Why is it important to screen children for scoliosis?

Scoliosis is an abnormal curve of the spine causing a three-dimensional deformity that results in changes to the structure and function of the spine as well as the soft tissue surrounding it.

When viewed from the front or back, the spine should look fairly straight. In scoliosis, however, the spine’s straight position begins to bend sideways. Scoliosis can take the form of a single curve (C-shaped) or a double curve (S-shaped). This curving can lead to changes in the shoulders, ribcage, pelvis, waist, and the overall shape of the back.

Any part of the spine can be affected by scoliosis. However, it is most often seen in the thoracic and lumbar spines. The vertebrae curve to one side and may rotate, which makes the waist, hips or shoulders appear uneven. In the great majority of cases, the cause is unknown and the condition is called “idiopathic”.

Scoliosis is twice as common in girls than in boys. It affects approximately 4% of the population and can be seen at any age, but usually starts in puberty. In children, scoliosis is associated with increased pain, reduced function and poor self-image. In adults, it is associated with increased back pain, poor quality of life, and self-reported disability.

Scoliosis is also hereditary. People with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of curves from one generation to the next.

Scoliosis in Children

Scoliosis in children is often seen as a curve in the lower thoracic region with a possible rotation of the vertebrae. As the vertebrae rotate, the ribs shift causing a noticeable rib hump on one side of the spine. This hump can be better observed when the child is bent forward at the waist.

Juvenile idiopathic scoliosis develops earlier in boys than in girls. Skeletal maturation happens later in boys, this allows for a greater risk of progression of the curve as compared to girls.

Scoliosis is a usually painless condition. The first clue is rarely pain but noticing that clothes don’t fit right, or that the child’s posture is not straight.

As the spine starts to curve, the body adjusts naturally to keep the head centred over the pelvis. Consequently, the shoulders and hips may appear uneven, causing one shirtsleeve or pant leg to seem shorter than the other. Often there is a rotation of the vertebrae causing an uneven waist that makes a pair of pants or skirt twist to one side.

Signs Of Scoliosis:

• uneven shoulders
• uneven hips
• uneven breasts (girls) or nipples (boys and young girls)
• prominent or winging shoulder blades particularly on one side
• leaning to one side
• bump or rib hump on one side of the spine, most noticeable when bending forward at the waist

What Should You Do?

If you notice one or more of these signs in your child, we suggest a need for an examination by a pediatrician, primary care physician, chiropractor or physiotherapist. There are important health consequences of severe scoliosis that need to be addressed as early as possible.

Scoliosis screening can be done quickly as part of a routine physical examination. In some schools, screening may be provided annually for students between the ages of 10 and 14 (grades 5 through 9), but this is uncommon in Canada. The examination takes about 30 seconds and may be done by a school nurse or physical education teacher. Most provinces, unfortunately, do not provide screening for scoliosis in schools.

While scoliosis itself is not usually painful, the curvature and resulting rotation of the spine can result in pain coming from the associated muscles, joints or ligaments as uneven pressure or tension is placed upon these structures. Children and teenagers may develop back and neck pain, hip pain, knee pain, ankle pain or an uneven gait.

Taking Care Of Scoliosis

Treatment for idiopathic scoliosis depends upon the severity of the curvature – which can be measured using plain radiographs. It is classified as mild ( less than 20°), moderate (20° to 40°), or severe ( more than 40 °) depending on the degree of curvature. For mild scoliotic curves, patients are usually monitored for progression. However, if the curve shows signs of rapid progression, back bracing may be recommended. In situations where conservative treatments like bracing may be ineffective, and curvature progresses, surgery may be required to help stabilize and straighten the spine.

Idiopathic scoliosis is widely treated by chiropractors and common goals of treatment include correction or stabilization of curve severity and pain relief. It’s often the case where a chiropractor may be the first healthcare professional that document abnormal curves in a patient, as the signs of scoliosis are subtle and can be easily missed. It can be diagnosed using family history, a physical examination, and X-rays of the spine.

Traditional chiropractic treatment for scoliotic patients is similar to what a chiropractor would do for any other patient experiencing back problems. Chiropractors may use different therapies for each patient, depending on the severity of scoliosis. The primary method of chiropractic treatment involves the adjustment and mobilization of the spine and joints. Chiropractors may also use other therapies to support the main treatment. Exercises in conjunction with chiropractic care are often used to help improve mobility, and symmetry and help patients to return to pain-free lifestyles.

The majority of people with scoliosis lead normal, happy and productive lives. It is best treated when found early, so if you suspect scoliosis in your child or are unsure, book an online appointment with your chiropractor to get more information.