The spine is what holds your body upright and provides the main support for your body. When viewed from the side, a healthy spine will have three natural curves that form a loose ‘S’ shape - two concave curves found in the neck (cervical) and lower back (lumbar), and one convex curve found in the mid-back (thoracic). From the rear, a normal spine should look straight, from the neck, all the way down to the tailbone (coccyx). When a person has a scoliosis, their spine has an abnormal sideways curves which makes the spine looked deviated in either an ‘S’ or ‘C’ shape when viewed from the rear. Any abnormal curve observed in a child’s spine should be assessed and investigated, regardless of whether or not the child feels any pain.
Scoliosis can affect many people of all ages, with 80% occurring between the ages of 10-18. It is one of the most common spinal deformities presenting to orthopaedic surgeons today. The most commonly seen scoliosis presenting to health clinics, eight out of ten times, is idiopathic scoliosis. The causes of idiopathic scoliosis are largely unknown, however, scientists have discovered that the onset often coincides with puberty and periods of rapid growth, and it affects seven girls for every one boy. 38% of scoliosis patients have a familial history and therefore children who have parents, grandparents, or siblings with the condition should be assessed.
Initially, a scoliosis is always almost pain free but later symptoms can range from mild to severe. Symptoms may include:
A scoliosis is diagnosed via X-ray and careful physical examination. A health professional evaluates the spinal curvature by observing the child bend forward to reach his or her toes to assess for the presence of rib humping and a postural assessment. An X-ray is then used to confirm the diagnosis and to measure the degree of your child’s spinal curve. During the X-ray examination, the factors that are assessed include:
A scoliosis diagnosis can be scary for parents and children, particularly when Doctors mention back braces and spinal surgery. Treatment depends on many factors including the child’s age, their stage of development and if they are still growing, the location of the curve, and the degree of the curve. The good news is that informed parents are far more likely to achieve a positive outcome for their children. Understanding scoliosis and knowing what to expect will help with proper care and outcomes.
Approximately 50% of the population are said to have some degree of scoliosis. A large majority of the time, it’s mild and either requires no treatment or exercise treatment. A small percentage of the time, approximately 3%, the curves progress enough to require bracing or surgical intervention. While most scoliosis cases will not continue to advance, the odds of progression increase as the child ages and the curve grows, which will help determine what stage the scoliosis is in:
0°-10°: No scoliosis detected
10°-20°: At this stage, a scoliosis is considered as mild. Within this range, conservative therapy and scoliosis-specific exercises is recommended to help improve postural alignment and muscular asymmetries.Exercise helps your child strengthen the muscles required to hold the body upright and increase flexibility.
20°-50°: If the child’s spine is still growing when the curve reaches this range, Doctors may recommend bracing to help slow or prevent further progression of the curve.
50°>: Spinal surgeons may recommend spinal surgery at this point.
The best form of treatment involves early detection of the condition. Every scoliosis curve is different. There’s no one-size-fits-all treatment, and no two curves present and behave in exactly the same way. The best time to detect scoliosis is between ages 12-15. If this condition is left unassessed or treated it may lead to a variety of problems later in life.
Chiropractic and physical therapy can help identify and treat muscle asymmetries and postural issues in children with a mild scoliosis. An exercise program can be developed to include techniques to encourage good posture, increase flexibility, increase trunk muscle strength, and decrease discomfort. It is important to note that currently, there is no evidence that supports exercise in substitution of bracing, nor on the impact that exercises and conservative therapy has in decreasing or slowing the progression of a scoliotic curve.The most beneficial method for the management of scoliosis is an early detection and a team approach involving multiple health professionals to assist with management and providing the best care for your child.
If you suspect that your child may have scoliosis, book an appointment with your family Doctor and Chiropractor.
Dr Melanie Xabregas is an experienced and passionate chiropractor with a special interest in helping children experience optimal performance and longeviety in dance and gymnastics. She brings a gentle, caring and friendly approach to her examination and treatment. Learn more about Dr Melanie
Available for consultations Tuesday & Friday between 2pm - 6pm