Scoliosis

[plansrme]

My 10 yo failed my screening test for scoliosis. I noticed today that one of his shoulders is higher than the other. Dr. Google pulled up the Adams test, and I can definitely see discrepancies there. He has an appointment with a real doctor next week to check, but what can you tell me about it in real life? I just have visions of this girl I went to high school with who wore a big, ugly brace 24/7. I am sure that is not the treatment any more. Please tell me it isn't. And also that he can continue to play baseball. . ..

[Ellie]

:grouphug:

 

 

Chiropractors can help scoliosis.

[ChocolateReignRemix]

A brace can be needed but would not need to be worn 24/7 (unless maybe in really extreme cases.)  A dear friend's daughter was diagnosed with scoliosis and managed to earn All State Track honors in back to back seasons.  At this point you should assume your son will be able to participate in whatever he wants in the years ahead.  Depending on the curvature, there is the possibility no treatment will be needed.

 

With that said, please make sure you take the treatment plan (if any) seriously and follow through with whatever they ask your son to do.  DH failed the screening when he was 12, and due to family finances there was never any follow up.  He now suffers with incredible back pain and will need surgery at some point.

 

ETA: braces can still be part of the treatment.  I believe most kids who end up in a brace now only have to wear it at night.

[marbel]

My daughter has scoliosis and wore a "Boston brace" which is not a huge ugly thing (most people couldn't tell she was wearing it) for about 4 years. I think the type of brace depends on the type of curve in the spine, though.   My son has it too, but he was never braced, just watched.  Neither kid has far progressed to a point pointing to surgery, though my daughter is close.

 

Both kids were told that exercise is good and to keep on with it! 

 

Both the orthopaedists we saw said to stay away from chiropractors offering scoliosis treatments.  I know there is disagreement on that.

 

:grouphug: :grouphug:

[marbel]

A brace can be needed but would not need to be worn 24/7 (unless maybe in really extreme cases.)  A dear friend's daughter was diagnosed with scoliosis and managed to earn All State Track honors in back to back seasons.  At this point you should assume your son will be able to participate in whatever he wants in the years ahead.  Depending on the curvature, there is the possibility no treatment will be needed.

 

With that said, please make sure you take the treatment plan (if any) seriously and follow through with whatever they ask your son to do.  DH failed the screening when he was 12, and due to family finances there was never any follow up.  He now suffers with incredible back pain and will need surgery at some point.

 

ETA: braces can still be part of the treatment.  I believe most kids who end up in a brace now only have to wear it at night.

 

One doctor we saw told us that that is backwards thinking (not on your part but on doctors who suggest it).  He said that it's more important to wear the brace when upright and gravity is acting on the spine.  So I would ask about that for sure.   As with most things medical, there is probably disagreement on that too!

 

[Ellie]

 

 

Both the orthopaedists we saw said to stay away from chiropractors offering scoliosis treatments.  I know there is disagreement on that.

 

 

 

Many medical doctors will tell their patients to stay away from chiropractors, period. Happily, I ignored the medical doctors, who could only offer me drugs, and saw a chiropractor who actually put my bones back in order so that there was no pain. :-)

[G5052]

Like anything medical, I would get a second opinion before committing to expensive, long treatment.  I know that's a expensive and troublesome, but we've always been glad we did this when something big was on the horizon.  In one case the specialist was very gracious and complete, but told us that we'd be back after seeing the other two doctors we had lined up.  And indeed both of those doctors said that the case was beyond their skills and pointed us back to the original doctor to do the procedures and treatment he had outlined.  So we felt good about that of course.  We also look at the whole picture, not just the proposed treatment.  We want a doctor that we like associated with a solid hospital with good staff members.

 

Some scoliosis can be treated with chiropractic, some with physical therapy, some with a brace, and some with surgery.  I wouldn't worry about it until you know the score.  I wore one of those big braces, and actually they said 20 hours a day, not 24/7.  I took it off for sports and physical therapy, and a little time in between.  And I still had a boyfriend and went to prom without it.

[ChocolateReignRemix]

One doctor we saw told us that that is backwards thinking (not on your part but on doctors who suggest it).  He said that it's more important to wear the brace when upright and gravity is acting on the spine.  So I would ask about that for sure.   As with most things medical, there is probably disagreement on that too!

 

 

What the one doctor actually says makes a lot of sense. 

 

[ChocolateReignRemix]

 

 

Both the orthopaedists we saw said to stay away from chiropractors offering scoliosis treatments.  I know there is disagreement on that.

 

:grouphug: :grouphug:

 

When dealing with the spines of children I think that is fairly sound advice.

 

[dirty ethel rackham]

Dd has scoliosis.  She was screened at age 11 and there was no sign of scoliosis.  I also would have noticed because she was sewing many of her own clothes and I would help fit her.  6 months later, I noticed a curve while out walking with her.  Also, when I was helping her fit a dress she was making as a 4-H project, we noticed that we had difficulty getting it even.  I took her in and they found a 27 degree curve.  She had grown about 4 inches in those 6 months.  One side of her had grown faster than the other.  Even her rib cage on that side was bigger.

 

Since she is an athlete (competitive rock climber,) we looked at our various options and she has a bending brace that she wears only at night.  Although some say it is important to wear a brace while upright, there can be a significant decrease in core strength while wearing a brace during the day time.  Since dd's sport requires a lot of core strength, we knew that a daytime brace would not only be detrimental for her sports performance, I was concerned about her long-term progress.  One theory supporting the bending/nightime brace is that children grow a lot in their sleep and the brace supports growing properly.  2 years ago, she had a 27 degree curvature.  Now it is closer to 20 degrees.  She is almost done growing so she may only be in it another year.  Her sport is ideal for the physical therapy they want her to do.  We see a sports-medicine chiropractor and he does not do any adjusting, but has created a physical therapy program that supports her musculature to pull more evenly on her spine.  She had been receiving chiropractic care beforehand so I don't think chiro cures scoliosis.

 

She has a friend who is also a climber who had an S-curve.  Her particular curve would not respond well to a bending brace because that would only help with one of the curves.  She was in a brace for 16 hours a day.  Her orthopedist wanted her to be as active as possible and to continue in her sport.  She also had some intensive physical therapy.  In a year, her curve decreased by 12 degrees.

 

With most orthopedists, stopping the progression of a curve is considered a success (providing the patient is still growing.)  Decreasing the curve is considered an outstanding success.  The treatment options vary depending on the type and severity of the curve - from watchful waiting to bracing to surgery for some of the most severe cases.  We know a competitive climber who had surgery since her curve was so large and not responding to treatment.  A year later, she won the national championship in her age bracket. 

[Pawz4me]

Youngest DS has scoliosis.  It was discovered when we pursued an evaluation because of him having difficulty running and what to us looked like an "off" gait when walking.  He didn't need a brace, but did need physical therapy due to muscle imbalances that the orthopedic doctor said were very likely due to the scoliosis.  And he had an MRI, because apparently scoliosis in boys is a bit more worrisome (i.e., much less common) than in girls, so the docs like to make sure there's no underlying cause when it occurs in boys.  DS was monitored with twice a year appointments and x-rays for a few years to keep tabs on the degree of curvature.  His doctor said that if his degree of curvature was going to get worse, it would do so during his adolescent rapid growth period.  He's 15.5 now and probably done with most of his really fast growth, so he's been set free from regular monitoring.

 

ETA -- DS played baseball.  One of the things that caused us to pursue an evaluation was noticing that he was having difficulty with base running and making his turns.  During the evaluation we also were told that  DS has spondylolisthesis, and the orthopedic doc was more concerned about that and playing sports than he was about having scoliosis and participating in sports.  He said baseball was fine, but he nixed DS ever playing football or doing very heavy weightlifting.  He also said he'd think a long time before allowing him to play soccer.  But baseball was DS's love, so the rest was no big deal at all.

[Catwoman]

Youngest DS has scoliosis. It was discovered when we pursued an evaluation because of him having difficulty running and what to us looked like an "off" gait when walking. He didn't need a brace, but did need physical therapy due to muscle imbalances that the orthopedic doctor said were very likely due to the scoliosis. And he had an MRI, because apparently scoliosis in boys is a bit more worrisome (i.e., much less common) than in girls, so the docs like to make sure there's no underlying cause when it occurs in boys. DS was monitored with twice a year appointments and x-rays for a few years to keep tabs on the degree of curvature. His doctor said that if his degree of curvature was going to get worse, it would do so during his adolescent rapid growth period. He's 15.5 now and probably done with most of his really fast growth, so he's been set free from regular monitoring.

What kind of underlying causes might there be for boys? I had never heard of that.

[Pawz4me]

What kind of underlying causes might there be for boys? I had never heard of that.

 

It's been a long time ago, so I don't remember specifically, other than that they said there are congenital vertebral issues that can cause scoliosis.  Most cases are considered idiopathic (no known cause).

[Catwoman]

It's been a long time ago, so I don't remember specifically, other than that they said there are congenital vertebral issues that can cause scoliosis. Most cases are considered idiopathic (no known cause).

Thanks -- that's what I have heard, too, but I was wondering if I'd missed something -- which would not be unusual for me! :)

[plansrme]

Thanks, everyone, for the input.  We have an appt with the ortho tomorrow instead of the ped next week.  I called to make an appointment figuring it would take two or three weeks to get in, and they offered tomorrow instead.  The ped is just going to say, "Yep, needs to see an ortho," and I am happy to skip that step.  I am hopeful that they are going to say it isn't anything to worry about, but my gut tells me it's at least eventually going to require treatment.  My gut is usually right on these sorts of things, so I appreciate everyone's real-life experiences.  

[jenn-]

My DD's spine has curved a couple of times in her life.  Both times were right before a major growth spurt.  She straightened back up after she had done the shooting up.  She was also told to stay physically active to help keep the back muscles strong.  I hope you get some good news from the ortho.

[Harriet Vane]

I have scoliosis and have had chronic pain from it for many years.

 

Often if the curve is "not that bad," they recommend just waiting and watching. This is a really, really bad idea.

 

No matter how minor or how profound her curve is, please embrace a challenging exercise program that focuses on core and upper body strength. In addition to targeted strength exercises, she should engage in a sport such as swimming, basketball, rock climbing, or some other sport that also emphasizes core and upper body strength. This is the number one best thing to do to decrease the curve and remain pain free.

 

Second, please take your child to a chiropractor. While the spine is still growing, you have the chance to make this better. A judicious combination of chiropractic care, bracing (if deemed appropriate by the ortho), and exercise can have a magnificent effect.

 

Third, look into the benefits of hanging. A friend's son had scoliosis (diagnosed at age 13 or 14--I don't remember specifically other than that he was a young adolescent). His chiropractor wanted him to hang from a bar (hands grasping the bar) daily. That gentle traction helped quite a bit. My friend's son's curvature improved dramatically over the course of several months.

 

Bottom line--exercise is key. Not just a little. Aggressive, strength-building, beefy exercise.

[wapiti]

What kind of underlying causes might there be for boys? I had never heard of that.

 

I don't know about boys specifically (as opposed to both boys and girls), but IIRC, one possible underlying cause for scoliosis is a tethered spinal cord.

[zimom]

Sent you a pm for a great scoliosis ortho in your area.

[plansrme]

I have scoliosis and have had chronic pain from it for many years.

 

Often if the curve is "not that bad," they recommend just waiting and watching. This is a really, really bad idea.

 

No matter how minor or how profound her curve is, please embrace a challenging exercise program that focuses on core and upper body strength. In addition to targeted strength exercises, she should engage in a sport such as swimming, basketball, rock climbing, or some other sport that also emphasizes core and upper body strength. This is the number one best thing to do to decrease the curve and remain pain free.

 

Second, please take your child to a chiropractor. While the spine is still growing, you have the chance to make this better. A judicious combination of chiropractic care, bracing (if deemed appropriate by the ortho), and exercise can have a magnificent effect.

 

Third, look into the benefits of hanging. A friend's son had scoliosis (diagnosed at age 13 or 14--I don't remember specifically other than that he was a young adolescent). His chiropractor wanted him to hang from a bar (hands grasping the bar) daily. That gentle traction helped quite a bit. My friend's son's curvature improved dramatically over the course of several months.

 

Bottom line--exercise is key. Not just a little. Aggressive, strength-building, beefy exercise.

Thanks for this. I am expecting them to put him in the "wait and see" camp tomorrow, but I will definitely be researching what to do in the meantime. "Wait and see" is not really my m.o. as a mom, so I appreciate the advance encouragement to be more proactive.

[plansrme]

My DD's spine has curved a couple of times in her life. Both times were right before a major growth spurt. She straightened back up after she had done the shooting up. She was also told to stay physically active to help keep the back muscles strong. I hope you get some good news from the ortho.

He did just go tnrough a growth spurt. Or maybe he is still in one. Will definitely keep this in mind.

[Julie Smith]

I'm not sure what I was reading that talked about it (It was some times ago). But it was a new type of brace that was not a hard shell. The article at the time talked about how comfortable and good it was compared to other braces. I'm not sure why it stuck in my mind. But here are links to that type of brace. 

 

https://www.google.ca/search?q=%22SpineCor+brace%22&lr=&as_qdr=all&tbm=isch&tbo=u&source=univ&sa=X&ei=qSRHU4SMK8TisATR9ILoAw&ved=0CDcQsAQ&biw=1177&bih=749

 

 

[Tiramisu]

Youngest DS has scoliosis.  It was discovered when we pursued an evaluation because of him having difficulty running and what to us looked like an "off" gait when walking.  He didn't need a brace, but did need physical therapy due to muscle imbalances that the orthopedic doctor said were very likely due to the scoliosis.  And he had an MRI, because apparently scoliosis in boys is a bit more worrisome (i.e., much less common) than in girls, so the docs like to make sure there's no underlying cause when it occurs in boys.  DS was monitored with twice a year appointments and x-rays for a few years to keep tabs on the degree of curvature.  His doctor said that if his degree of curvature was going to get worse, it would do so during his adolescent rapid growth period.  He's 15.5 now and probably done with most of his really fast growth, so he's been set free from regular monitoring.

 

ETA -- DS played baseball.  One of the things that caused us to pursue an evaluation was noticing that he was having difficulty with base running and making his turns.  During the evaluation we also were told that  DS has spondylolisthesis, and the orthopedic doc was more concerned about that and playing sports than he was about having scoliosis and participating in sports.  He said baseball was fine, but he nixed DS ever playing football or doing very heavy weightlifting.  He also said he'd think a long time before allowing him to play soccer.  But baseball was DS's love, so the rest was no big deal at all.

 

Spondylolisthesis can cause scolioisis. I know two girls that identified their spondylolisthesis through investigating the more obvious scoliosis.

 

Having had a dd who needed surgery to repair spondylolistheis, I agree that it's serious when it shows up when they are young. There was at least one research study having to do with soccer and spondylolisthesis that I remember reading. Also quarterbacks and gymnasts can develop it from hyper-extending their spines. I would avoid anything like that, but work hard to maintain core strength in a way that's appropriate. 

[Tiramisu]

Thanks for this. I am expecting them to put him in the "wait and see" camp tomorrow, but I will definitely be researching what to do in the meantime. "Wait and see" is not really my m.o. as a mom, so I appreciate the advance encouragement to be more proactive.

 

There has been a genetic test developed to screen for cases of scoliosis which are likely to develop into serious curves. 

 

I have one dd with a minor curve who also has very mild kyphosis, but they showed up on xrays done for something else. An orthopedist said not to worry at all with that small degree, but she was done growing when we found the curves.

[Alexigail]

The Alexander Technique has helped me with my "mild curvature" in the past - less pain, more freedom of movement.  In a nutshell, it's a method for improving posture.  This book is a great introduction:

 

http://www.amazon.com/Body-Learning-Introduction-Alexander-Technique/dp/0805042067

 

 

[Pawz4me]

Spondylolisthesis can cause scolioisis. I know two girls that identified their spondylolisthesis through investigating the more obvious scoliosis.

 

Having had a dd who needed surgery to repair spondylolistheis, I agree that it's serious when it shows up when they are young. There was at least one research study having to do with soccer and spondylolisthesis that I remember reading. Also quarterbacks and gymnasts can develop it from hyper-extending their spines. I would avoid anything like that, but work hard to maintain core strength in a way that's appropriate. 

 

That's interesting and good to know.  I don't remember DS's doc ever mentioning that one could cause the other.  He gave me the impression that they were co-existing but unrelated conditions.

[plansrme]

OP here.  The ortho says there is only an 8 degree curve and to see him back in 6 months.  I feel kind of stupid now.  The shoulder-height discrepancy is 1 1/2 inches--I measured it!  It is easily visible and just seemed like a lot to me.  The ortho looked at the x-rays before she saw him, and I think that even she was surprised by the shoulders after seeing just the x-rays. He does play a lot of baseball, so maybe that exaggerates the shoulder thing?  The lower shoulder is his throwing arm.  He also has lately developed a significant sway-backed posture that we get onto him about regularly, but my husband apparently had the same thing as a kid.  Maybe that throws the shoulders out as well.  I dunno, but I am still going to be looking at everyone's suggestions.  A little hanging, a little chiro and a lot of strength training certainly never hurt anyone.

 

Thanks, everyone, for your info.  I really appreciate it.

[Catwoman]

Thanks for the update -- I'm glad it's nothing serious!

[Tiramisu]

That's interesting and good to know.  I don't remember DS's doc ever mentioning that one could cause the other.  He gave me the impression that they were co-existing but unrelated conditions.

 

With spondylolisthesis the spine slips into an incorrect (?)  position and the body tries to compensate and thus scoliosis can develop. The girls I knew who had this happen had high grade spondylolisthesis (grade 4+). The scoliosis can then straighten out after surgery naturally, at least that's what I've seen but it's probably dependent on age and growth. My dd had grade 3. Her spine could not have been straighter but the position of her pelvis changed completely, rotating forward to stabilize. Her orthopedist said she could compensate like that because she was so young and that wouldn't happen with older people. Her pelvis did normalize in the year after surgery.

 

When you get spondylolisthesis at a young age, there are almost always underlying factors. The first is spina bifida occulta, which is when the lower vertebrae don't form perfectly so there's inherent instability in the lumbar spine, but the kids can be otherwise fine with no neural tube involvement. This condition is actually rather common among the general population. The second factor is a possible  connective tissue disorder which make ligaments loose. It's not a bad idea to be aware of this possibility. Based on the experience of people we knew, I don't think it could ever hurt to look at the major signs of these syndromes like Ehlers-Danlos, Marfan, and Loeys-Dietz. I suspect we have a more benign form of EDS in the family which makes for very flexible joints.

[Harriet Vane]

 Thanks for the update.

 

An 8-degree curve can still result in the shoulder discrepancy and in joint problems both in the spine and in the other joints. The curve causes the whole body to not line up correctly. Ask me how I know.

 

It is my opinion, based on decades of pain, that orthopedic doctors tend to under-respond to scoliosis. They are specialists who are used to treating more severe cases. What looks to them like it's "not that bad" can and does still cause pain and ongoing health issues for the person living with the curvature.

 

An 8-degree curve is still worthy of a much greater response than wait-and-see. Seriously.

 

At the least, please, please address this with aggressive strength exercises and hanging.

 

Please also go see a chiropractor.

 

Even if you do not embrace the idea of chiropractics, at the least do the strength and core exercises and hanging.

[Melinda S in TX]

My daughter had scoliosis and it is completely managed with chiropractic care.  It was found when she was 6 and now she is 16.

[Supertechmom]

My son developed it during a growth phase. The ortho thought was to brace,wait and see what happens and when he had finished growing in his 20's , do surgery if the curve was great enough. I laughed in his face because I thought he was joking. He wasn't. Since we had started this path due to severe headaches and that check up revealed the spine curve, we went to the chiro. He said he couldn't cure scoliosis but could help with the headaches. Thanks to aggressive chiro treatment during every growth spurt, he has actually reduced the scoliosis to almost nothing. I think it has a slight curve still maybe a couple of degrees, down from 16 degrees. Chiro does wonderful with the shoulder and hips being out of alignment and keeps him in top shape. I would not rule out the magic a chiro can accomplish especially coupled with growth spurts.

[dirty ethel rackham]

Please don't count on chiro to fix scholiosis or prevent it.  My daughter was under regular chiropractic care and still developed scoliosis - severe enough to treat - a 27 degree curve.  Most people don't notice it, but I do, especially if she is wearing a tighter top. 

[Pawz4me]

With spondylolisthesis the spine slips into an incorrect (?)  position and the body tries to compensate and thus scoliosis can develop. The girls I knew who had this happen had high grade spondylolisthesis (grade 4+). The scoliosis can then straighten out after surgery naturally, at least that's what I've seen but it's probably dependent on age and growth. My dd had grade 3. Her spine could not have been straighter but the position of her pelvis changed completely, rotating forward to stabilize. Her orthopedist said she could compensate like that because she was so young and that wouldn't happen with older people. Her pelvis did normalize in the year after surgery.

 

When you get spondylolisthesis at a young age, there are almost always underlying factors. The first is spina bifida occulta, which is when the lower vertebrae don't form perfectly so there's inherent instability in the lumbar spine, but the kids can be otherwise fine with no neural tube involvement. This condition is actually rather common among the general population. The second factor is a possible  connective tissue disorder which make ligaments loose. It's not a bad idea to be aware of this possibility. Based on the experience of people we knew, I don't think it could ever hurt to look at the major signs of these syndromes like Ehlers-Danlos, Marfan, and Loeys-Dietz. I suspect we have a more benign form of EDS in the family which makes for very flexible joints.

 

I'm aware of the connective tissue disorders.  DS was evaluated and treated (PT) through the pediatric orthopedic department of a university teaching hospital.  So while anybody can miss things, I feel relatively confident that any underlying factors would have been diagnosed.

[Harriet Vane]

Please don't count on chiro to fix scholiosis or prevent it.  My daughter was under regular chiropractic care and still developed scoliosis - severe enough to treat - a 27 degree curve.  Most people don't notice it, but I do, especially if she is wearing a tighter top. 

 

It is true that chiropractic care is not a guarantee. I can say, however, that it is has helped me enormously. The curve on my spine coupled with the bone spurs I developed over the years means that the bad posture created by the scoliosis causes the bone spurs to compress nerves, resulting in my hands going numb. The chiro eases that compression. Also my friend's child was cured of his scoliosis, though my friend's daughter (same family) was not cured. Same family, different outcomes. The point is that it is a viable treatment that helps many, and might help the OP. Both perspectives have validity, so further investigation is certainly appropriate.

[mom@shiloh]

I didn't read the other replies, so maybe this was covered.....  My dd was diagnosed when she was about 6.  We had x-rays taken at a medical center and then they were sent to the orthopedic surgeon who confirmed the diagnosis.  A year later we did a follow-up appointment.  This time the x-rays were taken at the office of the orthopedic surgeon and there was no sign of scoliosis.  Moral of the story:  make sure the x-rays are being taken by someone who knows what they're doing.  I was watching the first x-rays and could see a definite curve, but as it turns out it was just because my dd wasn't standing straight.  Someone who is trained should have caught that.  Maybe this info will help someone else.

 

Even if your ds has it, it can be very minor and easily treated.  One of my ds's girlfriends had it and wore a brace during her teen years, but was able to be a very active athlete.  

 

 

[kbutton]

Please don't count on chiro to fix scholiosis or prevent it.  My daughter was under regular chiropractic care and still developed scoliosis - severe enough to treat - a 27 degree curve.  Most people don't notice it, but I do, especially if she is wearing a tighter top. 

 

There are many different types of chiropractic out there, but if my chiro could not help my son's mild scoliosis, he would be the first to say so. However, I do think a healthy dose of skepticism is in order even with practitioners (chiro, dentist, doctor, etc.) you trust. My husband is in the medical field, and he contends that EVERYONE is biased, even the best of caregivers.

 

Yikes! Edited to save a kitten from an apostrophal death.