My child has scoliosis, now what?

My child has scoliosis, are words no parent wants to hear. Understandably, you have many questions which we hope to answer for you here.

You might have recently been dealt some concerning news, you have found out that your child has a spinal deformity – scoliosis or Scheuermann’s disease – and while you are still reeling with the information you are probably wondering…what now?!

Understandably, you have many questions to ask and you begin scouring the internet for answers. Although the sea of information is daunting, what is reassuring is that with today’s scientific and technological advances, scoliosis is treatable in most instances. Naturally, like most other medical conditions, the earlier it is detected and treated the better the outcomes.

Let’s start by explaining a few things about the spine

A normal spine should be completely straight when looking at it from the front or back. When looking at the spine from the side, there should be curves that fit within a normal range. 

A typical spine, when viewed from behind, is straight from the neck to the buttocks. In a back affected by scoliosis, the spine is not straight up and down. Scoliosis causes the spine to form a curved line in the wrong direction, and the spine may curve to the left or right.

But sometimes the spine is not within normal limits and there can be several causes for this. Most causes are known or can be identified, but certainly, the most common type (the Idiopathic type) has no known cause. This type can be well managed using specific techniques and therapies. 

The fact that some spines are in a normal configuration is in itself a miracle. There are so many things that can go wrong with the spine, most of which have a known cause.

Because the cause of idiopathic scoliosis (the most common type of scoliosis) is not known, there is no known way to prevent the problem. Concerned parents often ask what they could have done to prevent scoliosis, or if bad posture or heavy backpacks could have led to their child’s condition. While heavy backpacks can aggravate existing idiopathic scoliosis and bad posture may be associated with other spine and back conditions, they don’t cause scoliosis.

What is of the utmost importance, is that the sooner intervention is applied, the better the outcome in most cases. If left untreated, this type has a life-long progression and can cause significant complications down the line.

What can be done if the spine is not in the normal range?

The meaning of the term idiopathic is “of unknown cause or origin”. Several suggestions have been put forward as to what may cause idiopathic scoliosis, but no known cause has been identified to date. The spine won’t be able to straighten voluntarily, and the condition is usually progressive – meaning that the spine will continue to bend to the side unless it is managed and controlled.

Luckily, not all scoliosis requires surgical correction – in fact, surgery (for most scoliosis types) should really only be considered under only a few circumstances, namely:

  • Significant deformity
  • Unmanageable pain (unusual with scoliosis)
  • Significant progression despite any other (conservative)  interventions
  • Very large scoliosis curves (usually larger than 60 degrees)

Obviously one would like to manage spine deformity in the most conservative way possible. In some instances where there is minimal deformity one only adopts an observation protocol where the angles are noted and the person continues life as normal. Measurements should be taken again roughly 6 months later to see if the condition has resolved, or if in fact, it’s getting worse.

If in 6 months it has deteriorated then the next level of treatment may be only spine-specific exercises done by a qualified *scoliosis-specific therapist trained so that the exact exercises for the curve type can be implemented. You must see someone extremely familiar with spine deformities as it has been shown in research studies that if the wrong method is applied, the condition can be made worse. Making sure that you have the right partner for your child’s condition is therefore paramount.

Once the correct exercises have started, the spine is monitored again in another 6 months’ time. If there are still signs of progression, then a brace may be required.

Bracing can be applied in various ‘dosage’ forms namely, night-time only, part-time (± 16 hours per day), or full-time rigid bracing.

Determining which treatment course is best will depend on several factors, but one fact is certain, no scoliosis bigger than 10 degrees should have a “let’s wait and see” approach.

 Despite growing international evidence and guidelines to support conservative treatment options for scoliosis, there are still doctors out there of the opinion to ‘do nothing’ unless scoliosis progresses to the point of needing surgery. 

This traditional approach to treating scoliosis has been viewed as conservative and apparently sensible with experts in conventional treatment agreeing that the best method is to wait and watch. These physicians err on the side of caution, being reactive instead of proactive, convincing their patients and families that their approach is rational, practical and rooted in the most modern best practices. 

But here’s the downside…

All the watching and waiting that’s done by patients affected by scoliosis never improves their condition. 

In almost all cases, watching and waiting means watching as a spinal curvature progresses, and then waiting to undergo expensive and invasive surgery.

The ‘let’s wait and see approach to scoliosis is not a healing strategy nor is it the correct treatment option. 

3 – 4 % of children will develop scoliosis and since scoliosis usually develops in children it should be treated as soon as possible to maximise the chances of a successful outcome.

Timely treatment is vital to patients when there are options available to assist with conservative care.

Detection and diagnosis of scoliosis early on and then taking the appropriate action to stabilise and correct the spine is the key to a successful outcome. Parents, in particular, should have their children screened regularly should they have concerns because unlike 20 years ago, today the prognosis is a good one.

Scoliosis progression risk is highest during growth spurts

It is so important that scoliosis patients are given the option to receive conservative treatment care in the form of controlled observation, specific exercises and/or bracing, especially in cases of very young children with juvenile idiopathic scoliosis (JIS) and adolescents with idiopathic scoliosis (AIS). Progression and increased structural and postural damage are often highest during growth spurts. 

Understandably, the nature of untreated scoliosis is to continue its progression

When you fail to be proactive in the treatment of scoliosis, the condition is allowed to continue to progress over time. This will lead to the inevitable point where surgery presents itself as the only possible option for relief. And even then, surgery is not guaranteed to stop the progression of the curvature, much less reverse it, it is, however, guaranteed to cost a lot of money.

Patients with Scoliosis deserve to be empowered with choice

There are treatment options available for patients and patients have the right to be informed of their choices. Patients with scoliosis also have the right to decide if conservative treatment options are worth pursuing to help them with additional goals such as improving aesthetics.

Rowan’s approach builds confidence, creates measurable improvements, helps patients avoid surgery and, importantly, restores hope.

While progression risk is a little harder to predict with curves between 21 and 30 degrees during the first two years of puberty we are still becoming more certain every day that these kids may benefit from a treatment regime of scoliosis specific exercises and bracing. If the curves are caught early enough, some patients may even be able to try a course of scoliosis specific exercises without the bracing. 

Remember kids with scoliosis will eventually be adults with scoliosis. Missing out on early treatment options does lead to a missed opportunity to empower these patients with choice. 

Why does early detection with Scoliosis matter?

Early detection is especially important in scoliosis cases since research has shown a direct link between the age of detection and the outcomes achievable. Today, through modern bracing technology, it has been demonstrated that conservative treatment with a brace is now highly effective in treating juvenile idiopathic scoliosis. In one recent study of 113 patients, the vast majority achieved a complete curve correction and only 4.9% of patients needed surgery.

If you or your child are dealing with a scoliosis diagnosis, I know first-hand what you are facing and although we cannot always change or cure a disease or deformity, we can make a difference and restore quality of life. Click here if you would like to make an appointment

Although certain principles remain the same through time, technological advances, research studies, and the availability of new materials and techniques have enabled spine specialists to treat and manage spine deformities which previously could only be managed surgically or worse still, simply left to progress – leading to a lifetime of deformity, pain, and disfigurement. 

*A specialist that is accredited by Schroth or SEAS or Dobomed or Lyon-method or other recognised spine society.