growing. Curves 40 degrees and above usually require surgical treatment.7

A healthcare provider may diagnose dextroscoliosis by taking a medical history, a family history, and performing the following:8

Physical exam: During the physical exam, a healthcare provider will assess the curvature of the spine and any associated postural changes or symptoms.
Imaging: X-rays help healthcare providers visualize the spine to measure the degree and location of the curvature, identify any underlying structural abnormalities contributing to the condition, and determine the most appropriate treatment.

Risks of Untreated Dextroscoliosis

Dextroscoliosis is a progressive condition that requires regular monitoring to ensure the curve does not worsen. Left untreated, a spinal curve can progress, and serious problems can develop, such as:910

Chronic pain: Back, neck, and shoulder pain can occur as the curvature becomes more pronounced.
Reduced lung function: Severe dextroscoliosis can compress the chest cavity and reduce lung capacity, leading to shortness of breath and difficulty breathing.11
Cardiovascular problems: In severe cases, dextroscoliosis can affect the heart’s ability to pump blood efficiently, leading to an increased risk of cardiovascular problems.12
Spinal irregularity: Untreated dextroscoliosis can cause a visible irregularity in the spine, which can be socially and emotionally challenging for some people.
Neurological problems: Though rare, severe dextroscoliosis can compress the spinal cord or nerve roots, leading to neurological problems such as numbness, weakness, and loss of bladder and bowel control.

Exercises to Improve Dextroscoliosis

Exercise is an essential component of dextroscoliosis treatment. While exercise will not correct a spinal curve, it can help manage symptoms and improve overall spinal health. Scoliosis-specific exercises combine strength and stretching techniques to help improve flexibility and range of motion and strengthen the muscles that support the spine.13

At-Home

Examples of at-home exercises to manage dextroscoliosis include:13

Plank

Begin in a push-up position, with your hands and toes touching the ground, ensuring your hands are directly below your shoulders.
Engage your core and glutes to maintain a straight line from your head to your feet.
Hold this position for as long as possible, aiming for at least 30 seconds.
Release the plank by gently lowering your knees to the ground.

Bird-Dog

Begin on your hands and knees, with your knees under your hips and hands directly under your shoulders.
Extend your right arm and left leg straight out, keeping your body straight.
Hold for several seconds, then return to the starting position.
Repeat on the other side, extending your left arm and right leg.

Pelvic Tilt

Lie on your back on a comfortable surface with your knees bent and feet flat on the ground.
Relax your arms by your sides and take a deep breath in.
As you exhale, gently tilt your pelvis back towards your feet, flattening your lower back against the ground.
Hold the position for a few seconds, then inhale and release the tilt.
Repeat the exercise several times, aiming to complete 10 to 15 repetitions.

Before beginning an exercise program, talk to a healthcare provider or qualified fitness professional to develop a safe and effective exercise program for your needs.

With a Physical Therapist

Physical therapy is often a component of dextroscoliosis treatment. If your healthcare provider refers you to a physical therapist (PT), the PT will work with you to develop a personalized exercise program that addresses your specific needs and goals. Exercises a physical therapist may recommend include:14

Stretching exercises: Stretching can help improve flexibility and range of motion in the spine. Your physical therapist may recommend stretches such as the seated spinal twist or the side bend stretch.
Strengthening exercises: Strengthening the back, abdomen, and hip muscles can help improve spinal stability and reduce pain and discomfort. Examples of strengthening exercises include the row, the bird dog, and the side plank.
Postural exercises: These exercises improve posture and alignment in the spine. Your physical therapist may recommend exercises like the chin tuck or the wall angel.
Aerobic exercise: Aerobic exercises such as walking, swimming, or cycling can help improve your overall fitness and reduce the risk of cardiovascular disease.

Dextroscoliosis Surgical Treatment

Severe dextroscoliosis may require surgical treatment if the spinal curve causes significant pain or functional limitations and nonsurgical interventions have been ineffective. The type of surgical procedure depends on your age and the location and severity of the spinal curve. Dextroscoliosis surgeries include:15

Spinal fusion: Involves connecting two or more vertebrae in the curved area of the spine with rods, screws, or other hardware and then fusing the vertebrae to heal into a single, solid bone. This procedure straightens the spine and helps prevent further curvature progression.
Growth-friendly surgery: For children and adolescents who are still growing, expandable rods (growth rods) are placed along the spine to correct the curve gradually. The rods are adjusted to accommodate a child’s growing body and eventually removed for a spinal fusion once the child has stopped growing.16
Vertebral body tethering (VBT): This newer surgical technique uses a flexible cord to pull on the curved vertebrae and straighten the spine. The cord is attached to screws or hooks inserted into the vertebrae and then tightened to correct the curvature.
Osteotomy: A more complex surgical procedure that involves removing a section of bone from the curved area of the spine. Sometimes, a bone graft is placed where the bone was removed and held with rods, screws, plates, and pins to hold the graft in place and realign the spine.17

Summary

Dextroscoliosis is a form of scoliosis that causes a right-sided spine curvature. It can occur in children and adults and is often idiopathic, meaning the cause is unknown. Symptoms of dextroscoliosis can include back pain, muscle stiffness, and limited mobility.

Nonsurgical treatments for dextroscoliosis include regular monitoring, exercise and physical therapy, and bracing. Surgery is usually performed for severe and progressive cases. Early diagnosis and intervention are crucial to preventing further curvature progression and minimizing the risk of complications.

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