scoliosis

Scoliosis causes a sideways curve of your backbone, or spine. These curves are often S- or C-shaped. Scoliosis is most common in late childhood and the early teens, when children grow fast. Girls are more likely to have it than boys. It can run in families. Symptoms include leaning to one side and having uneven shoulders and hips. Sometimes it is easy to notice, but not always.

Children may get screening for scoliosis at school or during a checkup. If it looks like there is a problem, your doctor will use your medical and family history, a physical exam, and imaging tests to make a diagnosis. Treatment depends on your age, how much more you're likely to grow, how much curving there is, and whether the curve is temporary or permanent. People with mild scoliosis might only need checkups to see if the curve is getting worse. Others might need to wear a brace or have surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

When you look at an object, you're using several muscles to move both eyes to focus on it. If you have a problem with the muscles, the eyes don't work properly.

There are many kinds of eye movement disorders. Two common ones are:

• Strabismus - a disorder in which the two eyes don't line up in the same direction. This results in "crossed eyes" or "walleye."
• Nystagmus - fast, uncontrollable movements of the eyes, sometimes called "dancing eyes"

Some eye movement disorders are present at birth. Others develop over time and may be associated with other problems, such as injuries. Treatments include glasses, patches, eye muscle exercises, and surgery. There is no cure for some kinds of eye movement disorders, such as most kinds of nystagmus.

Friedreich ataxia is an inherited disease that damages your nervous system. The damage affects your spinal cord and the nerves that control muscle movement in your arms and legs. Symptoms usually begin between the ages of 5 and 15. The main symptom is ataxia, which means trouble coordinating movements. Specific symptoms include:

• Difficulty walking
• Muscle weakness
• Speech problems
• Involuntary eye movements
• Scoliosis (curving of the spine to one side)
• Heart palpitations, from the heart disease which can happen along with Friedreich ataxia

People with Friedreich ataxia usually need a wheelchair 15 to 20 years after symptoms first appear. In severe cases, people become incapacitated. There is no cure. You can treat symptoms with medicines, braces, surgery, and physical therapy.

NIH: National Institute of Neurological Disorders and Stroke

The mitral valve is one of the four valves in your heart. Heart valves have flaps that open and close. The flaps make sure that blood flows in the right direction through your heart and to the rest of your body. When your heart beats, the flaps open to let blood through. Between heartbeats they close to stop the blood from flowing backwards.

The mitral valve opens to let blood flow from your heart's upper left chamber to the lower left chamber. When the lower left chamber contracts (squeezes) to pump blood to your body, the mitral valve closes tightly to keep any blood from flowing backwards.

Mitral valve prolapse (MVP) happens when the flaps of the mitral valve become floppy and don't close tightly. In some cases, blood may leak backwards through the valve to the chamber it came from. This is called backflow, or regurgitation. When there is a lot of mitral valve backflow, the heart can't push enough blood out to the body.

But most people who have MVP don't have any backflow. In fact, MVP doesn't cause any health problems for most people who have it.

Anyone can have MVP. Most people who have it were born with it. MVP tends to run in families, but researchers don't know the exact cause.

You may be more likely to develop MVP if you:

• Are older. The risk of MVP increases as aging affects the valve.
• Had rheumatic fever, a disease that can develop after a strep throat infection and cause damage to the heart valves.
• Were born with a connective tissue disorder, such as Marfan syndrome or Ehlers-Danlos syndrome.
• Have Graves' disease, a type of thyroid condition.
• Have scoliosis (a side-to-side curve of the spine) or other problems with the bones of your body.
• Have some types of muscular dystrophy.

Mitral valve prolapse with backflow is most common in men and people who have high blood pressure.

Most people who have MVP don't have any symptoms. But if it does cause symptoms, they may include:

• Heart palpitations (feeling that your heart is fluttering, skipping beats, or beating too hard or too fast)
• Shortness of breath (feeling like you can't get enough air)
• A cough
• Fatigue, dizziness, or anxiety
• A migraine
• Chest pain

In rare cases, MVP can cause other problems. They're most often caused by backflow. They can include:

• Arrhythmia, a problem with the rate or rhythm of your heartbeat
• Endocarditis, an infection in the lining of the heart and heart valves
• Heart failure

Health care providers often find MVP during routine health check-ups. If you have MVP, your provider may hear a clicking sound when listening to your heart with a stethoscope. If blood flows backwards through the valve, your heart may also make a whooshing sound called a heart murmur.

You may also need certain heart tests. The most useful test is an echocardiogram, or echo. This is a type of ultrasound that uses sound waves to make a moving picture of your heart.

Most people don't need any treatment for MVP. If you have symptoms with little or no backflow, you may only need medicine to relieve your discomfort.

If the amount of backflow is significant, you may need treatment to prevent other heart problems from developing. Treatments may include:

• Medicines to help your heart work better.
• Heart surgery to repair or replace a very abnormal mitral valve with backflow. The goal of surgery is to improve your symptoms and reduce your risk of developing heart failure.

When possible, valve repair is generally preferred over replacement. That's because repairs are less likely to weaken the heart muscle, and they're less likely to cause heart infection.

You can't prevent mitral valve prolapse. But if you have mitral valve prolapse, you can help prevent the rare but serious problems it can cause by:

• Brushing and flossing your teeth regularly. That helps keep bacteria out of your bloodstream, which further reduces the rare risk of a heart infection.
• Asking your provider if you need to take antibiotics before dental work or surgery to lower your risk of heart infection. This mostly applies to people who have had valve repair or replacement surgery.
• Getting regular check-ups and taking any medicines that your provider may have prescribed.
• Making heart-healthy habits part of your life to prevent heart disease.

NIH: National Heart, Lung, and Blood Institute

Muscular dystrophy (MD) is a group of more than 30 genetic diseases. They cause weakness of the muscles. Over time, the weakness gets worse and can cause trouble walking and doing daily activities. Some types of MD can also affect other organs.

There are many different types of MD. Some of the more common types include:

• Duchenne muscular dystrophy, which is the most common childhood form. It is severe and affects boys more often than girls. The symptoms usually start between ages 3 and 6.
• Becker muscular dystrophy, which is similar to Duchenne but is less severe and gets worse more slowly. It often starts in the teenage years.
• Congenital muscular dystrophies, which are present at birth or before age 2. They can be mild or severe.
• Facioscapulohumeral muscular dystrophy, which often starts in the teenage years. At first, it affects the muscles of the face, shoulders, and upper arms.

Each of the types of MD can be different in many ways, such as:

• Who is more likely to get them
• Which muscles they affect
• When they appear, such as in infancy, childhood, middle age, or later
• What the symptoms are
• How serious the symptoms are
• How quickly they get worse
• Whether they run in families
• Whether they affect other organs

Even within the same type of MD, people can have different symptoms.

MD is genetic, meaning that it caused by a change in one or more genes. Gene changes are also called gene variants or mutations. The gene changes in MD affect proteins that strengthen and protect muscles.

There are different gene changes that cause each type of MD. And sometimes people who have the same type of MD can have different gene changes.

Muscular dystrophy can run in families, or you can be the first in your family to have a muscular dystrophy.

To find out if you or your child has MD, your health care provider may use:

• A medical and family history
• A physical exam
• Blood and urine tests, including genetic tests and tests for certain enzymes that may be released by damaged muscles
• Muscle biopsies
• Electromyography and nerve conduction studies to find out if muscles are responding the right way to nerve signals
• Heart testing, such as an electrocardiogram (EKG), since some types of MD can cause heart problems
• Exercise tests to measure muscle strength and breathing and detect any increased rates of certain chemicals following exercise
• Imaging tests such as an MRI to look at muscle quality and bulk and measure fatty replacement of muscle tissue

There is no cure for muscular dystrophy. Treatment can help with the symptoms and prevent complications. It usually includes a combination of therapies, such as:

• Physical therapy to help keep muscles flexible and strong
• Occupational therapy to relearn lost motor skills and learn ways to work around weakened muscles
• Respiratory care, such as breathing exercises, oxygen therapy, and ventilators
• Speech therapy to help with speech and swallowing problems
• Assistive devices, such as wheelchairs, splints and braces, and walkers
• Medicines to help delay damage to muscles or minimize the symptoms of MD
• Surgery to treat some of the conditions associated with MD, such as heart problems, scoliosis, and cataracts

NIH: National Institute of Neurological Disorders and Stroke

Polio, or poliomyelitis, is a disease that spreads from person to person. It is caused by the poliovirus. The virus attacks the nervous system. In serious cases, it can cause paralysis (where you can't move parts of the body). The paralysis may be lifelong and can sometimes be life-threatening.

Because of vaccines, polio is rare in the United States. But polio does occur in some parts of the world, and travelers can spread the virus.

The poliovirus is very contagious. It spreads through contact with:

• The stool (poop) of person who has the infection
• Droplets from a sneeze or cough of someone who has the infection

This contact can happen if:

• You get contaminated stool or droplets on your hands and then touch your mouth
• A child puts contaminated toys or other objects into their mouth
• You share food or utensils with someone who has the infection

People who have the infection can spread it to others just before and up to several weeks after the symptoms appear. People who don't have symptoms can still spread the virus to others and make them sick.

Polio mainly affects children under age 5. But people of any age (including adults) who are unvaccinated are at risk of developing polio. People who live in or travel to areas where there is polio are more likely to get polio.

Most people who get infected with poliovirus do not have any symptoms. But one out of four people who get polio will have flu-like symptoms. These symptoms usually last 2 to 5 days, and they include:

• Sore throat
• Fever
• Fatigue
• Nausea
• Headache
• Stomach pain

In rare cases, polio can be very serious. It can lead to:

• Meningitis, an infection of the covering of your spinal cord and/or brain.
• Weakness or paralysis in your arms, legs, or both. This paralysis or weakness can last a lifetime. It is possible for the paralysis to become life-threatening if it affects the muscles that you use to breathe.
• Post-polio syndrome (PPS), which happens later in life.

Post-polio syndrome (PPS) is a condition that affects polio survivors many years after they recovered from polio. It usually happens 15-40 years later. It is not contagious.

People who get PPS start having new weakening in muscles that were previously affected by the polio infection. Symptoms may range from mild to serious. The symptoms of PPS include:

• Muscle weakness
• Muscle atrophy (wasting away of muscles)
• Loss of muscle function
• Mental and physical fatigue
• Joint pain
• Curving of the spine (scoliosis)

PPS is rarely life-threatening, but the symptoms can interfere with your daily life.

If you think you or someone in your family has symptoms of polio, call your healthcare provider right away or go to an emergency room.

To find out if you or your child has polio, the provider:

• Will do a physical exam.
• Will take a detailed medical history, including your vaccination history and history of any recent travel.
• Will collect samples of body fluids, such as stool, saliva, blood, urine, and spinal fluid. Poliovirus is most likely to be detected in stool specimens.
• May do an MRI to look at pictures of the spinal cord.

There is no cure or specific treatment for polio. For a mild case, getting rest and drinking plenty of liquids may help with some of the symptoms.

If the polio is more serious, you or your child may need:

• Physical or occupational therapy to help with arm or leg weakness. The earlier therapy is started, the better.
• Pain relievers to help with pain and treat fever. If your child is sick, do not give them aspirin unless their provider tells you to.
• A ventilator to help with breathing if the breathing muscles are weak or paralyzed.

There is no cure for PPS. Treatments may help you manage your symptoms. They include:

• Non-fatiguing exercises (exercises that do not cause pain or fatigue that lasts more than 10 minutes). These exercises may improve muscle strength and reduce tiredness. Your provider can help you figure out which exercises are best for you.
• Mobility aids.
• Ventilation equipment.
• Lifestyle changes, such as eating a healthy diet, getting enough sleep, and not smoking.

There are two types of vaccine that can prevent polio:

• Inactivated poliovirus vaccine (IPV) given as an injection in the leg or arm, depending on how old you are. Since 2000, this has been the only polio vaccine used in the United States.
• Oral poliovirus vaccine (OPV) is given as drops in the mouth. It is still used throughout much of the world.

Children in the United States get four doses of PV as part of their routine childhood immunizations. Most adults in the United States were vaccinated against polio as children.

There is a one-time IPV booster. It may be given to adults who have completed their polio vaccinations but are at higher risk of contact with poliovirus. You may be at higher risk if you are:

• Traveling to a country where the risk of getting polio is greater
• Working in a laboratory or healthcare setting and handling samples that might contain polioviruses
• A healthcare worker who has contact with patients who could have polio

Another way to help prevent the spread of polio is to wash your hands often with soap and water. Alcohol-based hand sanitizers will not kill poliovirus.

Centers for Disease Control and Prevention

Respiratory failure is a condition in which your blood doesn't have enough oxygen or has too much carbon dioxide. Sometimes you can have both problems.

When you breathe, your lungs take in oxygen. The oxygen passes into your blood, which carries it to your organs. Your organs, such as your heart and brain, need this oxygen-rich blood to work well.

Another part of breathing is removing the carbon dioxide from the blood and breathing it out. Having too much carbon dioxide in your blood can harm your organs.

Conditions that affect your breathing can cause respiratory failure. These conditions may affect the muscles, nerves, bones, or tissues that support breathing. Or they may affect the lungs directly. These conditions include:

• Diseases that affect the lungs, such as COPD (chronic obstructive pulmonary disease), cystic fibrosis, pneumonia, pulmonary embolism, and COVID-19
• Conditions that affect the nerves and muscles that control breathing, such as amyotrophic lateral sclerosis (ALS), muscular dystrophy, spinal cord injuries, and stroke
• Problems with the spine, such as scoliosis (a curve in the spine). They can affect the bones and muscles used for breathing.
• Damage to the tissues and ribs around the lungs. An injury to the chest can cause this damage.
• Drug or alcohol overdose
• Inhalation injuries, such as from inhaling smoke (from fires) or harmful fumes

The symptoms of respiratory failure depend on the cause and the levels of oxygen and carbon dioxide in your blood.

A low oxygen level in the blood can cause shortness of breath and air hunger (the feeling that you can't breathe in enough air). Your skin, lips, and fingernails may also have a bluish color. A high carbon dioxide level can cause rapid breathing and confusion.

Some people who have respiratory failure may become very sleepy or lose consciousness. They also may have arrhythmia (irregular heartbeat). You may have these symptoms if your brain and heart are not getting enough oxygen.

Your health care provider will diagnose respiratory failure based on:

• Your medical history
• A physical exam, which often includes
• Listening to your lungs to check for abnormal sounds
• Listening to your heart to check for arrhythmia
• Looking for a bluish color on your skin, lips, and fingernails
• Diagnostic tests, such as
• Pulse oximetry, a small sensor that uses a light to measure how much oxygen is in your blood. The sensor goes on the end of your finger or on your ear.
• Arterial blood gas test, a test that measures the oxygen and carbon dioxide levels in your blood. The blood sample is taken from an artery, usually in your wrist.

Once you are diagnosed with respiratory failure, your provider will look for what is causing it. Tests for this often include a chest x-ray. If your provider thinks you may have arrhythmia because of the respiratory failure, you may have an EKG (electrocardiogram). This is simple, painless test that detects and records your heart's electrical activity.

Treatment for respiratory failure depends on:

• Whether it is acute (short-term) or chronic (ongoing)
• How severe it is
• What is causing it

Acute respiratory failure can be a medical emergency. You may need treatment in intensive care unit at a hospital. Chronic respiratory failure can often be treated at home. But if your chronic respiratory failure is severe, you might need treatment in a long-term care center.

One of the main goals of treatment is to get oxygen to your lungs and other organs and remove carbon dioxide from your body. Another goal is to treat the cause of the condition. Treatments may include:

• Oxygen therapy, through a nasal cannula (two small plastic tubes that go in your nostrils) or through a mask that fits over your nose and mouth
• Tracheostomy, a surgically-made hole that goes through the front of your neck and into your windpipe. A breathing tube, also called a tracheostomy, or trach tube, is placed in the hole to help you breathe.
• Ventilator, a breathing machine that blows air into your lungs. It also carries carbon dioxide out of your lungs.
• Other breathing treatments, such as noninvasive positive pressure ventilation (NPPV), which uses mild air pressure to keep your airways open while you sleep. Another treatment is a special bed that rocks back and forth, to help you breathe in and out.
• Fluids, often through an intravenous (IV), to improve blood flow throughout your body. They also provide nutrition.
• Medicines for discomfort
• Treatments for the cause of the respiratory failure. These treatments may include medicines and procedures.

If you have respiratory failure, see your health care provider for ongoing medical care. Your provider may suggest pulmonary rehabilitation.

If your respiratory failure is chronic, make sure that you know when and where to get help for your symptoms. You need emergency care if you have severe symptoms, such as trouble catching your breath or talking. You should call your provider if you notice that your symptoms are worsening or if you have new signs and symptoms.

Living with respiratory failure may cause fear, anxiety, depression, and stress. Talk therapy, medicines, and support groups can help you feel better.

NIH: National Heart, Lung, and Blood Institute

Spinal muscular atrophy (SMA) is a group of genetic diseases that damages and kills motor neurons. Motor neurons are a type of nerve cell in the spinal cord and lower part of the brain. They control movement in your arms, legs, face, chest, throat, and tongue.

As the motor neurons die off, your muscles start to weaken and atrophy (waste away). The muscle damage gets worse over time and can affect speaking, walking, swallowing, and breathing.

There are different types of SMA. They are based on how serious the disease is and when the symptoms start:

• Type l is also called Werdnig-Hoffman disease or infantile-onset SMA. It is the most severe type. It is also the most common. Babies with this type usually show signs of the disease before 6 months of age. In more severe cases, the signs show up even before or just after birth (Types 0 or 1A). The babies may have trouble swallowing and breathing and may not move around a lot. They have chronic shortening of muscles or tendons (called contractures). They usually cannot sit up without help. Without treatment, many children with this type will die before 2 years of age.
• Type ll is a moderate to severe type of SMA. It usually first noticed between 6 and 18 months of age. Most children with this type can sit without support but cannot stand or walk without help. They may also have trouble breathing. They can usually live into adolescence or young adulthood.
• Type lll is also called Kugelberg-Welander disease. It is the mildest type that affects children. The signs of the disease usually show up after age 18 months. Children with this type can walk by themselves but may have trouble running, getting up from a chair, or climbing stairs. They may also have scoliosis (curvature of the spine), contractures, and respiratory infections. With treatment, most children with this type will have a normal lifespan.
• Type IV is rare and often mild. It usually causes symptoms after 21 years of age. The symptoms include mild to moderate leg muscle weakness, tremors, and mild breathing problems. The symptoms slowly get worse over time. People with this type of SMA have a normal lifespan.

Most types of SMA are caused by a change in the SMN1 gene. This gene is responsible for making a protein that the motor neurons need to be healthy and to function. But when part of the SMN1 gene is missing or abnormal, there isn't enough protein for the motor neurons. This causes the motor neurons to die off.

Most people have two copies of the SM1 gene - one from each parent. SMA normally only happens when both copies have the gene change. If only one copy has the change, there usually aren't any symptoms. But that gene could be passed down from parent to child.

Some of the less common types of SMA may be caused by changes in other genes.

Your health care provider may use many tools to diagnose SMA:

• A physical exam
• A medical history, including asking about family history
• Genetic testing to check for the gene changes that cause SMA
• Electromyography and nerve conduction studies and a muscle biopsy may be done, especially if no gene changes were found

Parents who have a family history of SMA may want to do a prenatal test to check to see whether their baby has an SMN1 gene change. An amniocentesis or in some cases a chorionic villi sampling (CVS) is used to get the sample for testing.

In some states, genetic testing for SMA is part of newborn screening tests.

There is no cure for SMA. Treatments can help manage symptoms and prevent complications. They may include:

• Medicines to help the body make more of the proteins that the motor neurons need
• Gene therapy for children under 2 years of age
• Physical, occupational, and rehabilitation therapy to help to improve posture and the mobility of the joints. These therapies may also improve blood flow and slow muscle weakness and atrophy. Some people may also need therapy for trouble speaking, chewing, and swallowing.
• Assistive devices such as supports or braces, orthotics, speech synthesizers, and wheelchairs to help people stay more independent
• Good nutrition and a balanced diet to help maintain weight and strength. Some people might need a feeding tube in order to get the nutrition they need.
• Breathing support for people who have muscle weakness in the neck, throat, and chest. The support may include devices to help with breathing during the day and to prevent sleep apnea at night. Some people might need to be on a ventilator.

NIH: National Institute of Neurological Disorders and Stroke

Your spine, or backbone, protects your spinal cord and allows you to stand and bend. Spinal stenosis causes narrowing in your spine. The narrowing puts pressure on your nerves and spinal cord and can cause pain.

Spinal stenosis occurs mostly in people older than 50. Younger people with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include:

• Pain in your neck or back
• Numbness, weakness, cramping, or pain in your arms or legs
• Pain going down the leg
• Foot problems

Doctors diagnose spinal stenosis with a physical exam and imaging tests. Treatments include medications, physical therapy, braces, and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include:

• Infections
• Injuries
• Tumors
• Conditions, such as ankylosing spondylitis and scoliosis
• Bone changes that come with age, such as spinal stenosis and herniated disks

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.