Scoliosis: Learning the curve
By Dr Suhel Kotwal, MS (Orth)
Did you know… ?
From 5 to 10 of every 100 young people from ages 9 to 14 will develop scoliosis.
Most cases of scoliosis are mild and do not need any treatment except for regular examinations.
A few cases do need treatment so that other problems will not develop in later years.
The best way to find and control scoliosis is to look for it often during the years when your bones are growing the fastest.
What is scoliosis?
Everyone’s spine has 3 natural curves. These curves are round our shoulders and make our lower back curve slightly inward. Some people have spines that also curve from side to side. Unlike poor posture, these curves cannot be corrected simply by learning to stand up straight.
This condition of side-to-side spinal curves is called scoliosis. On an x-ray, the spine of an individual with scoliosis looks more like an ‘S’ or a ‘C’ than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person’s waist or shoulders appear uneven.
Scoliosis is not poor posture and is not caused by the way you carry objects. Scoliosis is not a disease. You cannot catch scoliosis from someone else and you cannot prevent it. For most people who have scoliosis, the causes are not known.
Who gets scoliosis?
Scoliosis affects approximately 2% of the population. A family history of scoliosis increases the risk to approximately 20 per cent. If anyone in your family has curvature of the spine, you should be examined for scoliosis.
Children: Most scoliosis are ‘idiopathic,’ meaning its cause is unknown. It usually develops in middle or late childhood, before puberty, and is seen more often in girls than boys. Although scoliosis can occur in children with cerebral palsy, muscular weakness, spinal abnormalities, and other miscellaneous conditions, most scoliosis is found in otherwise healthy youngsters.
Adults: Scoliosis usually develops during childhood, but it also can occur in adults. Adult scoliosis may represent the progression of a condition that actually began in childhood and was not diagnosed or treated while the person was still growing. What could have started out as a slight or moderate curve may have progressed in the absence of treatment.
In other instances, adult scoliosis can be caused by the degenerative changes of the spine. Other spinal deformities such as kyphosis or hump back are associated with the common problem of osteoporosis (bone softening). As more people in today’s age reach over the age of 65 years, the incidence of scoliosis and kyphosis is expected to increase.
If allowed to progress, adult scoliosis can lead to chronic severe back pain, deformity, and difficulty in breathing.
The importance of early detection: Tips for parents
Idiopathic scoliosis can go unnoticed in a child because it is rarely painful in the formative years. Therefore, parents should watch for the following warning signs of scoliosis when their child is about 8 years of age:
Uneven shoulders
Prominent shoulder blade or shoulder blades
Uneven waist
Elevated hips
Leaning to one side
Any one of these signs warrants an examination by the family physician, a paediatrician, or an orthopaedic specialist.
Treatment
In planning treatment for each child, an orthopaedic surgeon will carefully consider a variety of factors, including the history of scoliosis in the family, the age of the child when the curve began, and the location and severity of the curve.
Most spine curves in children with scoliosis will remain small and need only to be periodically assessed by an orthopaedic specialist for any sign of progression. If a curve does progress, an orthopaedic brace can be used to prevent it from getting worse. Children undergoing treatment with orthopaedic braces can continue to participate in a limited range of physical and social activities.
Electrical muscle stimulation, exercise programmes, and manipulation have not been found to be effective treatments for scoliosis.
If a scoliotic curve is severe when it is first seen, or if treatment with an orthopaedic brace does not control the curve, surgery may be necessary. In these instances, surgery has been found to be a highly effective and safe treatment for scoliosis.
Summary
Scoliosis is a common problem that usually requires only observation with repeated examination in the growing years. Early detection is important to make sure the curve does not progress. In a relatively small number of patients who require medical intervention, advances in modern orthopaedic techniques have made scoliosis a highly manageable condition. Orthopaedic specialists for diseases of the muscles and skeleton, are the most qualified group of physicians to diagnose, monitor, and treat scoliosis.
Your orthopaedic surgeon is a medical doctor with extensive training in the diagnosis, and non-surgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.
Remember
You can find scoliosis early, if you know exactly what to look for.
Check often for signs of scoliosis between ages 9 and 14 years, when growth is most rapid.
Ask your primary health care provider to check for scoliosis during regular checkups.
Treatment is available to help control scoliosis.
Find and treating scoliosis is a team effort. You are a key member of the team!