Scoliosis is a highly-variable condition that ranges from mild to moderate and severe to very severe, and particularly with mild forms in children, it can be difficult to detect. Getting a scoliosis diagnosis can be the first step on the road to proactive treatment, and treatment-option awareness is key because different approaches offer different potential outcomes.
While there are never treatment guarantees, as a progressive condition, early detection can increase the likelihood of treatment success. Getting a scoliosis diagnosis means an unnatural sideways spinal curvature, with rotation, and a Cobb angle measurement of 10+ degrees has developed.
When it comes to progressive conditions like scoliosis, early detection and reaching a diagnosis are key to starting treatment early, while the spine is going to be most responsive to treatment.
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The spine’s natural and healthy curves make it stronger, more flexible, and better able to absorb stress, like a coiled spring.
If the spine loses one or more of its healthy curves, it disrupts the biomechanics and function of the entire spine, as each spinal curve is dependent upon the health of the others.
There are a number of spinal conditions that involve a loss of its healthy curves, so certain parameters have to be met to reach a diagnosis of scoliosis.
Being diagnosed with scoliosis means a person has developed an unnatural sideways spinal curve, with rotation and a Cobb angle measurement of 10+ degrees.
The rotational element is important and makes scoliosis a 3-dimensional condition; the spine doesn’t just bend unnaturally to the side but also twists from front to back, back to front.
A patient’s Cobb angle is a measurement taken during an X-ray that tells me just how far out of alignment a scoliotic spine is while placing conditions on a severity scale:
As a progressive condition, scoliosis has it in its nature to worsen over time, so where a scoliosis is at the time of diagnosis is not indicative of where it will stay.
Mild scoliosis can easily progress to become moderate, severe, or very severe, particularly if left untreated or not treated proactively.
So for a diagnosis of scoliosis to be reached, an unnatural sideways spinal curve, of at least 10 degrees, with rotation, has to be present.
While scoliosis screening used to be offered in schools, conducted by the school nurse when it comes to children, the onus is now on parents to seek out scoliosis screening options, and knowing the condition’s early telltale signs can help with early detection.
When it comes to scoliosis screening, this would involve a physical exam, during which time I observe the patient’s posture and gait; I can tell a lot about a patient’s spine by the way they walk.
I also take the patient’s medical and family history. While scoliosis is considered more familial than genetic, the likelihood of developing scoliosis does increase if another family member has it.
Then I’ll perform an Adam’s forward bend test, which is a safe, noninvasive screening exam, and while it’s not a diagnostic tool on its own, it does indicate whether or not further testing is warranted.
The patient stands upright with their arms at their sides, and then they bend forward as if going to touch their toes at a 90-degree angle; in this position, the spine and any related postural deviation are highly visible.
Next, I use what’s known as a Scoliometer. This looks almost like a ruler with a bubble inside. I run it along the spine to gauge the angle of trunk rotation (ATR).
If the bubble in the Scoliometer aligns with 7 degrees, this equates to around a 20-degree measurement on an X-ray. When the Adam’s test is combined with a Scoliometer, it’s even more effective at screening for condition indicators.
So what are the condition’s early telltale signs, and how does the diagnostic process differ between children and adults?
Scoliosis Diagnosis in Children
When it comes to diagnosing scoliosis in children and adolescents, this is the age group that early detection is particularly beneficial because they are at risk for rapid-phase progression.
There are different types of scoliosis, but the most prevalent is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18.
The idiopathic designation means we don’t fully understand why the condition developed, but we do know how to treat it effectively, and we do understand what triggers its progression: growth and development.
Because of the uneven forces the condition introduces, the body’s overall symmetry is disrupted, and in adolescents, the earliest telltale signs are often uneven shoulders and hips.
Every case is unique, and how noticeable it is will depend on a number of variables, including condition severity, but other common postural signs of scoliosis to watch out for in adolescents include:
In addition to the aforementioned postural changes, issues with coordination and balance are other signs to be aware of.
While noticing some of the aforementioned postural signs doesn’t guarantee a person has scoliosis, it does indicate the need for further testing, which would involve an X-ray.
While scoliosis is far more prevalent in children and adolescents, it does also affect adults, so let’s move on to addressing how the diagnostic process tends to differ in older patients.
Scoliosis Diagnosis in Adults
The main forms of scoliosis to affect adults are idiopathic and degenerative.
Cases of idiopathic scoliosis in adults are extensions of AIS cases that were left undiagnosed and untreated in adolescence and have progressed with maturity and time into adulthood when scoliosis becomes a compressive condition.
Degenerative scoliosis is caused by natural age-related spinal degeneration and is more common in women due to hormone and bone-density changes related to menopause.
Scoliosis isn’t always easy to detect, particularly in mild forms, as it’s not known to cause noticeable functional deficits, and postural changes can be subtle. In addition, the condition does not tend to become painful until skeletal maturity has been reached.
Scoliosis not being painful in children and adolescents is another challenge to early detection as the constant lengthening motion of a growing spine counteracts the compressive force of the curve; it’s compression of the spine and its surrounding muscles and nerves that are the main cause of condition-related pain.
So in cases of adult idiopathic scoliosis, had these patients received a diagnosis and treatment during adolescence, their spines would be in far better shape than by the time they come to me for a diagnosis and treatment.
That being said, the best time to start proactive treatment is always now, regardless of age.
When it comes to diagnosing scoliosis in adults, this tends to be easier because, in cases of idiopathic scoliosis, the condition has been progressing for years. Once it becomes compressive in adulthood, it starts to become more noticeable and painful.
Pain is the number-one symptom of scoliosis in adults, and this can take the form of localized back pain or radicular pain that’s felt throughout the body.
In fact, in adults, it’s often pain in the arms, hands, and feet that’s the most common, and this is due to nerve compression.
Regardless of age, the aforementioned parameters that have to be in place to reach a diagnosis of scoliosis are the same.
The main difference in how scoliosis is diagnosed in adolescents versus adults is in their symptoms; the postural deviation is the main sign of scoliosis in children and adolescents, while pain is the number-one symptom in adults.
Once a diagnosis is reached, the most important decision moving forward is how to treat it, and there are two main scoliosis treatment approaches for patients to choose between: traditional and conservative.
When it comes to treating scoliosis, as a progressive condition, being proactive is key, but the traditional approach to scoliosis can be described as more reactive than proactive, and the conservative approach values starting treatment as close to the time of diagnosis as possible.
The traditional approach involves watching and waiting until a condition progresses past the surgical-level threshold at 40+ degrees when patients are often told that spinal fusion is the best remaining treatment option.
Spinal fusion is a lengthy and invasive procedure that comes with some heavy risks and potential side effects.
Fortunately, there is a less-invasive non-surgical treatment option available for patients who choose to forgo a surgical recommendation or for those simply interested in trying another approach with proven results.
Here at the Scoliosis Reduction Center, under a conservative chiropractic-centered treatment approach, patients benefit from proactive and customized treatment plans that integrate multiple forms of condition-specific treatment for the best results.
While no treatment results can be guaranteed, by combining chiropractic care, in-office therapy, corrective bracing, and custom-prescribed home exercises, I can work towards impacting the condition structurally in the form of a curve reduction, increasing core strength so the spine is optimally supported, and customizing a home-rehabilitation program for further stabilizing the spine and sustainable long-term results.
When it comes to getting a scoliosis diagnosis, knowing some of the condition’s early telltale signs can help with early detection and put patients on the path of proactive treatment.
While surgery can be successful at straightening a crooked spine, it does so at the expense of the spine’s natural strength and function, while a conservative non-surgical treatment approach prioritizes preserving as much natural spinal function as possible.
Receiving a scoliosis diagnosis means an unnatural sideways spinal curve, with rotation, has developed, with a minimum Cobb angle measurement of 10 degrees.
Once a diagnosis is reached, the most important decision is how to treat it, and here at the Center, patients benefit from a modern conservative chiropractic-centered treatment approach capable of impacting the condition on every level.