Spotting scoliosis early gives patients the ability to be more proactive with their care. Scoliosis screening can be a great tool to catch and treat scoliosis before more drastic measures become necessary. Early detection can be the difference between an invasive spinal surgery and a short home exercise routine.
Scoliosis tends to get worse around the ages of 11 or 12, so detecting it before then should be a high priority. Unfortunately, based upon the recommendations of the U.S. Preventative Services Task Force, many states have eliminated scoliosis screenings in schools.
Scoliosis screenings were first introduced in the United States through the efforts of Dr. John H. Moe, the founder of the Scoliosis Research Society. In 1974, the American Academy of Orthopedic Surgery (AAOS) made a formal endorsement of scoliosis screening, and by 1989, 20 states had laws requiring students to be screened for scoliosis.
The goal of scoliosis screening was to reduce the number of teenagers who would progress to the level where surgical fusion was recommended. And the most commonly prescribed treatment method was the Boston brace, which was worn for 23 hours daily, over a period of three years or more.
Over the years, concerns were raised about the relative dangers of idiopathic scoliosis, as well as the effectiveness of bracing. Were some kids being forced to endure wearing a brace for years, when their scoliosis was never in danger of increasing? Were other kids slipping through the cracks until surgery is recommended in their teenage years? Conflicting answers to these questions led many to question the value of spinal screenings.
There’s one aspect of this scoliosis bracing and screening discussion which is conspicuously absent. If scoliosis screening detected many cases too late, and the effectiveness of bracing was uncertain, perhaps these processes could be improved to address some of these concerns.
Scoliosis screenings are surprisingly expensive. Because of this, many schools forgo them or allow them to be conducted by a school nurse. School nurses are wonderful, hard-working and dedicated people, but they don’t have the same experience with posture and the spine that chiropractors do. Because of this, sometimes they send kids to the orthopedist who don’t have scoliosis (false positives), or even worse, miss a case of scoliosis in a child who really does have it (false negative). Their traditional methods of scoliosis screening (such as Adam’s Forward Bending Test) sometimes only catch cases when they are already severe enough to warrant surgery.
These missteps led scoliosis screenings to be labeled as somewhat of a controversy. Some have thrown out the scoliosis screening altogether rather than look for ways to improve the process. Instead of one outdated test, multiple tests should be conducted looking for problems with balance and spinal tension, as well as the standard posture evaluation.
To catch the subtleties, these tests should be conducted by a scoliosis specialist. For example, the ribs may be a teensy bit higher on one side in comparison to the other, a sign of scoliosis in its early stages. This is virtually undetectable to the untrained eye, but a good chiropractor would catch it. Scoliosis screening by a chiropractor will catch all other postural issues as well. So a child with Scheuermann’s disease or another postural disorder would also benefit from a screening by a chiropractor.
Having a chiropractor screen your child for scoliosis won’t hurt. And if your child is found to have scoliosis, beginning treatment early when the curve is small is always less time-consuming and more affordable than managing a severe curve. Aside from identifying the problem so that you can begin treatment, there are a plethora of other benefits to scoliosis screening.
Girls most often develop scoliosis between the ages of 7 and 14, while boys are a bit later between the ages of 9 and 16. By screening for scoliosis once a year during this age range, chiropractors will be able to diagnose the scoliosis before it increases to the point of extensive treatment and even surgery.
Alternative treatments have seen a lot of success curbing the progression of scoliosis. Exercises, stretches, physical therapy and scoliosis-specific chiropractic adjustments are just a few of the many methods that have stopped the Cobb angle in its tracks and even reduced it to a more natural spinal curve. Although possible and incredibly helpful for scoliosis in its later stages, non-surgical treatments are more effective the earlier the scoliosis is diagnosed.
There are ways for a chiropractor to see risk factors in a screening before scoliosis develops at all. For example, children with tension in their spinal cords are at greater risk. And there are multiple tests that can detect this tension early. Knowing your child is at greater risk for developing scoliosis helps parents stay on track with recommended screenings and keep an eye out for signs of scoliosis as the child grows.
Knowledge and research on scoliosis in its early stages is an ongoing journey. And over the last 20 years, we’ve had plenty of advances. For example, there have been studies linking the angles of the foot and ankle to scoliosis. However, many of these avenues (including the angles of the feet and ankles) are not being diligently explored or incorporated into screenings, diagnosis or treatment. With more mainstream screenings, we’d find more cases of early-stage scoliosis. The interest would be greater and further incentivize the research. Perhaps this incentivization would even lead to a known cause and a cure for idiopathic scoliosis. And what an amazing discovery that would be!
Currently, the majority of scoliosis cases are first discovered by family members. They may know it could be an issue in the future, but due to the mystery and misconceptions surrounding scoliosis, they may not see it as an immediate concern. Even the traditional method of scoliosis treatment lists observation as the first step. Wait and see if the Cobb angle increases.
The fear and anxiety that comes with waiting around to see if the scoliosis will progress can easily be curbed. Alternative treatments can help you be proactive in preventing progression rather than passively waiting for things to get worse. A scoliosis expert will be able to provide you with preventative treatment or refer you to someone who can.
While these screenings are controversial, they can make all the difference to a child with scoliosis. At the end of the day, looking at the individual and the importance of one child’s health and quality of life makes scoliosis screenings worth the hassle and possible expense of bringing in a chiropractor experienced in scoliosis. Some families might see this as a waste of time, but it makes all the difference to your child with scoliosis.
We know that these screenings can be expensive. That’s why many CLEAR doctors provide free scoliosis screenings. Some may even be interested in helping out schools in their communities. Contact the nearest doctor to you for more information.
Have you or your child been screened for scoliosis? How was your experience? We’d love to hear from you in the comments!