Episode Transcript
Dr. Gellner: Most of us have heard our mother's say, "Stand up straight you're going to make your back so it's hunched over." Well what if the back problem has nothing to do with your posture and has more to do with your spine? We're going to talk about scoliosis today. I'm Dr. Cindy Gellner on The Scope.
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Scoliosis in Children
Dr. Gellner: So most of you if you've been to seventh grade you've had the spine check where they have you take off your shirt, bend over, touch your toes, and they look at your back. Most of us start checking the spines around age 10 or 11, because that's usually when kids are about to have their big growth spurt, and during the growth spurt that's when you're usually going to pick up scoliosis.
So scoliosis is basically meaning that the spine curves from side to side rather than going straight down the back and it most often effects the bones in the upper back not the lower back. So if your child has lower back pain we need to think of another issue going on. Most likely that's going to be a muscle problem not a spine problem.
Scoliosis Causes
Scoliosis happens more in girls than boys. Scoliosis does seem to run in families and the cause really isn't that known, it could be caused because the bones in the spine aren't shaped correctly, the legs are different lengths, the rib muscles pull harder on one part of the spine than the other causing the bones to twist and move out of line. If you've had an injury to your spine it can cause some curving, some certain diseases like cerebral palsy also make people more prone to scoliosis.
What Does Scoliosis Look Like?
How do you know if you have scoliosis if you haven't been to a doctor and no one's checked your back? Well there are other things to look for. If your shoulders are uneven or your hips are uneven, like one is higher than the other, if you are bending over and somebody says, "Wow what's that hump on your back on the left side?" That could be a sign that your spine is crooked. If one or both of your shoulder blades are sticking out, not just because you're skinny, but they are actually like sticking out like wings, if you have a slight lean to one side but it's only from the waist up, or if you're having a lot of mid to upper back pain.
Next Steps After Diagnosis
So if we do pick up scoliosis on the physical exam, what do we do about it? Well the first thing we're going to do is an X-ray. If your child's x-ray shows that the scoliosis is less than 10 degrees, we just monitor it. When we do the x-ray we can actually measure the angle of the curve using something that looks like a protractor like you used in math, and if it's more than 10 degrees but less than 15 we usually just monitor it once a year. If it's between 15 and 20 degrees we monitor it every six months. If it's more than 20 degrees that's when we get the bone doctors involved, the orthopedic doctors, because if it's that bad then we need to have the orthopedic doctors talk to you about the treatment options.
Scoliosis Treatment Options
Sometimes people if their spine is that crooked they need to wear a back brace. Sometimes physical therapy can help. It also helps your child learn proper posture and helps keep your child with a good range of motion so they can move in all directions, and quite often by helping to strengthen the muscles around the spine. It also helps with the pain and muscle spasms that some people get with scoliosis.
If the scoliosis curve is severe then you're child may need to have surgery but that's not very common unless you have one of those other predispositions for having scoliosis like cerebral palsy.
Help Your Child Maintain a Healthy Spine
So how can you help with scoliosis? Well unfortunately there's not a whole lot you can do. This is something, again with just how they're spine grows and genetics, because again it does tend to run in families. But that old adage of, "Stand up straight," yeah it's a good thing to do. Your child needs to remember to stand up straight, practice good posture that will help with all the back muscles too.
Your child also needs to learn how to protect their back, so that means if they're going to lift something heavy they need to bend at the knees not with their back. If they're carrying heavy backpacks, which going back to school that's something that a lot of people are going to be dealing with, they need to remember to use both straps on the backpack. Your backpack comes with two straps for a reason so you need to actually use both of those rather than just having on one shoulder, because that will also cause strain on the back. Also kids who are overweight can lose some weight and that also helps back muscles. A lot of back pain is due to extra weight.
If your child does have scoliosis, especially if they need some of the interventions like needing to wear a brace, that can be something they're very self-conscious about so make sure that you talk to your child and let them know, "Hey this isn't anything you did or you have any control over and it's a short term fix so that you can fix a long term problem."
So if your child can't stand up straight or you notice any of those other signs, have your pediatrician check out your child's back and make sure that they don't have the early signs of scoliosis and if they do you can get it fixed.
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