There are many types of dwarfism. Various treatments can assist with the associated musculoskeletal pain.
What is Dwarfism?
Abnormally short stature (adults under 4’ 10”), resulting from delayed or slow growth from a medical condition, is considered dwarfism. There are actually about “200 distinct medical conditions” associated with dwarfism. Characteristics, therefore, vary greatly depending on the condition. “Disproportionate dwarfism” concerns “one or more body parts being relatively large or small” when comparing to the average adult. “Proportionate dwarfism” is when the body is unusually small all over. Because so many different medical conditions can lead to dwarfism, treatments are also variable. For example, bone growth disorders may require surgery, hormone disorders can be managed with medications and hormone therapy (before fusion of the growth plates), and nutritional causes can be treated with diet. Specialized furniture and other equipment, as well as support groups and social services may also be utilized for “facing the challenges of an ableist society”. In the US and some other countries, people with dwarfism prefer the term “little people”. The most common cause of dwarfism is genetics. Achondroplasia is due to a chromosome 4 mutation. If there is a medical disorder causing the dwarfism, the patient is treated for that underlying condition. Types of dwarfism are classified based on the source and location of the condition. Dwarfism can affect the upper or lower limbs, the hands and feet, vertebrae, and the cartilage or bones. Osseous dysplasia, osteochondrodystrophy, and chondrodystrophy are other examples of dwarfism definitions. Pituitary dwarfism (due to a deficiency in growth hormone) and achondroplasia are the two most common dwarfism cases. There is often disability and pain associated with dwarfism, and if an underlying medical cause cannot be treated, then pain management, surgery, orthotics, and physical therapy can help patients. Hairstyle modifications and shoe lifts are “simple interventions” that may be employed. A controversial intervention is distraction osteogenesis (where bones are fractured and lengthened), but this process is expensive, disruptive, painful, and cannot treat many types of dwarfism.1
Patients with achondroplasia may suffer from lumbar lordosis, where the lower spine has a backward curve. They could also experience nerve compression in the lower back, with tingling and numbness in the legs.2 The patients’ legs may be bowed, and they have an increased risk of arthritis and joint inflammation and pain. Lumbosacral spinal stenosis may also occur in achondroplasia. In LSS, there is a “narrowing of the channel in the lower spine” which “puts pressure on the spinal cord”.3 Chiropractors are specialists in treating musculoskeletal pain. Medications and surgery carry side effects and risks. Chiropractic treatment avoids surgery and medicines.4 To treat someone with dwarfism, chiropractors need to have experience with this rare condition. Performing gentle adjustments with a device may be more appropriate with these patients.5 Various physical therapy techniques could also be used to increase range of motion and strengthen muscles.6