Scoliosis; Twisted Spine With Twisted Politics!

This is yet another topic surrounded by controversies. There is a good chance you or someone you know (perhaps your kid in elementary school) has been diagnosed by Scoliosis. Scoliosis is an abnormal curvature of the spine seen in X-rays demonstrated by the picture below. There are different degrees of this curvature which can be anywhere from very mild to life threatening. 

The life threatening angles are usually rare and are serious due to the pressure they exert on neighbouring organs and the spinal cord. These will generally require a spinal fusion surgery with a good chance in resolving the problem. The controversies are surrounding the curvatures that require conservative treatments (non-surgical), in order to fix the curvature and/or prevent the curve from progressing further.

Last year I had the privilege to be a guest at a hospital designated for patients with scoliosis in the city of Bad Sobernheim, Germany. In this hospital, kids usually around age 16 or younger (since it is easier to fix the curvature before full spinal maturity), were treated for 3 weeks by practitioners certified in Schroth Method (only 3 practitioners in Canada) and specific Cheneau braces customized to each person. The success rate of the hospital is over 90% based on the orthopedic surgeon running the place.   

So why can’t we have our kids treated here in North America? The answer is really short; money! Everything in Germany is paid by their public insurance; the cost of the brace by itself in North America would be around $15,000, so what do we do here, you guessed it; surgery! 

Again to be clear, conservative treatments may help with the management of pain, and many patients may have mild scoliosis which was discovered “accidently” on x-ray which may not be causing their current symptoms; but the treatments I discussed above will be able to children in Europe and not our children due to our pathetic public insurance. 

Please contact me with any questions you may have,

Dr. Masoumi

www.facebook.com/drmasoumi

Orthotics; an income or a solution?

Custom made orthotics can be a really good source of income for your doctor. But does it really help? The answer to this question is dependent on your diagnosis and the doctor prescribing it. Even though many practitioners can make orthotics, they don’t really fully understand how to make them.

The biggest misconception about orthotics is its effect on relieving foot pain only. As humans, we spend the majority of our times on our feet; therefore any excessive movement in our feet will affect our knees, hips and lower back (called the Kinetic Chain). The majority of people getting orthotics are diagnosed by over-pronation, which simply means rolling your foot in. Here is a picture of normal vs. severe over-pronated foot.

Normal

Over-Pronation

                            

About 90% of people are over-pronators, but that doesnt mean they all need orthtoics! A custom made orthotic should be prescribed after a complete history, biomechanical exam, gait analysis (gait analysis is analysing the way you walk most often using a scanner), and casting techniques.

                                             

An orthotic is a device desinged to align the foot and ankle into the most anatomically efficient position. they look like insoles, but are biomechanical medical appliances that are custom made to correct your specific foot imbalance. You are not required to get bigger shoes and they usually feel really comfortable the first time you use them.

Orthotics can be a good compliment in the resolution of your pain and discomfort, but having proper shoes along with proper exercises and lifestyle changes can be of a bigger importance.

So, is orthotics a good source of income for your doctor or a solution to your problem? The answer is dependent on you diagnosis, your doctor's ethics and knowledge of prescribing the right pair of orthotics for your condition.

 

Dr. Masoumi

www.facebook.com/drmasoumi