A crooked back, stoop, one shoulder above the other – what other problems with posture have you noticed in your children? It turned out that sports and dancing are not a panacea for this problem.
Experts told Lethidore in detail about scoliosis and scoliotic posture, how they differ, why the spine is formed incorrectly, and what parents can do if the doctor has noted a violation of the child’s posture.
Comments on Olga Borisovna Zugel, children’s traumatologist-orthopedist at the Zdravitsa clinic network (Novosibirsk)
Olga Borisovna Zugel
Posture is a complex concept of the habitual position of the body of a laid-back person. It is determined and regulated by reflexes of posture and reflects not only the physical but also the mental state of a person.
When evaluating posture, attention is paid to physiological bends and to the deflection of the spine in the frontal plane (i.e. to the side).
Violation of posture is an unfixed curvature, that is, a person can independently, by willpower (actively turning his head on) eliminate this violation, and when examined in a prone position, the doctor will not see deviations from the age norm.
Scoliotic posture – deflection of the spine in the frontal plane.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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- What habits badly affect posture
- Types of Scolis
- Scoliotic disease and causes of scoliosis
- SCOLIOSIS is treated only “fresh”
- Scoliosis 1 and 2 degrees: the rules of treatment
- Symptoms of scoliosis of various degrees
- Treatment of scoliosis of the 1st degree
- Treatment of scoliosis of the 2st degree
- Prevention of disease progression
- Scoliosis of the 1st degree
- Types and degrees of scoliosis
- Symptoms of the disease and signs of occurrence
- Causes of Scoliosis
- Scoliosis of the 1st degree in children
- Scoliosis of the first degree in adolescents
- Scoliosis of the 1st degree in adults
- Treatment of scoliosis of the spine of 1 degree
- Healing Fitness
- Scoliosis Massage
- Scoliosis treatment at home
What habits badly affect posture
The main thing: posture = habit.
Habits, good and bad, are formed in the process of raising a child. Some children have predisposing factors: decreased muscle tone, muscle imbalance, poor nutrition, genetically weak fixative ligamentous apparatus, etc.
But this is no excuse. With a properly organized regimen, rational physical activity, inclusion of elements of therapeutic gymnastics in the day regimen, and a balanced diet, the child develops a normal posture.
Everyone knows that at school you need to sit up straight and not hunch. But along with this there are still many reasons for concern.
- The child has a long bang, covering one eye, which causes the habit of tilting the head – because of this, the shoulder girdle is skewed and the spine deviates to the side.
- A schoolboy carries a bag on one shoulder, sits, leaning in one direction, engages in an asymmetric sport (tennis, fencing) – this is how a violation of posture develops.
- At the age of 13-14, teenagers who practice classical or folk dancing, have rhythmic gymnasts forming a flat back (the back of the habit and training to keep the back straight), which leads to the deviation of the spine to the side. This is because physiological bends are needed to cushion during shock during walking, and if they are not there, a lateral bend is formed.
- Gadgets (phone, tablet), when working with which the head is lowered, the child sits leaning forward. The result is stoop, “gadget neck”, “accounting tubercle”, “double chin”.
- The child has a small difference in the length of the legs (3-5 mm), which is a variant of the norm for a person, but this gives a distortion of the pelvis and a compensatory deviation of the spine to the side. Also, asymmetrical flattening of the feet (flat feet, valgus installation of the feet) will be the cause of the pelvic distortion.
- Psychological factor: remember the expression “hung his nose”, “slave pose”, etc. Often seeing the relationship of the parents with the child at a reception, even in the presence of an outsider, I personally want to hide, pull my head in my shoulders or shyly lower it, and the child lives and constantly hides “in itself”. The same thing happens in school.
The key to success is the desire of the parent and child, as well as consistency and efforts to strengthen the so-called muscle corset (daily for 30-40 minutes a day, gymnastics, constant control of the posture).
Violation of posture is treated comprehensively, so massage as a panacea and wearing a posture corrector are ways to clear conscience, not treatment.
Types of Scolis
What is scoliosis? Scoliosis (Greek. Σκολιός – “curve”, Latin scoliōsis) – a three-plane deformation of the spine in humans. Curvature can be congenital, acquired and post-traumatic.
These scoliosis are called idiopathic (which means “unknown reason” in Greek). Such scoliosis occurs in girls about 4-7 times more often than in boys.
Idiopathic scoliosis has nothing to do with the so-called infant scoliosis, which manifests itself before the year of life and in which there are no abnormalities in the development of the bodies of individual vertebrae (in contrast to congenital scoliosis).
“Infant scoliosis” can disappear on its own. Idiopathic scoliosis occurs mainly in the phase of accelerated skeletal growth.
Scoliotic disease and causes of scoliosis
Scoliotic disease is a lateral curvature of the spine with mandatory rotation of the vertebral bodies (torsion), a characteristic feature of which is the progression of deformation associated with the age and growth of the child.
Scoliotic disease is a progressive (i.e. worsening) dysplastic disease of the growing spine of children aged 6-15 years (girls are 3-6 times more likely).
Let me explain, this is not a habit, this is a disease. And the best that can be expected from conservative treatment is the stabilization of the deformation or the slowdown in the rate of progression. Scoliotic disease is mainly treated promptly.
The remaining 20% of scoliosis occurs due to:
congenital deformities of the vertebrae (for example, Klippel-Feil syndrome);
diseases of the neuromuscular system (e.g. polio);
abnormalities in the development of vertebral bodies;
connective tissue diseases, bone metabolism;
acquired spinal deformities after injuries and amputations due to accidents or operations to remove malignant tumors;
in children after heart surgery;
due to the pronounced difference in the length of the legs;
in adolescents with Scheuermann’s disease – Mau (“juvenile kyphosis”).
SCOLIOSIS is treated only “fresh”
Sometimes the “laid-back” pose of a child falling apart at a desk, causing the teacher to be indignant – forced – he simply cannot stay in another for a long time. With scoliotic disease, he developed a “scoliotic posture”, which simply “bends” him, exacerbating the disease. The main article is the treatment of scoliosis (Kiev).
According to statistics, about 85% of children in one way or another suffer from scoliosis. In most cases, until a certain period, the disease is almost asymptomatic, and parents do not even suspect that the child needs urgent medical attention.
– There is an opinion that the origin of scoliosis is unknown, but what do you think, Gennady Vasilievich?
– Based on my 25-year practice, I affirm: scoliosis is “originally from childhood” and is laid in the womb. And then untimely detection and improper treatment of newborns (up to 1 year) leads to the development of scoliotic posture in early childhood and scoliosis in adolescence. Doctors do not recommend any treatment for children under 7-8 years of age, prescribe only massages, physical procedures, exercise therapy, orthopedic appliances, and at an older age they cannot determine where scoliosis comes from.
They say that 60% of all diseases are associated with a genetic predisposition, but if you approach medicine in a new way, i.e. form the correct stereotype of the musculoskeletal system from the first days of life in a timely manner, then these figures will decrease by three times.
If functional blocking of the spine occurred before the age of one month, then the carotid artery narrows at the same time, oxygen starvation of the brain occurs, and venous blood flow is also difficult. As a result, the metabolism in the hypothalamus is disrupted, which regulates the production of hormones by other glands, including the production of hormones responsible for normal growth and full development. It would seem a trifle, but leads to such serious violations. Blocking in the spine and radicular syndrome leads to all kinds of diseases of the internal organs. From childhood, it is possible to predict what diseases the adult will subsequently have.
Up to six months, all manipulations to eliminate the curvature of the spine can be carried out virtually painlessly and almost completely save the child from serious manifestations of scoliotic disease subsequently. But after six months, when the child takes an upright position, each subsequent day can be considered lost.
– Simply, not for a specialist, can this be explained?
– The human spine has four natural curvatures – forward in the cervical and lumbar regions, backward – in the thoracic and sacral regions. A properly and moderately curved spine acts as a shock absorber. These bends are formed up to 7 years of age, and by the age of 12-14 they are finally fixed. The pathological curvature of the spine in children, having taken a stable form, is no longer just a violation of posture – as a result, excessive forward bending (lordosis) or backward (kyphosis), as well as scoliosis (S-shaped bending of the spine to the sides) can be fixed. A combination of these curvatures is also common.
– And what does it threaten?
– In addition to reducing the depreciation function of the spine, impaired cerebral circulation and internal organs, impaired respiratory function, immunity is weakened. Result – the body is susceptible to viral infections, dysbiosis, allergies. In girls, by the time of puberty, polycystoses can occur, hormonal disorders occur. In the future, when they are preparing to become mothers, with a skewed pelvis they face a weak labor activity, increased pain during childbirth, and many other problems. In boys, a different pathology manifests itself during a period of intensive growth, but the first manifestations also occur at the age of 18.
It all depends on what changes have occurred in the children’s body. Indeed, with scoliosis, there are many concomitant diseases. The asymmetry of the blades, for example, leads to the fact that one lung will be smaller than the other and, therefore, will work worse. A consequence of the asymmetry of the body may be a different size of the kidneys. With the first and second degrees of scoliosis, one can still hope for a cure, but only before the onset of sexual development. When puberty occurred and the skeleton was fully formed, negative processes can only be stopped to some extent. If there is a deformation of the skeleton and costal arches, if the skeleton is already formed and ossified, the vertebral segments become uneven, wedge-shaped – this is the third or even fourth degree of scoliosis, which is not treated at all, and in which any kind of manipulation is contraindicated.
– But is manual medicine harmful to children?
– It is harmful to not take timely manual medicine from a specialist.
– Why do you think massage is unacceptable in the treatment of scoliosis?
– Relaxing massage will not bring harm, but also benefit. It happens that during the massage elements of manual therapy are ineptly used, and this can lead to instability of the spine. During such a massage, characteristic crunches and clicks are heard, the vertebrae are twisted, stretching the intervertebral hernia, both for children and adults. Therefore, many doctors, when they hear about manual therapy, are scared and do not recommend it.
– How many receptions do you recommend for the treatment of scoliosis?
– If we are talking about children, then they are recommended to go through 3 doses every other day, then individual physical exercises are prescribed for a month, and after another month, one more reception. In the future, if necessary, I advise you to take one-time receptions in half a year.
How to recognize it?
1. When bending forward (legs are straight), the child should freely reach with his fingers – toes. In this case, pay attention to the back: costal arcs on the right and left should be symmetrical. Check to see if your child has any deformation of the ribs or rib hump. Ask to tilt to the side – fingers should reach to the level of the knee.
2. In a standing position, look from the back – the shoulders should be horizontally at the same level, the position of the shoulder blades should also be symmetrical, the waist lines on the left and right should be symmetrical.
3. In the supine position, hands at the seams, head on the chin – note whether there are separately convex asymmetric (relative to the spine left and right) muscles and ribs. The length of the legs should be the same, there should not be flat feet.
4. In the supine position, pay attention to the chest, for any deformities.
Five years ago, a family approached Dr. Ignatiev. The eldest son is 20 years old, the youngest is 2 years old. On examination, it turned out that the young man had scoliosis of the III degree. Parents seriously engaged in his treatment in childhood, carried out all the recommendations of orthopedists, did massages, ultraphoresis, etc. Twice a year, he underwent treatment in sanatoriums. He wore corsets, was engaged in swimming, pumped up a muscle corset, which supposedly will hold the spine. But, despite this – kyphoscoliosis.
With the birth of the second child, similar symptoms began to appear as in the older. Parents did not have scoliosis in the family. Having bitter experience, they turned to me.
Unfortunately, they were late with the treatment of the eldest son. On X-ray, numerous wedge-shaped vertebrae were observed, there were practically no gaps between the vertebrae. The doctor could only help him slightly by eliminating pain and discomfort. It is impossible to correct scoliosis at this age, but you need to deal with the treatment of osteochondrosis.
At the initial examination of the youngest son, it turned out that he had the same predisposition as the eldest. His mother complained that he was often sick, prone to allergies, and little mobility. For 5 years, the baby has visited my reception only 10 times. At the physical examination at school, there were no violations of posture, the child is healthy.
Appointment for consultation and treatment by phone: +38 (044) 227-32-51, 067 920-46-47
Scoliosis 1 and 2 degrees: the rules of treatment
Scoliosis is a curvature of the spine, which is most often manifested in childhood and adolescence. In total, there are 4 degrees of this violation of posture, but, as a rule, orthopedists discover it already in the first two stages. Moreover, scoliosis of the 3rd and 4th degree develops only in 10-20% of cases. MedAboutMe understood how to properly treat the initial stages and stop the progression of the disease.
Symptoms of scoliosis of various degrees
The degree of scoliosis is determined by the degree of curvature of the spine:
- Scoliosis of the 1st degree – up to 10 degrees. The easiest form, which often does not cause any discomfort to a person. After physical exertion, minor back pain may occur, a feeling of stiffness may occur. Curvature is weak and almost imperceptible.
- Scoliosis of the 2nd degree – from 10 to 25 degrees. A more serious form, in which the violation of posture is clearly noticeable: the shoulders and shoulder blades are at different levels, sometimes there is a curvature of the pelvis. The patient may complain of pain in different parts of the spine, fatigue.
- Scoliosis 3 degrees – from 25 to 50 degrees. A well-marked curvature, which often causes pain, leads to a loss of flexibility of the spine, can affect the internal organs – squeeze them. Starting from this stage, deformation cannot be completely eliminated, and treatment is aimed only at slowing the progression of the disease, partial rectification of the spine.
- Scoliosis of 4 degrees – more than 50 degrees. Such a violation of posture is rarely observed and is most often associated with concomitant diseases – skeletal development disorders suffered by polio, cerebral palsy and others. The patient is given disability. The main objective of the treatment is to minimize the effect on the internal organs, as well as to preserve the possible permissible flexibility of the back.
Treatment of scoliosis of the 1st degree
The human body can have individual characteristics – the asymmetry of the right and left sides. This, in turn, affects the location of the spine. Therefore, some cases of scoliosis of the 1st degree may not be a pathology, but just a variant of the norm. Moreover, if such a diagnosis is made, nevertheless, one should not neglect visiting an orthopedist. There are several reasons for this:
- Even the minimum curvature should be kept under control – make sure that the degree of bending does not increase, or if additional symptoms appear.
- In the case when it comes to true scoliosis with torsion of the vertebrae (twisting around the longitudinal axis), treatment is required. This condition is diagnosed solely by an x-ray, therefore, if a degree 1 diagnosis is made, it is imperative to undergo this examination.
- Scoliotic posture (curvature without twisting of the vertebrae) in preschool children should be the reason for strict control of their health by parents. The fact is that scoliosis actively develops precisely at school age, until about 17-18 years, while the body is actively growing. Therefore, at this time, the progression of the disease is possible.
Scoliosis of the 1st degree is successfully compensated by physical activity. Only picking up the sport is necessary correctly. Unacceptable species where only one side of the body or one arm is involved (archery, badminton, tennis, etc.). The best option will be the usual morning exercises, exercises for the comprehensive strengthening of the body. Swimming, skiing, ice skating and roller skating are also good.
Treatment of scoliosis of the 2st degree
Scoliosis of the 2nd degree is a more complex diagnosis, but still one that can be completely eliminated. The most important thing is to provide complex therapy.
The basics of treating this posture disorder are:
- Physiotherapy. Exercise therapy is necessary without fail, since it is here that a set of exercises will be offered that will not only strengthen the muscles of the back, but also help to compensate for curvature of the spine. With scoliosis of the 2nd degree, a slight loss of flexibility of the spinal column can be observed, but any standard stretch marks of the back are contraindicated in this diagnosis – they can exacerbate spinal instability. Exercise therapy helps to safely compensate for stiffness. In addition, the complex includes exercises aimed not only at strengthening the muscular corset, but also at correcting the posture.
- Massage. Used as adjunctive therapy, which makes therapeutic exercises more effective. The main task of massage for scoliosis of the 2nd degree is to adjust muscle tone on both sides of the spine. The fact is that with a curvature to the right or left, an increased tension of the muscular frame of one side is observed. This can cause pain, and is also an additional factor in the progression of curvature.
- Manual therapy. It is used both in traditional and in alternative medicine. It is very effective specifically for the treatment of spinal problems, in particular, it will be relevant for people with true scoliosis when vertebral torsion is noted. Osteopaths prescribe courses of manual therapy exclusively in combination with other methods of treatment, in which case it is most effective.
As an additional treatment, various suitable sports, electrical stimulation of the back muscles can be used, vitamin courses and calcium supplementation to strengthen bones can also be prescribed. Wearing orthopedic corsets is prescribed only in extreme cases, only if there is a rapid progression of the disease. Most often, corsets are used, starting from the 3rd degree of scoliosis.
Prevention of disease progression
According to the speed of the disease, scoliosis is divided into:
- Slowly progressing.
- Fast progressing.
The latter pose the greatest danger, since they very quickly lead to a condition that is no longer possible to completely correct. If scoliosis of the 2nd degree is detected in a child aged 6-8 years, and at the same time there is no history of diseases of the musculoskeletal system, injuries, pathologies of the development of muscle and bone tissue and other provoking factors, it can be assumed that we are talking about a rapidly progressing disease. To clarify this diagnosis, you must regularly visit an orthopedist and undergo a diagnosis.
If diagnosed, treatment should begin immediately. It is most effective under the age of 14, but after 18 it practically does not give results, since the spine is already formed.
That is why, even after treatment in adolescence, the condition of the spine should be constantly monitored. In particular, preventive examinations by an orthopedist should be carried out at least once a year, and at least once every 6 months at the first time after treatment.
- Regular exercise. They strengthen the muscles of the back and help stabilize the spine.
- A mattress for sleep should only be orthopedic.
- Convenient desktop. The distance from the eyes to the countertop should be at least 30 cm. The chair is selected such that the child sits directly, the legs bent at the knees form a right angle.
- Protein-rich food. Meat, dairy products, cheeses, nuts should be present in the diet.
Scoliosis of the 1st degree
Scoliosis is a disease of the spinal column, in which one or more bends (deviations) are formed relative to the vertical position. The disease can manifest itself regardless of age, but in most of the diagnoses made, it falls on children of preschool and school age.
Types and degrees of scoliosis
From the degree of curvature of the spine (angle of deviation from the vertical axis), scoliosis is divided into four degrees:
- 1 degree – the initial stage, expressed by a mild form of curvature with an angle of deviation of less than 10 degrees.
- 2 degree – a stage at which the deviation angle is 11-25 degrees.
- Grade 3 – like the second stage of moderate severity, in which the angle of deviation of the spine is 26-50 degrees.
- Grade 4 – a severe form, with her bending the spine from a vertical axis over 50 degrees.
The amount and direction of bends are used to classify curvatures in scoliosis.
The following types of scoliosis are distinguished, which depend on the number of bends: with one bend – in the image C, with two – in the image S, with three – in the image Z. The direction of curvature of the spinal column is directed to the right or left. Localization of deformation occurs in the neck, sternum, or lower back.
Summing up, we can say that scoliosis of the first degree happens:
Diagnosis can be done in two ways. In the first case, the orthopedic surgeon can detect during a routine medical examination. Or by radiography in a standing position. But radiography at the initial stage is rarely prescribed by a doctor and is considered not advisable.
Symptoms of the disease and signs of occurrence
With scoliosis of the 1st degree, there are its inherent symptoms. Pronounced are the asymmetric arrangement of the shoulders or pelvis. At the same time, posture is disturbed, stoop is clearly visible and lordosis is increased. Do not confuse asymmetric or lethargic posture with another disease. The symptoms seem to be the same, but it is caused due to an imbalance in the muscles. Having laid a person in a horizontal position, external defects disappear.
Causes of Scoliosis
The main cause of the first degree of scoliosis is muscle weakness and uneven spinal growth. They account for about 40% of the causes of diseases.
Congenital anomalies that accelerate curvature account for up to 25% of the causes. These include defects of the vertebrae, pelvic bones, chest, undeveloped structure of muscle and connective tissue with the spine, pathology with cerebral palsy.
Acquired causes of scoliosis of the 1st degree with subsequent progression include:
- sitting at the table, the wrong position is selected (the head is propped up by the hand, the leg is bent, and others are bent strongly).
- a long time spent at a computer or TV (loads from different sides with varying intensity are placed on the spine).
- sedentary lifestyle.
- in contrast, increased loads when playing sports in such forms, where the muscles develop unevenly.
- unstable and uncomfortable shoes.
- moving heavy weight on one shoulder or arm.
- improperly selected furniture for age (table, chair).
In addition to causes, there are diseases that provoke the appearance of scoliosis. This is a hormonal surge or imbalance, a decrease in calcium intake in the body, vertebral tuberculosis, osteomyelitis.
Scoliosis of the 1st degree in children
The first degree is the initial stage, in which the spine is slightly curved. And in children of kindergarten and primary school age, scoliosis is caused by an unformed and weak muscle frame, improper seating at a table or school desk. Indeed, for a large number of children, one teacher cannot be seen. But do not exaggerate. Prevention and treatment of children leads to a positive result.
The progression of scoliosis of the 1st degree in children can be caused only by a lack of attention and a negligent attitude to the health of the child by parents. To identify signs of the disease, it is enough to visit a doctor in the clinic 2-3 times a year. He will follow the dynamics of development and adjust the method of treatment.
For parents, a reminder that the child needs to be reminded of incorrect posture when he plays, is engaged will not be amiss. Buy a table and chair for occupations corresponding to age. To sleep in a crib, you should put an even hard mattress and a low pillow.
Scoliosis of the first degree in adolescents
The most common diagnosis after preventive examinations of schoolchildren is scoliosis. This is due not only to the fact that a teenager sits in class for a long time, but the fact that when he arrives home he sits down at a computer. Social networks, virtual games for a long time. Not a desire to play sports. Here are the root causes.
Sports fortifying have a preventive effect on the spine of a teenager. It is recommended to engage in martial arts and dancing from the east, swimming or just fitness.
Scoliosis of the 1st degree in adults
A diagnosis of scoliosis of the 1st degree for adults is considered the norm. The displacement of the vertebrae from the vertical axis by several degrees is diagnosed in most cases of adults. At what treatment is not required. The main prevention is that the disease does not go to the 2nd degree, in which headaches and a violation of the vascular and cardiac systems can occur.
Treatment of scoliosis of the spine of 1 degree
For children and adolescents, treatment is limited to preventive actions. This is enough for effective therapy. At the initial stage of scoliosis, using general strengthening methods, posture is leveled, back muscles are strengthened.
For adults, other methods of treatment are used: conservative, manual and medication. In the first two cases, physiotherapy, wearing a corset, massages, physiotherapy exercises and manual therapy are used.
With the medical method of treatment, drugs are used that strengthen and restore the cartilage between the vertebrae (chondroprotectors), increase blood flow to provide muscle tissue with nutrients and minerals.
Activities prescribed for the treatment of scoliosis of the 1st degree:
- Healing Fitness
- simulator classes
- balanced diet.
Physical therapy classes are prescribed by a doctor, while a set of exercises is selected for a specific person. Localization and the shape of the bend are taken into account. At the initial stage, simple basic exercises.
Training and initial classes are conducted in the clinic under the supervision of an instructor or exercise doctor. After you can do at home. The main sense of proportion. Excessive exercise can trigger relapse.
Exercises recommended for physical education are diverse. These include:
- exercises that warm the muscles of the back, chest, helping to unload the spine.
- stretching (stretching) of the spine.
- exercises to strengthen the abs (anterior abdominal wall), back muscles.
Classes are held in well-ventilated rooms. Mirror is welcome. Clothing with shoes should not hamper movement and be comfortable from natural materials.
The main direction in the treatment of scoliosis of the 1st degree is massage. It is recommended for any age. The main purpose of the massage is: removing high muscle tone, restoring and improving blood flow, normalizing and improving regeneration, creating a roller from the muscles on the concave side of the curvature.
During the massage, longitudinal, deep stroking, rubbing, friction with weighting, vibration are used. During the course of massage, lasting 8-10 sessions, it is advisable to change the procedure to exclude recurrence.
The following exercises are recommended for the treatment, prevention and strengthening of the muscle corset.
- stretch the heels and head in opposite directions for 10 seconds with repeating 4 times.
- exercise “scissors”, performed 10 times with a rest of 2-3 minutes.
Lying on his stomach:
- arms and legs rise to the top as when swimming breaststroke, 2-3 sets of 10 times.
- “Scissors” on the stomach, 10 times with small interruptions.
- circular rotation of the arms, with the arms bent at the elbows, fingers pressed to the shoulders, 10-15 rotations in each direction in 2 sets.
Scoliosis treatment at home
At home, scoliosis is treated according to the recommendations of an orthopedic surgeon. It is based on the implementation of a specially selected set of exercises, wearing a corset. A regular visit to the gym is recommended. Exercise bikes and ski simulators are used.
The equipped horizontal bar in a doorway the best national exercise machine. Daily hanging for one minute for 1-2 months helps to straighten the spine.
It is recommended daily physical activity in the form of active walking or walking, from half an hour to two, take baths with coniferous concentrate, put salt compresses.