Baby boomers may recall the days of being screened for scoliosis in elementary or middle school. While this practice was common in states across the US for a number of years, it has stopped in many communities.
Some may also remember when kids diagnosed with scoliosis wore heavy-looking metal braces. This full-torso brace extended from the pelvis to the base of the skull. Designed by Milwaukee-area physicians and commonly referred to as “The Milwaukee Brace,” it was the most popular bracing approach in past decades.
Today, screenings and treatment approaches are varied.
Screen early, screen often
Wisconsin is one of more than 25 states where school screenings are not currently mandated. Yet many organizations recognize the benefits of screening programs including the American Academy of Orthopedic Surgeons (AAOS), Scoliosis Research Society, and American Academy of Pediatrics.
Most physicians perform screenings during annual check-ups. Yet, a challenge exists because many adolescents do not have routine wellness doctor visits.
Screenings take as little as 30 seconds and are commonly performed on children between 10 and 15. A trained health care professional views the spine in both standing and bending positions. Children with suspicious findings should see a physician who often orders an x-ray. Parents may also want to have a child examined by a physical therapist (PT) to discuss exercise-based approaches to treatment.
Most children with scoliosis have mild curves and won’t need aggressive treatment. When a curve is suspected or confirmed, routine screenings are critically important. Some parents opt for screenings every three months rather than semi-annually or yearly, especially during times of rapid adolescent growth. Information about a curve’s progression is important in determining the best treatment approach.
Treatment options: Physical therapy can play an important role
Medical organizations publish treatment guidelines. The decision to treat scoliosis is based on many factors, including age, maturity, sex, family history, curve size and how much the child is likely to grow.
Traditionally in the US, treatment involved a “wait and see” approach. Physicians have most commonly monitored curve progression and initiated treatment if the curve passed a certain threshold. Typically, physicians recommend bracing or surgery, or both. Scoliosis surgery involves techniques to fuse or join the vertebrae along the curve
Bracing options have expanded. The most commonly used brace is a thoraco-lumbo-sacral orthosis (TLSO), or underarm brace. It is more easily concealed under clothing than the Milwaukee Brace. Additional bracing approaches have emerged in recent years with some options including (insert list).
In the US, PT has also recently emerged as a valuable treatment. In past decades, while PT has played a minor role in scoliosis treatment in America, it is now becoming more popular among a growing number of patients.
One PT-based approach has seen increased popularity in the US within the past five years. The Schroth method is a conservative, non-surgical, exercise-based approach developed in Germany in the 1960s. In Europe, more than 3,000 patients are treated with Scroth annually. Today, fewer than 20 therapists in the US are Schroth-certified; three are on staff at our Milwaukee area clinic which draws patients from across the US.
Schroth involves an attempt to reduce curve progression and provides additional benefits such as improved breathing. Patients work intensively with a physical therapist, learning how to expertly perform exercises specific to their scoliosis curve pattern. In many patients, Schroth is combined with the Rigo-System Cheneau (RSC) brace. Until recently, this brace was available only in Europe. The US has fewer than 10 orthotists who are trained to fit RSC braces; one offers services at our Milwaukee-area clinic.
Many US physicians say research is inconclusive for bracing or physical therapy. With Schroth, most patients report a benefit of being empowered to take action in addressing scoliosis, and many report improved postural deformity. Physical therapists at Spinal Dynamics of Wisconsin have successfully prevented surgery for some patients who believed it was their only option, including those who travel to the clinic from out of state. In some patients, curve reduction has been achieved.
Decision about screening for and treating scoliosis are always individual choices of families. Parents and children should be aware of the importance of screening and explore various treatment options if scoliosis is diagnosed.
Cindy Marti is a physical therapist and president of Spinal Dynamics of Wisconsin. She has traveled to Europe to study the Schroth method, a non-surgical approach to scoliosis treatment used wiedly across Europe for decades. She and two of her clinic’s colleagues are among fewer than 20 US-based physical therapists now certified in Schroth.
Sidebar: What is Scoliosis?
Scoliosis is the medical term for an abnormal curvature of the spine. It occurs in approximately 2-3% of people in the US, most commonly children. Idiopathic scoliosis means that the spinal curve develops for unknown reasons. Scoliosis curves are at highest risk for worsening during adolescent growth spurts. At onset, scoliosis rarely involves pain; thus, it is often not diagnosed early. Once progressed, scoliosis can seriously impact a person’s quality of life. Early detection is important to ensure optimal management of scoliosis. For additional information, visit the National Scoliosis Foundation website at scoliosis.
Spinal Dynamics of Wisconsin believes early and frequent scoliosis screenings are important. We offer the following on the first Saturday of each month.
8:00 to 8:30 a.m.: free screenings for children ages 10-15; physician follow-up is recommended if a potential problem is identified
10:30 to noon: free lecture about scoliosis and the Schroth treatment, an exercise-based approach to treatment
Sessions are at 2300 N. Mayfair Rd, Suite 555, in the Mayfair Bank Tower. Registration is required. Visit www.sdwpt. We also encourage schools and community groups to contact us to discuss scoliosis screenings at their locations.
National Scoliosis Foundation