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Scoliosis & Richard III

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University of Leicester archaeologists today (12 September) announced the discovery of an adult male skeleton suffering from scoliosis, which they believe may be the remains of Richard III.

What is scoliosis?
ichard's twisted spine. Copyright University of LeicesterScoliosis is an abnormal sideways curvature of the spine, where the spine curves either to the left or to the right of the body.  As this is usually a double curve, the neck and head remain in their usual central position.  In a living person, the signs of scoliosis vary depending on the severity. These may include having  one shoulder higher than the other,  one shoulder blade higher and more prominent than the other, one hip more prominent than the other, or a slight lean to one side.

The most common areas to be affected by scoliosis are the chest area (thoracic scoliosis), and the lower part of the back (lumbar scoliosis).

How is this detected in skeletal remains?

If the spine is complete and well preserved, scoliosis can be detected fairly easily.  Signs include  wedge-shaped vertebrae at the apex of the curve, asymmetry of the neural arch and vertebral processes, horizontal torsion of the vertebral body, and skewed spinous processes (the parts of bone closest to your skin).  The transverse processes in the lumbar spine may also be short and plump on the convex side, and long, slender and pointed on the concave side.

As the ribs are attached to the spine, changes in their shape and curvature is also common.

A debilitating condition?
The amount scoliosis would affect a person generally depends on the severity of the condition. Usually the only sign is back pain, other than the physical changes in appearance, and therefore wouldn’t affect day-to-day life.

In the UK today, scoliosis affects around 3-4 children in every 1,000, but in 90% of cases no treatment is ever needed.  One particularly notable person with scoliosis today is Usain Bolt, which shows that it doesn’t necessarily affect a person’s movements at all.

Other famous people with scoliosis include:

  • Usain Bolt
  • Sarah Michelle Gellar
  • Liza Minnelli
  • Elizabeth Taylor
  • Kurt Cobain

Richard III – not a hunchback
The University of Leicester archaeologists have made clear that the remains thought to be Richard III did not have a condition known as kyphosis.  This is the curving of the spine that would have caused a bowing or rounding of the back, causing a hunchback appearance. Generally speaking, kyphosis is a forward curvature of the spine, whereas scoliosis is a curve from side to side and doesn’t result in a hump.

 


Watch this space – full story on the discovery in CA 272!
Click here to read more about the Greyfriars excavation where the remains were found.
Click here to read more about the discovery of the burial.
Click here for more information on battle wounds identified on the remains.
Click here to find out about how the DNA analysis worked.

22 Comments

  1. The problem is while scoliosis does not affect day to day life, we are not talking about someone who lived quietly at home. Richard III was a renowned medieval warrior. He wore full plate armor and rode or waded across battlefields swinging a sword with great effect. At Bosworth field he almost got to within sword’s length of Henry himself and was only taken out by a group of men. I have known people with severe scoliosis where they had to live in a brace until they finished growing and could have a rod put in their spine. Prior to surgery, they could not have done the physical feats Richard was known for.

    Either the archaeologists were wrong in the severity of this skeleton’s scoliosis that they claimed at the outset (which the offset head they talked about recently would suggest that it was severe), or they have the wrong person. Truth is with the genetic test they propose, at best they will only be able to determine if this person is a relation of Cecily Neville. Not that it is Richard III for sure. The only way to do that is open one of the tombs of his immediate family, like Edward IV, and test the skeletons DNA against theirs.

    Either way, the entire thing has been handled very shoddily, rushing to announce before they had even established if the skeleton was old enough with carbon dating.

  2. It is good to see some information about scoliosis, thank you for publishing this!

    The information at the end of this artice is however incorrect; thoracic scoliosis CAN cause a rib hump, because the spine twists as it curves, pushing the ribs out of alignment. In cases of scoliosis the rib hump is on one side of the back, and the deformity can be severe. Cases are often referred to as “hunchback”, just as in cases of severe kyphosis.

    It has just been announced today (Feb 4th 2013) that the skeleton found in Leicester is Richard III and that he had severe Idiopathic Scoliosis, which would have resulted in a noticeable rib hump.

  3. Richard III’s scoliosis wasn’t severe enough to be that disabling. I know, because I have scoliosis as severe as his *after surgery* – my case was a lot more severe before I had surgery. Yet even back then I was able to ride horses and dance for hours and take part in all the same sports and games that my friends as school did. I have been a moderator on scoliosis forums for ten years now and I work as an orthopaedic technician, so I know plenty of people with various cases of scoliosis. I see no reason why Richard III wouldn’t be able to go into battle. His physical condition wouldn’t be optimal but he’d be able to do it, if he had been trained all his life to. By the way, the tennis player James Blake has severe scoliosis that warrants surgery yet he is able to play at the very top of his profession; he’s waiting until his career is over before he has it done. Usain Bolt also has scoliosis.

    • Toni is absolutely correct. I would hesitate to draw any conclusions on Richard III’s physical limitations until more detailed information about his scoliosis is revealed through a physical reconstruction. You can lay out the bones to make the scoliosis appear severe but until you know the degree of curvature and extent of rotation (because scoliosis is a three-, not two-, dimensional condition), you can easily overestimate the severity. This is especially so for individuals who are not accustomed to viewing scoliosis on xray film and comparing to the patient’s appearance and movement.

    • Thank you, Toni, this is the answer I’ve been searching the web for. Having mistakenly assumed what physical limitations scoliosis would present, I was never able to reconcile Richard’s reputation as a warrior with his condition. Now I realize there is no conflict and he would have been capable even if the reconstruction of his skeleton, as it is now, is accurate.

  4. Thanks SCRIancy, you’re quite right. I’d imagine that Richard III’s actual curve was visible in the position of the vertebrae as it lay in the archaeological trench before removal – what do you think? And yes John, you are right in thinking that Richard III would have been taller had his spine been straight. Depending on the curvature, people who have surgery to straighten their spines typically gain anything from a 1/2 inch to 4 inches or more. It’s an amazing feeling to wake up from surgery and suddenly find table surfaces and door handles are lower down than you previously thought! 🙂

  5. I don’t know enough to hazard a guess as to the details of the scoliosis based on the vertebrae lying flat as in the picture. No two cases of scoliosis are identical. Often, if a scoliosis patient’s C curve becomes severe, they will develop a second, less severe, compensatory curve (forming an S curve). I don’t see that in the picture. I see the shoulders not aligning with the hips which if accurate, would cause a loping gate that might be misconstrued as a limp. The degree of spinal rotation is different for each patient and does not directly correspond to the degree of curvature. The spinal rotation causes the ribs to also rotate which display the vertical hump on one side of the back. It can be mild or severe or not be present at all in scoliosis. Many people don’t understand the difference between kyphosis, lordosis, and scoliosis and assume the terms are interchangeable. I’ve heard several members of the media refer to Richard III as “the Hunchback” simply due to his scoliosis. I find this offensive, and furthermore, it is glaringly unsubstantiated.

    My child has been treated for idiopathic infantile (aka early-onset) scoliosis since the age of 2. The original curve was measured at 49 degrees, and I’m guessing is slightly smaller than Richard III’s remains. There was no pain prior to treatment. There was a mild rib hump that resolved during treatment. After two years of plaster of paris body casts (Early Treatment w/ Dr. Min Mehta’s specialized EDF casting applied by Shriners Hospitals in the U.S) and a brace since July, the curve was reduced to 20 degrees as viewed on xray film. A curve of 20 degrees is practically undetectable to the untrained eye.

    @John – with the application of the first cast, my child’s height increased by at least 1 inch, and that is without straightening completely. This was not growth, but achieved during the procedure itself.

    One thing in Richard III’s favor is he was of slight build. If he had carried extra body mass (fat or muscle), it would have made battlefield activity more exacting. He would have paid the price with increasing aches and pains until pain became an every day, all day long occurrence. Between his slight build and relatively young age, I venture to say he suffered less than some may imagine. However, the cruelty of his society and his position in vying for the crown may have contributed significantly to his personality and character.

    @Jennifer – they did carbon dating of the remains.

    • So glad your child has had success with the EDF casting, SRCIancy! I was the person who first told Heather Hyatt Montoya about this treatment, back when she was searching for an alternative to spinal fusion for her infant daughter. Until she promoted this treatment it was not used in the States, though it has been a standard treatment protocol for IIS in the UK since the 1970s. Heather has done amazing work in promoting this treatment and it is so good to hear success stories! I had IIS myself and went through serial casting, though it was only enough to hold my curves and prevent too much progression until I had my first fusion aged ten.

      Anyone seeking treatment for an infant with Infantile Idiopathic Scoliosis should look up the Infantile Scoliosis Outreach Programme on the internet, for information and support.

      • What a wonderful feeling it is for my family to be blessed through the actions of others. Thank you, Toni! Learning of this connection has made my evening. Heather is indefatigable, and ISOP is such a valuable resource.

  6. He would have been about 5 ft 8 so above average height of the period, with a straight spine. I am not sure of the difference but it would have taken maybe an inch or more off.

  7. I think when I look at the portrait of Richard III that I see a face which is drawn by chronic pain. Julie Myerson has described how he would have lived with scoliosis. The effects of pain are not part of the reconstruction, and perhaps in it we see the man as he might have looked without scoliosis. I assume he developed it in adolescence?
    There is some evidence, isn’t there, that his brother Edward, who became king was not his father’s son. Richard was a capable and intelligent ruler of the north, personally very brave. He must surely have felt that life had been very unfair to him, and that his elder brother Clarence, killed by Edward, had legitimate reason to rebel. Those feelings might have fuelled his ruthless actions against Edward’s sons – I have no doubt that he genuinely believed that they were illegitimate, as well as Edward himsef. It does not exculpate, but it does help explain.

  8. The reconstruction also shows a face which is spookily close to one of the portraits of his brother Edward – much more like him than the portraits of Richard III, which I guess might be due to the pain Richard suffered. I have read an account of someone who danced with them both, she said they were both very handsome, and Richard was the most handsome in the room after his brother – that figures by the paintings and reconstruction though she might have just been dipsy and hopelessly attracted by power, of course.
    But I am looking at Google images and the sites don’t tell me where the portrait is held or how old Edward was at the time… so do we assume that they both looked very like their mother? You history buffs, tell me.

  9. The spinal remains appear to be the result of a broken back, not Scoliosis. Any ER X-ray tech would tell you this. You see this in horrific auto accident cases where the body (usually a front seat passenger) is slammed to the floor and crushed between motor and seat.

    The criminals who buried him, broke his back so he would fit into a short grave. They apparently cut off his feet for the same reason – also explains the strange crunched position of head, arms and hands.

    Tudor mercenaries probably did the burial – most were newly released criminals from France and Wales – they were animals.

    • Examination of the vertebrae shows that they developed unevenly, consistent with a longstanding scoliosis which causes bone remodelling over time. Richard III most definitely had scoliosis.

      • Besides, he was buried by monks in a chapel within the walls of their monastic community – mercenaries wouldn’t have had access to the chapel at Greyfriars; no-one apart from monks from the community would.

  10. There is so much varying info here,much useful, others with some inaccuracy. I am a Harvard educated physician who was in part prompted to study medicine. This,I was somewhat ,maybe more than somewhat as one w/o advocates for scoliosis education. I find it most unfortunate that all too often, we see the idiopathic type of all age variable promoted as the only or primary type out there. It is far from being the most common and medically,with respect to those who suffer from its impact, by far by not what either a medical professional or one who suffers from any severe curve that affects one ‘slide after the Cobb angle of 40 degrees or the pain noted by one who suffered pain yet never seemed to have been informed her situation may have indicated surgery.! Sans the med history,I have no way of knowing.. I am a long-time member of the SEA, Scoliosis Research Society,an international group of primarily orthopedic surgeons who study,meet and advocate our researchers.I also teach at a medical school. Rarely is idiopathic scoliosis described as severe buy to everyone e, journalists included, everything is relative.

    I should not these article are some of the best I have read on scoliosis though cccccccc dry curious why no British experts on the topic were even consulted.And like most of you,I cringed when I heard Richard referred to as a hatchback. He may have had a “rib hump” also not unheard of especially with scoliosis secondary to Hemivertebrae or other conditions.

    My own case would take pages to present. While I was born with the congenital type secondary to other bone anomalies, the vertebrae I did possess were only about half there and hence the kyphosispop caused by that ,no or fused vertebrae from all thoracic and lumbar vertebrae., led directly to severe curves, both over 110 degrees by surgery. Spinal fusion to me was minor. What led up to it, halo femoral traction on a Stryker frame and 15 plus surgeries before that and 6 months of the now rarely used plaster cast, and earning to walk again on one ,would hardly meet that description. Part almost sounds like what Richard endured with the Spanish Inquisition like rack though I was 16 and tried to view it all as a learning experience. Like most who undergo even the most basiczlinalbfusion, now competed for idiopathic methodologies, in a couple weeks!!!, I longed for at least 8 inches of height but had to be satisfied with moving from 4’11” to 5’1″. Still, after seeing a few people paralyze whose situations were less severe than mine, and one ultimately die, I rarely complain. I have lung problems still (very low oxygen saturation levels) and lost most of my stomach in a partial hysterectomy,imho a result of so many NSAIDs for at times severe Chronic pain. My condition was such that just being alive and managing a wonderful career, family and volunteer work makes the pain,for which I now see a pain specialist wort it. I also have a minor heart condition which freaks out only anesthesiologist s, something I should understand since my grandmother was the first Jewish woman to graduate fro. Medical school in her jurisdiction, but there is a known correlation between those two.

    It just seems to me they make Richard’s scoliosis sound much worse than it rely was or are we being taught the right history? I think this entire narrative needs a book so if anyone wants to help, pls email me [email protected]. Thanks!

    • You are a Harvard trained surgeon, Abigail? In light of the way she has written this post, I would urge everyone to read Abigail’s claims carefully and make up their own minds about the things she says. NB there is only one member of the SRS called Abigail, and she did not train at Harvard.

      I am terribly sorry that you went through so much treatment though Abigail. I had a rare form of severe scoliosis since infanthood too, and also experienced halo traction, repeated surgeries, and bodycasts for many years.

    • Yes. People can have different degrees of scoliosis or kyphosis. Some people may only have a mild spinal curve with little noticeable deformity, and may go through life without even realising that they have it. Others may have a huge spinal curve that crushes their internal organs, causing them to have (for example) restricted lung function or gastrointestinal issues, as well as a very obviously deformed body. Modern medical treatment aims to catch and treat spinal curvatures before they can cause serious problems.

      Interestingly, the amount of pain that a scoliosis patient gets does not necessarily correlate to the size of their curve. There are patients with relatively minor curves who experience a lot of pain, and patients with very large obvious curvatures who don’t have any pain at all.

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