December 16th, 2016 marked 14 years since one of the most significant events in my lifetime so far. It’s scary to think that just one wrong move by the surgeon and I may not be where I am today. Having gone through both, the physical and emotional demands of the scoliosis journey, it reminds me that I can get through anything I want with determination and positivity. This post is really to shed light on scoliosis as an example that conditions that seem purely physical, have major mental and emotional components to them that often get overlooked by the medical community but need to be addressed to truly heal the person.
Spinal fusion surgeries for scoliosis curve correction carry an immense risk because the surgeon and his team are working in an area that houses your spinal cord, lots of nerves, and your spine – the backbone that keeps you erect. At the time of my surgery, I was told that there was a 4% risk of complete paralysis and a 7% risk of partial paralysis.
An adolescent with scoliosis who requires surgery doesn’t just have to deal with the stress, anxiety, worry, and fear of having the surgery due to this risk. Likely if surgery is warranted, the adolescent likely wore a back brace prior to surgery and the brace failed to continue producing positive results indicating surgery is necessary. Therefore, he or she had to deal with the psychological impacts of wearing this back brace.
Scoliosis is defined as the lateral curvature of the spine. Most commonly seen as an ‘S’ or a backward ‘S’ spine (thoracic and lumbar curves). Some people do have a ‘C’ spine where they only have one curve. In my case, I still have cervical, thoracic, and lumbar lateral curvatures post-surgery but all my curves reduced as a result of the surgical reduction to my thoracic curve. Most curves under 20 degrees typically require observation. It’s usually when the curve is over 25 degrees, bracing becomes a reality and surgery becomes the option of choice when curves reach 50 degrees or greater or depending on the risk of progression is for you. I was "lucky" enough to experiment with wearing a brace for 3.5 years (12-15 years of age) and then ended up having surgery! The implications of large degree curves include back pain, restrictive lung disease as the spine compresses the lungs making it harder for the lungs to expand with air, and possible compression and spatial displacement of other organs. Sometimes, the ribs can be removed to reduce the hump but this typically isn't necessary.
Scoliosis Fusion Surgery with Harrington Rods
While many medical professionals look at scoliosis from a physical disease viewpoint, what is often overlooked is the mental/emotional effects that an individual with scoliosis undergoes. No, it is not just the anxiety, stress, and fear about the surgery. Most people are in their prime pre-teen/teenage years around 12 years of age when diagnosed. This is a time when social relationships become important, intimacy and romantic relationships may begin, they want to fit in at high school, stay up-to-date with the latest fashion trends but often having a diagnosis of scoliosis makes these individuals feel different, especially if they have to wear a brace 23 hours a day.
The three major areas that can be impacted from a psychological standpoint in an adolescent with scoliosis, especially if he or she has to wear a back brace are relationships, self-esteem, and confidence, and, anxiety and depression.
This isn’t only about romantic relationships but any relationship or friendship. Wearing a back brace literally and metaphorically creates a “barrier” between the individual with scoliosis and the outside world. Its purpose is to prevent the curve from progression but it also acts as a shield protecting the person and preventing him or her from becoming closer to people. I remember when I would wear my back brace, I would intentionally keep my distance from people to prevent people from touching me because I didn’t want them to feel my hard shell. Yes – that meant I disliked getting hugs! This can lead someone to feel like a loner and your social life is almost non-existent.
Friendships may get threatened when you end up missing lots of school for doctor appointments and if you are supposed to have surgery, the amount of school you miss is incredible from pre-operative appointments, the week hospital stay following your surgery, and time off to recover at home.
Wearing this protection shield also means you cannot dress the way your peers dress. Rather than wearing fashionable clothes, you may have to wear sweatshirts and stretchy pants to go over this brace and attempt to cover it. This makes you stand out, feel different, and decreases your self-confidence. It’s hard to go out in public places without consistently worrying about what people think when they see the hump on your back from your scoliosis curve or your back brace. You are also scared to drop something or pick something up from the ground because you don’t want to bend over to pick it up (makes the brace evident). Instead of being confident and strong, one may tend to “hide” his or herself to not be visible making that individual appear shy and reserved and less confident. Now people you meet have an image of the individual as shy and reserved which further adds to lowered self-esteem.
Mental and Emotional Health
The negative impact that scoliosis may have on relationships and decreasing one’s self-esteem can start to play a role on one’s mental health leading to anxiety and depression from feeling lonely, socially isolated, different, and like you don’t fit in anywhere. I am sure many people have faced the same dilemma I faced when you just don’t want to wear your brace to a social gathering but are worried that it might impact the progression of the curve. It’s a battle of two worlds – to let people know the real ‘you’ or to shield the real ‘you’ from others. There is also the constant anxiety that precedes every follow-up appointment, taking that x-ray and hoping that the curve has not progressed because, let’s face it, nobody would want surgery if they didn’t need it.
Like any other health condition, it is important to address the mental and emotional states of being in a patient and not just the physical ailment because the emotional implications can stay with a person even after the physical condition has been resolved or treated and have an impact in other areas of their life. This is what naturopathic doctors and other holistic healthcare professionals are trained to do and is within the ND principles of practice. Since scoliosis is so structural, it is hard to pay attention to the psychological aspects of the condition but it cannot be ignored especially since most diagnoses occur in adolescence and can impact body image, appearance, and ability to connect with others.
If you or your adolescent child has scoliosis and is experiencing anxiety, depression, low self-confidence, and self-esteem or just wants to complement their scoliosis treatment with naturopathic healthcare to help strengthen the body's healing power and alleviate pain, contact me for an appointment. I've used complementary medicine during my scoliosis journey and it helped me tremendously with the outcome of my surgery, though everyone is an individual and may have different benefits.