June 2, 2021

Scoliosis- it all starts with a screen

"My daughter came home from school with a note that said she had a positive scoliosis screen. What exactly is Scoliosis and what do I now? According to Scottish Rite for Children "Scoliosis is not a disease. It is an abnormal curvature of the spine. In addition to the spine curving sideways, it also twists, making the ribs (which are attached to the spine) look uneven. This may cause a prominence or a “bump” on the back. Other signs include a shoulder or hip that looks higher than the other or the chest may appear uneven. Scoliosis is usually a painless condition. The diagnosis of scoliosis is confirmed by taking an X‐ray of the spine. If a curve measures more than 10 degrees, it is called scoliosis."

School screenings are the most common way to identify asymmetry that may need further screening. When in forward bend (Adam's test), a tool called a scoliometer can be used to detect a rotation. If greater than 5 degrees, you may have a positive screening. Other things you may notice is one shoulder consistently higher than another or a more prominent ribcage on one side of the spine.

This is not a diagnosis at this point. It flags the need for further testing. True diagnosis is based on an x-ray. If you have a positive screen, but no spinal rotation or lateral deviation on X-ray, there may be muscle asymmetry (imbalance)or joint restriction that is contributing to the functional scoliosis. Typically 10 degrees lateral deviation on x-ray (cobb angle) is what defines scoliosis as a diagnosis.

This is where a mild curve is often left to wait to see if it becomes more severe....THAT IS A PROBLEM! This is the time to intervene with scoliosis specific PT! This is the ideal time to learn positioning that will reduce risk of progression.

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