Signs of Scoliosis

Q: My daughter is 13 years old and has been diagnosed with scoliosis. She occasionally has back pain, but not always. How concerned should I be?

A: Let me encourage you that scoliosis, to some degree, is common. Your daughter is by no means unusual for having such a diagnosis.

When the human spine is seen on an X-ray film, looking straight at it as though through the belly button, one expects to find the spine essentially straight. Each bone is stacked neatly upon the other in an orderly column. In general terms, when any deviation from this vertical straightness is observed, such as a bending toward the right or left, the term “scoliosis” is often applied. Some will argue that not all such deviation truly qualifies for the term. Sometimes this occurs due to the pelvis being unlevel and can be corrected by altering leg length with a heel lift or arch support (orthotics). We’ll talk about the common “idiopathic” scoliosis, the kind your daughter likely has, and the cause of which is not clearly understood.

On a weekly basis I see many X-ray films (radiographs) of the human spine, and out of ten of them I expect to find scoliosis in at least five. My perspective is somewhat skewed, as scoliosis may be more prevalent in those who have back pain. Be that as it may, many people without pain demonstrate scoliosis and don’t realize it. I’ll submit to you that in the vast majority of cases the scoliosis is not a major contributor to back pain. I say this because the bulk of scolioses that I see are very mild curvatures.

There are cases, however, in which there is cause for concern. The severity of a scoliosis is measured in degrees of curvature. In an adult, a curvature of 30 degrees or greater is generally considered clinically significant; in other words, treatment options should be determined and discussed. Treatment may include rigorous exercises and traction, or rods that are surgically implanted along the spinal column. Though less common today, braces (eg, Milwaukee brace) were once widely used that fit about the torso. When the spine deviates, ribs move with it, and ribs in an abnormal configuration may compress vital organs. In a child, a curvature of 20 degrees or more is considered significant. This is of special concern while the spine is still growing, as it is during this stage that the curve may progress more rapidly. Bear in mind that not all curvatures progress. Most adult curvatures are relatively stable. A female spine typically stops growing around the age of 15, while that of a male stops shortly thereafter. Typical protocol in your daughter’s case would be to take follow up X-rays every three months to monitor any progression. Certain spinal exercises may also prove helpful to discourage such progression.

We see many cases of adolescent scoliosis in our clinic. Such curvatures develop points of tension in certain regions of the spine, and the pain that results is often alleviated with chiropractic care.

 

Hugh Cradduck, DC