Excerpt from Scoliosis and The Human Spine

The following excerpt is the forward to the book, Scoliosis and the Human Spine by Martha C. Hawes, a professor and research scientist at the University of Arizona who had success with nonsurgical treatment options for her own spinal curvature. Dr. Hawes was able to reduce her own thoracic curve by 40% without bracing or surgery.* Her personal interest in scoliosis led her to review hundreds of articles and research papers on scoliosis.

Dr. Hawes came to the conclusion that "statements claiming that scoliosis cannot be stabilized or reversed without bracing or surgery are not, and never have been, supported by scientific data. On the contrary, as detailed in this book, long-standing basic and clinical research results documented in reputable medical journals are consistent with the hypothesis that scoliosis can be reduced if not eliminated using nonsurgical approaches." (emphasis added)

*For an article on Dr. Hawes scoliosis including before and after x-ray images and pictures of her back, see the National Scoliosis Foundation's Spring, 2002 newsletter. (To download the newsletter you need to have Adobe Acrobat Reader installed on your computer).

The book Scoliosis and the Human Spine is available for purchase exclusively through the National Scoliosis Foundation's bookstore.

Reprinted with permission from Martha C. Hawes.

Beginning of excerpt:

      
 
Scoliosis and the Human Spine

A Critical Review of Clinical Approaches to Treatment of Spinal Deformity in the United States, and A Proposal for Change

by Martha C. Hawes

Author's Foreword

The goal of this book is to point out that (1) current clinical approaches to the treatment of spinal deformity in this country are inadequate and inappropriate, and that (2) basic and clinical research to design new strategies is needed. My interest in the problem stems from my personal experience with spinal deformity, as summarized below, but the book is limited to a critical analysis of published scholarly evidence from the peer-reviewed medical and scientific literature.

I was diagnosed with moderately severe thoracic scoliosis 'of unknown origin' at the age of eleven and I lived with it in a state of more or less continuous discomfort for three decades. My spinal deformity-associated symptoms included pain, chronic recurrent respiratory infections, shortness of breath, psychological distress, and torso deformity. At the age of forty, I unexpectedly began to get relief in the aftermath of a psychological breakdown which followed a year of intensive mobilization therapy. Over the next eight years, I continued to practice a combination of mobilization therapies. During the same period my longstanding symptoms improved in parallel with a progressive increase in my chest wall expansion (Hawes and Brooks 2001), and a corresponding forty-percent reduction in the magnitude of my curvature (Brooks and Hawes 2002). This improvement is within the range that can be achieved by spinal fusion surgery (Bradford 1995).

I had been told at the time of my diagnosis in 1964 that surgical intervention was needed urgently to prevent progression of my spinal curvature to a degree that would be deadly before I reached maturity. Furthermore, unless I accepted the spinal fusion surgery which was prescribed, there was nothing to be done to help me. My orthopedic surgeon assured me that after a year of healing I would be as good as new, but for the rest of my life I would need to avoid activities that might cause a sudden jolt which could break the fusion or damage the vulnerable unfused portion of my spine. Such activities included water skiing, gymnastics, and car wrecks. Recoiling instinctively at the concept of a lifetime spent avoiding sudden moves, I declined surgery against the vehement orders of my orthopedic surgeon. Instead I chose to use torso-strengthening exercises taught to me by a physical therapist, despite my surgeon's assurance that 'exercises don't work, and even if they did, children won't do them.'

In the ensuing decades I exercised daily but I never again sought treatment or read a single article or book about scoliosis, so I knew nothing beyond my own experience. As my recovery proceeded I wanted to find out why my own case had turned out to be so unusual. Not only had my curvature stabilized in childhood in correlation with daily strengthening exercises despite my surgeon's dire predictions (the magnitude of my curve was virtually unchanged three decades after diagnosis), but it had reversed in middle age with daily mobilization exercises despite popular belief that adult scoliosis is untreatable except by surgery. Being a research scientist by profession, it was natural for me to consult our university library to figure it out. By searching the peer-reviewed medical literature using Biosis, Medline, Science Citation Index, Allied and Complementary Medicine Index and HealthStar and papers cited therein, I found about 10,000 titles describing causes, symptoms, prognosis and treatment strategies for spinal deformity.

After three years spent absorbing the details of hundreds of articles, I realized that my recovery was not so surprising after all. The long-standing and widely promulgated notion that early stages of scoliosis are untreatable, it turned out, never has been supported by experimental data. To the contrary, several decades-old studies by prominent orthopedic surgeons yielded basic research consistent with the hypothesis that scoliosis can be reversed by nonsurgical means, if treated early in its development before growth is complete. In addition, research with children and young adults from the Schroth Clinic in Germany yielded results similar to my own outcome (Weiss 1991). In correspondence with Dr. Weiss, head of the Schroth Clinic, I learned that their therapeutic approaches also were similar to my own. It was perhaps surprising that I made so much progress as an aging adult, but otherwise my case was entirely congruent with the known biology of spinal deformity.

Thanks to school screening programs, we know that about two to three percent of U.S. children have scoliosis by the age of eight to fourteen. Spinal deformities present at skeletal maturity do not go away on their own, and most continue to worsen throughout life. Since new cases develop during adulthood and there is no established treatment to eliminate spinal deformity (even spinal fusion surgery only reduces the magnitude of the curvature), the prevalence presumably increases with time as the population ages. Therefore the number of people in the United States currently afflicted with scoliosis can be estimated at more than six million. Most cases do not become severe or life-threatening, but even mild cases of spinal deformity are associated with chronic pain, pulmonary dysfunction and psychological disturbance and can be a source of 'a considerable amount of disability and handicap' (Mayo et al. 1994).

School screening programs to detect cases of scoliosis in early stages have been in place for decades, but no effort is made to treat those found to have a spinal curvature. Instead, children with small curvatures are X-rayed at intervals until the deformity either stabilizes spontaneously or progresses to the point of requiring traumatic interventions like bracing and surgery. Patients and their parents are advised that proactive therapeutic methods including osteopathic manipulation, physical therapy, massage and chiropractic care are ineffective if not destructive, and have been subjected to insinuations that pursuing such methods is irresponsible. Given the lack of early intervention, it is not surprising that early diagnosis has not accomplished its goal of protecting children's health by reducing the incidence of spinal fusion surgery. As a result of this failure, some surgeons now are recommending the elimination of screening programs and a return to the days when cases of scoliosis, like my own, were not detected until they already had advanced to the point of needing surgery.

In summary, statements claiming that scoliosis cannot be stabilized or reversed without bracing or surgery are not, and never have been, supported by scientific data. On the contrary, as detailed in this book, long-standing basic and clinical research results documented in reputable medical journals are consistent with the hypothesis that scoliosis can be reduced if not eliminated using nonsurgical approaches. As such, multidisciplinary research dedicated to examining the utility of proactive therapies in the treatment of spinal deformity in children and adults, is long overdue.

The book was written to serve as a resource for clinicians interested in developing case reports or other research on spinal deformity. However, I have used language accessible to patients, parents and physicians because I believe their active participation will be critical to the success of any research efforts. Because I have limited my analysis to studies published in peer-reviewed medical and scientific journals, treatment regimes which are described only in internet websites and other popular literature are not discussed.

2002, West Press, Tucson Arizona, U.S.A.

Copyright Martha C. Hawes. All rights reserved. Printed in the United States.

Except as permitted under the Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of the author.

ISBN: 0-9719546-0-7

Cover photograph by Martha C. Hawes

Exclusive distributor
National Scoliosis Foundation
5 Cabot Place, Stoughton MA
www.scoliosis.org
1-800-NSF-MYBACK
Fifty percent of all profits from the sale of this book go to the NSF for research, patient education and support

Permission from John Wiley and Sons, Inc., the British Editorial Society of Bone and Joint Surgery, and Springer-Verlag to use specific quotations and figures is gratefully acknowledged. For critical review of this manuscript at various stages of preparation, and for helpful discussions, the author expresses sincere appreciation to I. Stokes, H. R. Weiss, H. D. VanEtten, W. J. Brooks, J. O'Brien, F. Wen, anonymous reviewers for Slack Publishing Company, K. Corn, C. Kotch, C. Kotlar, L. Gallina, and R. Bennett.

Special thanks to W.J. Brooks, D.O., for being a credit to his profession and to his species; and to H. D. VanEtten for being...there. Always.

LEGAL NOTICE The author is not responsible for use which might be made of the following information.

End of excerpt.

If you are considering which treatment options to pursue for your spinal curvature, you may wish to read Dr. Hawes book to get a polar opposite view from the treatment options recommended by most spinal surgeons.

Related Sections from My Web Site: How Exercise Helped My Scoliosis Scoliosis Exercises - Part I - Yoga and the Egoscue Method Scoliosis Exercises - Part II - Stretching, Callanetics and Trigger Point Therapy My complete index of all the scoliosis related pages. Recommended Book: Back Care Basics : A Doctor's Gentle Program for Back and Neck Pain Relief - has a chapter specifically on yoga for scoliosis

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