So here we are, it’s June already and June is National Scoliosis Awareness Month. I am a little bit late, 10 days to be exact, in posting this but that is the way it goes sometimes. Here are a few quick points about scoliosis to help you better understand this condition.
- Scoliosis can only be diagnosed by taking a standing radiograph (X-ray).
- While visually inspecting someones posture can help determine if taking a radiograph is necessary, this alone cannot be used to diagnose a scoliosis. There is a specific measurement that must be done on a radiograph and a specific value of that measurement is necessary to call a curve in the spine a scoliosis. In our office I used visual inspection of posture as a screening tool to determine if a radiograph is necessary, especially if the patient is a child with no symptoms.
- The screening done at school can be useful in determining who should get greater scrutiny but don’t believe that a positive finding in any screening means a definitive diagnosis.
- Scoliosis can be easily managed conservatively under the right conditions
- The patient must be a candidate for conservative management: Some people might not like to hear this but there is a time and a place for surgical intervention, with scoliosis that is when a curve is progressing rapidly or when the curve is very large over 50 degrees. When a curve is 40-50 degrees surgery may be considered on a case by case basis. Under 40 degrees we can do good things conservatively and especially in young patients.
- Conservative management should be intense: The care must include exercises and possibly even traction to stretch the spine back towards normal. In our office we use a combination of therapies to work to reduce a scoliosis or, at least, limit progression. Our care includes spinal adjusting, exercises, and traction. Our exercises and traction aim to overcorrect for the curve or take the patient to their mirror image posture. In the future I plan to add one more thing.
- Bracing might be necessary: No one want to put a kid in a rigid brace 20+ hours a day but the research supports this as being very effective even in those 40-50 degree curves. While we do not currently do bracing, in the future I plan to and the bracing we will offer is this. For now if a patient needs bracing there are several clinics I can send the patient to in his region for the bracing and I take care of the other therapy.
- Scoliosis is a complex condition.
- There is a asymmetrical growth of bone that creates the curvatures in the spine. While the growth that takes place prior to diagnosing a scoliosis can not be undone, with the right care we can limit progression and reverse the structure of the curve. The idea behind overcorrecting the curve is to change pressure across the growth plate, by doing so we can influence growth across the growth plate and reverse the asymmetrical bone growth.
- In some cases there can be a large thoracic kyphosis. This complicates care and need to be addressed just as much as the scoliosis curve. We do that in our office with more spinal adjusting, exercise, and traction.
I know there was not a lot of detail in this post on scoliosis but that was not the point. In talking with people in the community I find there is a lack of understanding about what exactly a scoliosis is and what things you could or should do to treat it. I will post again on scoliosis this month with some greater detail so stay tuned for more info which, I hope, helps to broaden your understanding on scoliosis.