It is generally agreed that scoliosis is diagnosed when a curve of 10 degrees Cobb angle or greater is identified. Curves under 20 – 25 degrees are considered chaotic – that is – whether or not the curve will progress cannot be accurately determined. Once a curve reaches 25 degrees Cobb angle, it is likely to progress – this is considered a linear curve.
There are different options regarding when to begin treatment. Age is a significant factor. Curvatures progress most rapidly during growth spurts. A younger child with a bigger curve is at a greater risk than an adolescent near the end of their growth period with a small, stable curve. Yet another factor is the onset of puberty. For girls there is a critical time of vulnerability just before the onset of menstruation and for approximately the 18 months following , as hormonal changes have a tremendous impact on their developing bodies. Boys are also vulnerable to curve progression during the hormonal changes of adolescence. It is our opinion that early detection and treatment of Adolescent Onset Scoliosis (AIS) is the wisest course of management for an optimal conservative treatment outcome. The intervention required can be much less intensive & very effective.
Scoliosis specific exercises which help a child become more aware of their alignment and breathing can be of benefit for the rest of their lives. I offer an example through the following brief case review:
M. Was 8 years old when her dance teacher noticed she was unable to achieve certain dance positions. An X-ray by her pediatrician identified a 13 degree Cobb angle of her lower spine. The pediatrician recommended to wait and observe. One year later, X-ray revealed the curve had progressed to 27 degrees. Not wanting to wait any longer, the mother of M. brought her to PT. The curve was not yet structural, but was certainly progressing. At 27 degrees, it was likely to progress further, and M. was only 9 years old. In 5 sessions over a 3 month period, M. learned to stand on both legs more equally, to control movement in her spine, and to breathe more normally for her age. Her mother helped her practice her home exercises. The next X-ray revealed no curvature. M. continued PT at about 3 month intervals to monitor her spine, to maintain her gains and to strengthen further. She continued to dance and showed no signs of a recurrence of curvature.
This wonderful success story has made us firm believers in early detection and early intervention. If you would like more information on how we might work with you or a loved one with curvature of the spine, please give us a call. We will be happy to talk with you about your situation.
