Your spine has natural curves that round your shoulders and make your lower back curve slightly inward. With scoliosis, the spine curves from side to side in the shape of an “S” or a “C.” The curvature usually occurs in children, especially girls, during the growth spurt just before puberty. Unlike poor posture, these curves cannot be corrected by learning to stand up straight. Roughly three in 100 people suffer from scoliosis.
Scoliosis is considered a medical mystery. In 80 to 85 percent of cases, it is considered to be ‘idiopathic,” meaning the cause of the disease is unknown.
For the remainder, there are possible causes, including genetics, birth defects, or neuromuscular diseases such as cerebral palsy.
Difficulties Associated with Scoliosis
Four out of five people with scoliosis have curves of less than 20 degrees. In those cases, the curve is so small it does not cause problems.
However, in growing children and adolescents, that curve can quickly worsen, 10 degrees or more in a few months. In severe cases, the rib cage may press against the heart and lungs, making it difficult to breathe and pump blood. Adults who had scoliosis as children are also prone to chronic back pain that, when untreated, may develop into arthritis of the spine.
Scoliosis can go unnoticed because it is rarely painful in children. Sometimes there are visible signs of scoliosis that you can detect in your child. Check the spine to detect any sideways curve. Also check to see if ribs are pushed out or one shoulder is lower than the other.
Public schools check for scoliosis in the 5th or 6th grade. Because scoliosis can happen gradually or not be accompanied by pain, it is always important to routinely see a doctor who will check for scoliosis during regular exams.
During an exam, a doctor will ask about medical history, perform a physical exam to check the curvature of the spine, and take an X-ray. The three of these can determine is scoliosis is present.
The majority of children with scoliosis have mild curves that do not require treatment, only checkups every four to six months to monitor any changes in the spine. However, if scoliosis gets worse or starts causing symptoms, it will need to be treated. There are three options in caring for scoliosis; braces, osteopathic manipulation, and surgery.
If your child’s bones are still developing and the scoliosis is mild to moderate, your doctor may recommend a brace. About 20 percent of kids with scoliosis wear a back brace. This does not cure scoliosis, but it prevents further progression. The effectiveness of braces is directly related to the amount of time it is worn; frequently they are worn day and night. Most braces fit under clothes and allow children to participate in activities. Overall, braces are 60 to 70 percent effective in preventing surgery.
Mild scoliosis may also be treated with osteopathic manipulation. The goal of osteopathic manipulative treatment is to release any tension around the mid back and neck.
The primary intent is not to straighten the spine, but to alleviate any pain by enabling the body to better compensate for the curvature of the spine. This course of action will include osteopathic manipulative treatment to the pelvis, head, rib cage, and abdominal wall in addition to the specific area where the spine curves.
In the cases where back braces or manipulation do not help, or if the spine is curved more than 45 degrees, surgery is the only permanent solution. The main surgical procedure is called spinal fusion. This type of surgery connects two or more vertebrae together with new bone. Metal rods, hooks, or screws may also be used to hold the spine straight while the bone heals.
Surgery calls for a six-week recovery. After the first week, the child will return home and should immediately be able to perform everyday tasks. After three or four months, they can take part in most activities. Typically, it takes a year before they can return to sports.
Scoliosis is common and usually only requires doctor’s visits and observation. If treatment is needed, early detection is important to make sure the curve does not get worse. Cases that are properly treated, whether through observation, back braces, or surgery, allow children with scoliosis to live an active, normal life.