Prevention of Scoliosis

Scoliosis is an abnormal curvature of the spine. In a normal anterior to posterior, or posterior to anterior X-ray of the spine, the spine would appear perfectly straight. In these same X-Rays that showing a spine with scoliosis, there would be one or more bends in the spine. The ways that doctors treat this condition depends on the severity of the abnormal curvature and whether or not the patient experiences back pain or other symptoms as a result of the condition.

Prevention of Scoliosis: Typically scoliosis develops as a result of a congenital condition, neuromuscular condition, or with no known cause. All three of these circumstances are beyond the patient's control. Thus, scoliosis cannot be prevented. On the other hand, there are several treatments that may be available to patients to keep the curve from getting worse. Back surgery is the only possible treatment that may be capable of straightening the spine.

Scoliosis Treatment: In many cases, patients with a mild to moderate lateral curvature of the spine (scoliosis) feel no pain or related symptoms as a result of their condition. In cases such as these, the doctor will recommend regular follow-up visits to check whether or not the curvature is worsening. If the curvature is worsening, than non-surgical and surgical treatment options may be presented to patients.

When doctors consider the treatment options that they recommend to patients with scoliosis, they will first consider two factors:
  1. The skeletal maturity of the patient. (have they stopped growing, or have the reached the peak of their physical development)
  2. The degree of spinal curvature (how abnormal is the spinal curvature)
Most cases of this condition are described as idiopathic scoliosis, meaning that the cause is unknown. For patients with idiopathic scoliosis, the doctor may decide to monitor or treat based on when the condition is identified in the patient's development:
  • When a small degree of curvature is discovered towards the end of the patient's physical development, the doctor will likely decide to monitor the condition rather than to treat it.
  • When the curve is more severe and is discovered earlier, than it is likely that the curve will become more severe as the patient continues to grow. In these cases, doctors will be more aggressive in treating the condition.
For adolescents with scoliosis, three main treatment options will be considered:
  • Observation (Doctors will periodically monitor the condition to see if it gets any worse during ongoing development)
  • Back Braces
  • Scoliosis surgery

There is no specific physical therapy treatment program or list of back exercises that has consistently been shown to reverse the scoliotic curvature or to prevent the degree of curvature from increasing. That being said, doctors give patients with scoliosis the same recommendation that they do to all people. Doctors recommend that healthy individuals as well as those with scoliosis exercise regularly and maintain an active lifestyle. Regular exercise keeps the back muscles strong and flexible.

Observation: Scoliosis may be detected by the school nurse or gym teacher, the patient's parents, or by the doctor when the patient comes in for regular checkups. Once scoliosis has been detected, the condition may either be aggressively treated early or continuously monitored.

Monitoring the Condition: Scoliosis may be observed and identified based on a visible inspection, though doctors will usually order X-Rays to Scoliosis may be observed and identified based on a visible inspection, though doctors will order X-Rays that they may use to compare to future X-Rays to monitor the possible progress of the condition. After X-Rays of the spine are taken, doctors will use a test called the "Cobb method" to record the exact angle of curvature.
  • Curves that are less than 10 degrees are categorized as a spinal asymmetry rather than the condition of scoliosis. Spinal asymmetry is not considered to be serious, and most doctors recommend observation and monitoring rather than bracing or surgical treatment options.
  • Curves beyond 20 to 30 degrees in a growing adolescent or child are more concerning, and will be monitored by an orthopedic surgeon every 4 to 6 months to see if the angle becomes more severe.
Back Bracing for Scoliosis: If the curve is more than 20 degrees and progresses more than 5 degrees at specific time intervals, than treatment may be required to slow or stop the condition's progression. Back braces may be the best non-surgical option available to stop the curve's progression. Back braces are more likely to help still growing patients, and they are less likely to provide any benefits to those who are skeletally mature. The goal of back bracing is to stop the progressing curve, not to reverse it. Adolescents will typically be fitted for and continue wearing the brace until they reach skeletal maturity. Once the person has reaches skeletal maturity, they will stop wearing the brace. They will stop wearing the brace because it will be unlikely that the curve will progress untreated.