While no scoliosis treatment outcome can ever be guaranteed, early detection and intervention are associated with a number of treatment benefits, but early detection is only possible with awareness and/or early screening.
Early signs of scoliosis you shouldn’t ignore include asymmetrical posture in children and radiating pain in the extremities in adults. Most cases are diagnosed during childhood, and the earliest signs of scoliosis to watch for include uneven shoulders and hips. Because scoliosis is progressive, the timing of treatment is crucial.
The early signs of scoliosis can be subtle, and without awareness of what to watch for, they can be easily missed.
The Power of Early Detection
The power of early detection is its outcome-shaping ability. As a progressive spinal condition that becomes increasingly complex to treat alongside progression, a proactive treatment approach works towards preventing progression and starting treatment while mild.
Scoliosis can range in severity from mild scoliosis to moderate scoliosis, severe, and very severe scoliosis.
Scoliosis involves the development of an unnatural side-to-side curve in the spine that rotates, and progression increases the sine’s unnatural curve and twist.
Progression makes the spine more rigid and less responsive to treatment, and the goal of proactive treatment is to work towards preventing progression, increasing effects, and the need for surgical intervention.
When scoliosis is diagnosed while mild, the curve is still small and flexible, and more easily correctable, and as significant progression hasn’t yet occurred, condition effects aren’t well established.
The benefits of early detection are only available to those who commit to a proactive conservative treatment approach that starts treatment immediately following a diagnosis.
So let’s talk about the earliest signs of scoliosis to watch for to achieve early detection.
Postural Changes
Scoliosis affects all ages, but is most often diagnosed during childhood. The most common form of scoliosis is adolescent idiopathic scoliosis diagnosed around the onset of puberty.
Postural changes are caused by the uneven forces disrupting the body’s overall symmetry, and in children, the earliest telltale signs of scoliosis are often uneven shoulders, shoulder blades, and uneven hips.
Additional postural changes to watch for include the development of a rib cage arch, an uneven waist line, pelvic obliquity, and arm- and leg-length discrepancies.
A prominent lean to one side is common, and a sign of asymmetrical posture is clothing hanging unevenly.
As posture is disrupted, the spine’s surrounding muscles can also be affected through imbalance and strain, and changes to balance, coordination, and gait can also occur.
In adults, postural changes also occur, but it’s more often pain that leads to diagnoses of adult scoliosis; scoliosis becomes compressive once growth stops, and radiating pain due to nerve compression can alert adults to the need for assessment and lead to a diagnosis.
So early signs of adult scoliosis to watch for include increasing back pain and the presence of radiating pain in the arms and hands, legs and feet.
Postural changes can be subtle in mild cases, so it’s important to know what to look for, particularly if risk factors are in place.
Scoliosis Risk Factors
Part of scoliosis awareness is understanding its prevalence, and if risk factors are in place, early and regular screening is recommended prior to the start of puberty.
There are a number of benefits to diagnosing scoliosis and starting treatment prior to a child’s first significant pubescent growth spurt, and a significant risk factor is a family history.
If other individuals in a family have already been diagnosed with scoliosis, this increases the likelihood of more diagnoses, and warrants regular early screening.
As most cases of scoliosis are diagnosed around the onset of puberty and scoliosis is most commonly diagnosed and progressive in females, adolescent girls approaching puberty with a family history are the most at risk.
Regular scoliosis screening was performed in schools across the United States in the past, but concerns over cost and misdiagnosis have ended most programs – making public awareness even more important as parents and patients themselves need to recognize the need for screening and the condition’s earliest signs.
A scoliosis screening examination involves a physical examination of the spine while the patient is bending forward, taking the patient’s medical and family history, and looking for postural asymmetries.
If a screening examination finds indicators of scoliosis, further testing, in the form of a scoliosis X-ray. is needed to diagnose scoliosis.
When scoliosis is diagnosed while mild, treatment is simpler, so let’s talk about the differences in treating mild and severe scoliosis.
How Early Detection Shapes Treatment
Early diagnosis means treatment can be started early when curves are at their smallest, most flexible, and are most likely to respond well.
Treatment that’s started early in the progression line of scoliosis is more likely to be successful. We don’t know what triggers most cases of scoliosis to develop initially, but we know growth causes progression, so how scoliosis is treated during growth is key.
When treating adolescent idiopathic scoliosis, in particular, due to rapid growth spurts, rapid progression is a risk, and treatment has to counteract progression while growth is occurring.
Part of treating adolescent idiopathic scoliosis involves close monitoring to determine how the spine is responding to treatment and/or growth, and adjusting treatment plans accordingly.
Early onset scoliosis treated in juveniles, for example, can be highly responsive to corrective bracing used as early intervention, and has potential to stop progression during growth.
When curves are larger and more rigid, treatment needs are more complex, and a more comprehensive treatment plan is needed.
When bracing is combined with the potential of a scoliosis-specific rehabilitative treatment plan and scoliosis-specific chiropractic care, there are fewer limitations to nonsurgical treatment.
In addition to correcting scoliosis, a main goal of nonsurgical scoliosis treatment is to prevent the need for invasive surgical treatment.
Avoiding Spinal Surgery
All surgeries come with risks, and spinal surgery is no exception. There are different types of scoliosis surgery, but are variations of traditional spinal fusion surgery.
In cases of highly progressive, atypical, severe, or scoliosis that’s been left untreated for years, spinal fusion surgery can be recommended. Spinal fusion fuses the curve’s most-tilted vertebrae into one solid bone; this is done to prevent the vertebrae from becoming more tilted over time (progression).
Metal rods are often attached to the spine to hold it in place, and when successful, spinal fusion surgery stops progression and maintains the spine’s straight alignment.
Spinal fusion can maintain the spine’s straighter alignment, although there are never guarantees, and it is contrary to the spine’s natural movement-based design.
Spinal fusion can disrupt the spine’s strength, flexibility and function, and a spine that’s less flexible and more painful can disrupt quality of life.
It’s important to understand that a fused spine is fused for life; if for any reason, spinal fusion is unsuccessful and/or hardware fails, more surgery is needed.
The risks of surgery increase with each procedure, so the ultimate goal of early detection is to help patients avoid progression to the surgical threshold and to preserve the spine’s long-term strength and function.
Conclusion
Early scoliosis signs in children include postural changes such as one shoulder blade protruding more than the other, one shoulder sitting higher than the other, an arch in the rib cage, and changes to movement.
In adults, postural changes are early signs, but it’s most often pain that brings adults in for assessment and diagnosis.
Recognizing early scoliosis signs can lead to early detection and intervention, and because scoliosis is progressive, the sooner treatment is started, the better.
Proactive treatment has the goal of preventing progression, and a significant amount of progression has to have occurred before crossing the surgical threshold, which provides a lot of time to act, and the sooner scoliosis is diagnosed and treated, the more time and potential there is for correction.
Spreading public awareness on the prevalence of scoliosis and the importance of early detection is a priority of the Scoliosis Reduction Center®; we want to help patients avoid the need for spinal surgery that can disrupt the spine’s long-term spinal health.
With early detection and intervention, the spine’s long-term strength and function is easier to preserve, and an integrative treatment approach combining the potential of corrective bracing, scoliosis-specific exercise, and chiropractic care work together towards the common goal of correction.
