By Richard Geshel, D.O.

Many of us take symmetric body movement for granted as we go about our everyday tasks, especially during strenuous physical activities. For some, such motion may be a problem undetectable to the naked eye, or become so pronounced that it becomes the object of scrutiny. Scoliosis is just such a condition.

What is scoliosis and how is it identified?

Scoliosis is defined as an abnormal curvature of the spine and is believed to occur in approximately three to four percent of the adolescent population. Girls tend to experience a tenfold increase in curvature progression, according to the American Family Physician. The reason for scoliosis in more than 80% of the cases isn’t really known, which is commonly referred to as idiopathic.

Often, scoliosis is identified as a curvature of the spine in a sideways direction, and is easily seen when a child bends forward, creating a ‘hump’ in the back. This is the means by which it is initially screened, and if necessary, followed by obtaining spinal X-rays in order to determine the angle of the curve.

In addition, a thorough evaluation of the individual vertebral segments is performed to ensure optimal motion of the vertebrae. An evaluation of the pelvis and lower extremities is equally important. Pelvic obliquity, short leg syndrome, knock-knees, ankle instability, and flat feet can all contribute to and accentuate a spinal curvature.

Why are periodic examinations necessary?

Adolescents with scoliosis need periodic re-evaluations at six-month intervals, as teens undergo torso growth. Spinal X-rays can help to determine if the curve has stabilized or progressed. During a physical examination, physicians can evaluate the thoracic and lumbar spine for muscle tightness, in particular along the inner curvature of the spine.

How is scoliosis treated?

Treatment usually includes a multi-disciplinary approach. First, physical therapy can provide specific exercises to strengthen the paravertebral musculature. Second, bracing, an external device worn to assist with spinal stabilization, can stop the curve from worsening. Third, and in cases of advanced scoliosis or scoliosis that is rapidly progressing, surgery with rod placement helps to straighten the spine. However, surgery is a most often treatment of last resort.

Osteopathic Manipulative Medicine (OMM) can offer another effective treatment. OMM utilizes gentle to more aggressive techniques to treat a body region or an individual vertebrae. OMM purposefully focuses on not just correcting the physical appearance of a scoliotic curve; more importantly, it treats the underlying neuromuscular and vascular physiology. This is performed by releasing fascial, tendonous, ligamentous, and muscular restrictions that inhibit normal, inherent physiologic processes. OMM physicians attempt to balance muscular control on either side of the curvature, something that becomes inherently unbalanced in anyone with scoliosis.

The information contained in this article is not intended to be a substitute for professional medical advice, diagnosis, care, or treatment. Always consult your physician or other qualified healthcare provider with any questions regarding any possible medical condition.

Richard Geshel, D.O., specializes in neuromusculoskeletal medicine (NMM), with an interest in adolescent scoliosis and pediatric autoimmune disorder, as well as sports and outpatient orthopedic medicine. He practices osteopathic manipulative medicine at the Midwestern University Multispecialty Clinic. Dr. Geshel completed his NMM Residency at Michigan State University and graduated from the Midwestern University Arizona College of Osteopathic Medicine.



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