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While most people have heard of scoliosis and understand it as an
abnormally-curved spine, it’s far more common than many realize. In
the United States alone, scoliosis accounts for 20 percent of all spinal
deformities. The National Scoliosis Foundation puts current estimates at
close to seven million Americans living with the condition, and in school-
aged children, it’s the most common spinal deformity.
When you keep in mind that we’re just talking about the United States,
if we were to cast a wider net and include confirmed cases world-wide,
plus somehow determine the number of people living with the condition
unaware, those numbers would increase exponentially.
The take-away from these stats and estimates is that scoliosis is
a common condition that deserves some attention and thorough
understanding. If you or a loved one has recently received a scoliosis
diagnosis, there is a lot of information out there to wade through, not all
of it accurate and current.
Here at the Scoliosis Reduction Center, we’re up to date on the latest
research, screening procedures, effective medical equipment, and
advancements in treatment approaches.
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Receiving a Scoliosis Diagnosis
We’ve all heard it time and time again:
“You have little if you don’t have your
health.” Let’s think about that for a
second. If you’re facing a medical issue,
you’re still the same person, likely will still
have the same people in your life, and
the same passions and interests.
Where that adage rings true is in your ability to navigate enjoying those aspects of your life
while dealing with potential pain, discomfort, and complications related to the medical issue.
That’s one of the hardest things about receiving a scoliosis diagnosis; patients are naturally
concerned with how the condition will affect their life in its most important areas.
When it comes to family, relationships, hobbies, work and play, a person who’s recently
learned they have scoliosis, and their family, is often hit with a mental blizzard of concerns
and questions.
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Common Questions that Follow a Scoliosis Diagnosis
Some of the most common questions I’m asked after giving a scoliosis diagnosis are among
the hardest to answer. This is because, although the condition is quite common, we don’t
understand as much about it as we’d like.
While we understand the age groups most commonly affected and have isolated some
important triggers for the condition’s progression, in terms of why it initially develops
remains somewhat of a medical mystery.
In 20 percent of scoliosis cases, we can pinpoint the causes as neuromuscular, congenital,
traumatic, or degenerative, but the remaining 80 percent of cases are classed as ‘idiopathic’,
meaning their development can’t be attributed to a single cause.
It’s hard to explain, to the majority of my patients, that we don’t know why their condition
developed because the natural fear I’m met with is that we also don’t know how to
adequately treat it. To this, I respond by saying that knowing the cause, in most cases,
wouldn’t change the necessary treatment.
I understand how scary being diagnosed with a progressive condition can be, so I have all
the time in the world to answer each and every question a patient and their family might
have. Following are some of the most common questions I’m asked immediately following a
diagnosis and how I commonly respond.
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IS THERE A CURE FOR SCOLIOSIS?
“There is no cure for scoliosis, so I caution you
against any person, medical professional or
otherwise, that promises you one. Scoliosis
is progressive, meaning it’s in its very nature
to worsen over time. I realize how scary that
sounds, but you’re already at an advantage
because you’re here, you have your diagnosis,
and we can effectively treat it by managing
its progression to the point where minimal
aspects of your life are affected.”
At this point, I refer to some of my patients who’ve experienced successful treatment and
are out living their best lives. I remind patients that this initial period of diagnosis and
starting intensive treatment is often the hardest, but at some point, it will be as though
they’re looking back on this time through a rear-view mirror: seeing it get smaller and less
important as time goes by and they adjust to life with the condition.
Being diagnosed with a medical condition like scoliosis can initially seem all-consuming
and to be the most important aspect of your life, but it doesn’t have to be that way, and it
most certainly doesn’t have to define you; with some hard work, determination, and effective
treatment, you’d be surprised at how your condition can seem to fade into the background
of your life.
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HOW MUCH WORSE WILL MY SCOLIOSIS GET?
DOES THIS MEAN I’LL HAVE TO GIVE UP SPORTS?
“This is hard to answer because I can honestly say that in all my
years of treating patients with scoliosis, I’ve never used the same
treatment plan twice. Every case is different. Even cases that start
out with similar characteristics such as age, curvature size, and
location can differ widely in how they progress. Some patients
experience rapid progression, while others seem to progress at a
glacial pace.
Once we determine what your pattern of progression is through
careful monitoring, we can tailor our treatment plan to stay ahead of
the curve. I will say that, most likely, at some point, your condition will
progress. No abnormal spinal curvature will simply correct itself, but
that’s why we’re here: to make that happen.”
“Absolutely not. When it comes to scoliosis, often times, adolescents
don’t even know they have the condition because many cases don’t
produce any noticeable cosmetic or functional symptoms. Now,
depending on the sport you’re engaging in, things might have to
change or be adjusted, but it’s actually very beneficial for people
with scoliosis to remain as active and physically fit as possible.
The key is finding that perfect activity-level balance. There are
certain sports that involve overusing one side of the body, such as
golf, or high-impact sports like football, that are deemed harmful for
people with scoliosis.
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The key is finding that perfect activity-level balance. There are certain sports that involve
overusing one side of the body, such as golf, or high-impact sports like football, that are
deemed harmful for people with scoliosis.
Most often, with adequate guidance from us, we can help you find that ideal balance so
you can still enjoy the sports you love and continue experiencing all the benefits of staying
active and healthy.”
Understanding Your Condition
When you receive a scoliosis diagnosis, it might include some terms you aren’t familiar with.
In order to determine the best possible course of treatment, each condition is classified
based on important characteristics: age, location of the curvature, and Cobb angle.
If you’ve ever watched a medical drama, you’ve likely noticed interns presenting a case with,
“We have a 31-year-old male complaining of…” Age is commonly the first classification point
because it not only helps determine causation, but also the patient’s overall health, and
potential condition-related symptoms they’re likely to experience.
When it comes to scoliosis, age is particularly important because it can indicate the type of
scoliosis a patient has, its most likely rate of progression, and what symptoms the patient is
likely experiencing.
PATIENT’S AGE
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We also know that adults, because their spine is no longer lengthening through growth, are
likely to experience pain as their scoliosis compresses the spine and its surrounding tissues
and nerves. As adolescents are constantly growing, they have to be monitored closely, and
this growth pattern is why many experience their condition painlessly.
To sum it up, age tells us what type of progression rate we are likely looking at, and whether
or not pain is likely to be an issue.
Adults with scoliosis experience scoliosis-
related pain very differently than adolescents
with the condition. Growth is the main factor
that accounts for this difference. Adults
have reached skeletal maturity, meaning
unpredictable growth spurts aren’t a concern.
As growth is the number-one risk factor
for progression, we know that an adult with
scoliosis is going to have different monitoring/
treatment needs than an adolescent.
ADULTS VS. ADOLESCENTS
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The spine is made up of three main sections:
cervical, thoracic, and lumbar. Cervical refers to the
upper portion of the spine that includes the upper
back and neck; thoracic refers to the middle back
(the most common site for scoliosis to develop);
lumbar includes the lower back and the tailbone.
Where along the spine a patient’s scoliosis
develops is an important classification point
because it not only determines where the work
has to be done, but also different symptoms that
are connected to the different locations along the
spine.
With your diagnosis, you’re likely to hear one of the
three sections mentioned, and this can help you
understand the nature of your condition better.
LOCATION OF THE CURVATURE
COBB ANGLE
‘Cobb angle’ has been coined the “gold standard” for assessing and diagnosing a patient’s
scoliosis. The Cobb angle is a measurement of the abnormal spinal curvature, and this is the
single most important classification point as it tells us the majority of what we need to know
about a patient’s condition.
The Cobb angle measurement is taken from reading a patient’s X-ray and measuring the
most tilted vertebrae at the apex of the curve. From this, the condition is further classified
as mild, moderate, or severe.
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MILD SCOLIOSIS:
MODERATE SCOLIOSIS:
SEVERE SCOLIOSIS:
Cobb angle measurement of 25 degrees or less
Cobb angle measurement between 25 and 40 degrees
Cobb angle measurement of 40+ degrees for adolescents and
50+ degrees for adults
The designation of mild, moderate, or severe helps determine the best treatment approach
moving forward, as well as the needs of the patient and the types of symptoms and
progression they are most likely to experience.
The classification points of age, location, and
Cobb angle tell me everything I need to know
about a patient’s condition and how to best
move forward after that initial diagnosis. Once
a patient’s condition is fully classified, we can
start customizing their treatment plan. The
sooner treatment is initiated, the better the
chances of achieving a curvature reduction
are.
HOW CLASSIFICATION HELPS DETERMINE THE BEST TREATMENT APPROACH
As mentioned earlier, scoliosis develops across a wide spectrum, with each case differing
from the next. A scoliosis X-ray, when read comprehensively and as a 3-D condition,
becomes the roadmap for treatment.
The patient’s age helps us determine their overall health and ability to handle the rigors of
scoliosis-specific chiropractic treatment, exercise, and therapy, as well as if pain is likely to
be an issue. It also helps determine likely rates of progression and how closely the patient
needs to be monitored.
The location of the curvature tells us where along the spine our efforts need to be focused
and in what direction we want the spine to move, as well as potential symptoms or mobility
issues connected with different sections of the spine.
The Cobb angle places the patient’s condition on the severity scale. This tells us how
much work needs to be done, just how intense that work will need to be, likely patterns of
progression, and potential symptoms and complications.
As scoliosis is already such a mysterious and complex condition, not knowing these
classification points, or not comprehensively reading the scoliosis X-ray, means not fully
understanding the treatment needs of the patient.
Another common question I get after giving a scoliosis diagnosis is, “What do we do next?”
To this, I strongly recommend starting treatment as soon as possible, and this is where
treatment-approach options fork in two different directions: traditional vs. alternative. To
me, this can be further broken down as observation vs. action.
I recognize the challenge that people and their families are faced with when determining
which treatment path to follow. There is a lot of information about scoliosis, treatment, and
surgery floating around, but not all of this information is 100-percent current and accurate,
which is what inspired me to open the Scoliosis Reduction Center.
CHOOSING THE BEST TREATMENT APPROACH
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For years, the traditional treatment approach
was the dominant choice because it was the
only choice. The traditional approach most
often involves a recommendation to watch and
wait. What this means, in terms of receiving
a diagnosis, is that when a condition is in its
earlier stages, the patient and their family are
often told that as it’s mild, they should simply
observe to see if the condition progresses.
For an adolescent patient facing puberty and unpredictable growth spurts, they’re already
at a high risk for rapid progression as growth is its number-one trigger. If a patient’s told,
“Your Cobb angle is only 15 degrees, so come back in three-to-six months for another X-ray
to see if the curvature has increased,” what could happen during that waiting period? That
patient could have a growth spurt and progress rapidly in between X-rays.
As mentioned earlier, with progressive conditions, it’s especially important to initiate
treatment as close to the time of diagnosis as possible. While it’s never too late to start
treatment, a curvature that’s caught early on is far easier to treat than one that’s been left
to progress unimpeded.
THE TRADITIONAL TREATMENT APPROACH AND OBSERVATION
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Invasive Surgery
My biggest concern with the traditional approach is how it funnels patients towards spinal-
fusion surgery. As passive observation is such a large part of the approach, when a patient’s
condition has been left to progress and progresses to a certain severity-level, they’re then
told invasive and expensive surgery is the best option. What I would like to point out is if
a proactive approach was taken from the onset, that severity level might not have been
reached, making surgery unnecessary.
Spinal-fusion surgery involves permanently fusing vertebrae together and eliminating
movement between them. Hardware such as rods, screws and wires are used to hold the
spine in alignment while the vertebrae heal as a solid unit.
In terms of making a crooked spine straight, spinal fusion can be seen as a success, but in
terms of long-term results and functionality, I see a lot of unnecessary complications and
potential side effects:
There’s no guarantee the curvature won’t continue progressing post-surgery
Hardware could weaken or break
The spine loses a lot of its flexibility and mobility
Patients have to live with their mobility limitations and deal with fear of their spine
snapping or hardware failing
Hardware failing could lead to subsequent surgeries
Patients also have to live with certain activity restrictions
Post-surgery recovery time is lengthy
The cost of spinal-fusion surgery can run anywhere between $100,000 to $200,000+
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This is another reason I established the Scoliosis Reduction Center: to give patients and
their families a more functional, safe, less expensive, and less invasive means of treating
their scoliosis.
As we’ve learned more about the condition over the years, a more dynamic and modern
alternative approach has garnered a lot of respect, along with impressive results: the
alternative treatment path.
We recognize variability as a central quality of the condition, which is why we also recognize
the need for patients to have access to multiple forms of treatment. Here at the center,
we have a team of scoliosis specialists certified in multiple modalities all under one roof.
Instead of seeking out the benefits of one form of treatment here, and another there,
our patients and their families can access a unique combination of scoliosis-specific
chiropractic care, therapy, exercise, and custom 3-D bracing in one convenient location.
Here at the Scoliosis Reduction Center, being
proactive is the keystone of our approach.
While monitoring a patient’s condition and
progression is a hugely important aspect of
treatment, passively observing is not.
THE ALTERNATIVE TREATMENT PATH AND ACTION
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With these multiple facets of treatment at our disposal, we can fully customize a patient’s
treatment plan to best address any and all aspects of their scoliosis. First, we address the
structural issue of the curvature through chiropractic adjustments.
Manipulating the Spine
When the spine loses its healthy curves, the body
responds by adding bad curves, and our goal is to
manipulate the spine to move in the direction we
want it to. By doing this in a natural way, we aren’t
just ‘holding’ the spine in a corrective position, as is
the case with spinal-fusion surgery, we are actually
‘correcting’ the curvature in a functional way.
By using this functional approach, the patient doesn’t
lose flexibility or mobility as the underlying issue
of the curvature is being addressed structurally, as
opposed to just treating the curvature as a symptom.
As the structural issue is being addressed, we augment those results with exercises and
stretches that the patient can do from home. Once a sustainable exercise regime is
established, we continue to monitor the patient’s scoliosis, and if my adolescent patients
experience so much as an inch of growth, I’m ordering an X-ray to see if that growth has
caused the curve to progress. If it has, we adjust the treatment plan accordingly; if it hasn’t,
we continue on the path we know is working.
I feel the greatest thing about this proactive scoliosis-specific chiropractic approach is
what it can offer our patients: the chance to see their condition as if looking at it through
that rear-view mirror.
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Our patients can move on with their lives in a healthy and positive way that designates
their condition as just one aspect of life, rather than their whole life. With a spine that’s
being actively and functionally corrected, there isn’t a loss of flexibility or mobility, and this
removes that fear and uncertainty that I hear so many patients speak of post-surgery.
If you or a loved one is facing a scoliosis diagnosis, please reach out to us here at the
Scoliosis Reduction Center. Together, we can face the condition head on and get you started
on that path to positive acceptance and functional recovery.
[email protected] www.scoliosisreductioncenter.com
Additional Resources:
Drtonynalda.com - Scoliosis Hope
Scoliosisreductioncenter.com - Results
Ncbi.nlm.nih.gov - Radiographic Disk Height
Increase After a Trial of Multimodal Spine
Rehabilitation and Vibration Traction
Clearinstitute.org - Cobb Angle
Scoliosis.org - National Scoliosis Foundation
