Important considerations in adolescent scoliosis diagnosis and management.
One of the more common adolescent conditions is scoliosis and occurs in up to two to three percent of this population. Scoliosis is most often idiopathic (cause unknown) and occurs during the adolescent period. Scoliosis is defined as a lateral curvature of the spine of greater than 10 degrees. Most often, this curve is not severe and does not cause serious health problems. In fact, it is considered normal to have a slight curve toward the side of handedness. But with some individuals, scoliosis can be severe and progressive, leading to other health complications.
Approximately 10 percent of adolescent idiopathic scoliosis will require bracing or surgery. Some risk factors that increase the likelihood of progression is the degree of scoliosis, younger age at diagnosis, female (10x more common), and early age of menarche (the onset of the menstrual cycle). While severe scoliosis is uncommon, it is important to make sure that your child is screened in the pre-teen or early teen years as it most commonly progresses during the adolescent growth spurt, most commonly occurring between the ages of 14-17 for boys and 16-19 for girls.If a screening test does find that your child has a scoliosis, timely consultation with your family physician or chiropractic physician is important for determination of appropriate treatment and achievement of the best possible outcome.
Most adolescents are screened for scoliosis at a routine physical or for a sports physical. Typically, this is performed by flexing the spine forward and observing for spinal curvature or rib humping (rib protrusion on one side). These signs are indicative of some degree of scoliosis. The next step is typically an x-ray of the thoracic and lumbar spine to determine the degree of the curve. The type of treatment will depend on both the degree of the curve and the degree of skeletal maturity of the child. The less skeletally mature the child, the more likely it is for the curve to progress. For example, if the child is skeletally mature, a 30 degree curve is typically just watched closely and unlikely to progress, but if the child is still quite skeletally immature, a 30 degree curve may be progressive and may be grounds for bracing.
It is important to find an orthopedic specialist that has experience in scoliosis treatment to ensure proper treatment of your child. If the curve is not significant and only requires observation, this child is a great candidate for chiropractic care to ensure proper joint function and muscular balance. Chiropractic physicians can help restore proper spinal joint motion as well as stretch/strengthen the appropriate spinal musculature to help decrease pain and potentially slow progression of less significant curves. If the curve is significant, (which may be anywhere between 30 and 50 degrees depending on skeletal maturity) bracing or surgical intervention may be warranted. If a significant curve is allowed to progress untreated, adverse health effects such as increased pressure on the lungs and heart may occur, resulting in long term chronic health conditions. Additionally, severe scoliosis may also cause increased pain and premature development of osteoarthritis.
Disclaimer: This article contains my personal opinion about health topics for information and educational purposes only and does not substitute medical advice. If you have any questions related with your condition you should contact your doctor or healthcare provider. If you think you may be suffering from any medical condition, you should seek immediate medical attention.
Edited by Sean Paler