Hannah is a fourteen-year-old girl who is more active in sports than most girls her age. She takes part in a variety of sports, but her favorite sport is lacrosse. The combination of multiple sports, like football, ice hockey, and basketball is what drew Hannah to it. But, what she appreciates most are the friends she plays with. Running, jumping, skipping, and passing are just a handful of adjectives that describe lacrosse.

In the early spring, just before coronacation, Hannah had experienced mild back pain, with which her mother treated with Motrin. However, the pain did not go away and made it hard for Hannah to fall asleep, especially when trying to get into a good sleeping position. Her mother explained to her the next day that she might be up for a visit from Aunt Flow. 

After a few days of nothing helping, Hannah was scheduled to visit her family pediatrician. Hannah’s doctor took a good look at her back and tried pinpointing the specific spot of pain. As he was doing that, the doctor noticed that she had a slight abnormal sideways curve, just at the center of the spine. Hannah’s pediatrician explained that she had a quite common condition referred to as scoliosis of the spine. After a lengthy discussion about how to help her manage the pain coming from scoliosis, the appointment was finished. As they left the exam room, the doctor requested for her to be seen in six months to see if the scoliosis got better or worse. 

During the car ride back to her home in Passaic, NJ, Hannah’s mother told her about how scoliosis was in fact quite common in the family. Though her mom did not have it, two out of four aunts did, along with her maternal grandmother. When Hannah heard that she was not suffering alone, it helped her cope emotionally with the news of the most recent diagnosis. What she was most concerned with was how she would perform in her very first lacrosse game after coronacation. Would her scoliosis flare up and cause her to have to sit out something which was so dear to her?

As Hannah would develop, her scoliosis would become more pronounced. Worst of all, was the fact that her tops had begun to fit differently. It was not due to an increase in body weight, but  because of the increase in the degree of the curvature of the spine that made her shoulders uneven. After a few teleconference calls with the doctor, she was recommended to go to a local scoliosis specialist where she was suited with a WCR brace. Hannah is currently being monitored by a scoliosis specialist and receives schroth therapy at least once a week. The doctors are confident that these therapies will stop the progression and improve her spinal curvature.

What should a parent do when they hear that their child has scoliosis?

The first thing parents want to do is find a doctor who specializes in scoliosis fast. When you are dealing with idiopathic scoliosis, progression can already have happened, and you want to begin treating it as soon as possible. As in Hannah’s story, you might hear from the pediatrician to come back in six months. The problem with that is that progression of the curvature of the spine might have already occurred or is in the process of just starting to happen. Waiting six months will only make things worse. As a parent, all you need to do is get a referral from your primary physician and schedule an appointment at a local scoliosis specialist. There, they may suggest therapy or some scoliosis exercises. At this point, you are on top of the scoliosis and you are under proper guidance and care. You may be surprised to hear that your child’s scoliosis is rather mild and it should not interfere with their daily life. But the best thing of all is that you got it checked out by a specialist and you are on top of the situation. The last thing you would want is for precious time to go by when you could be fixing the problem.

Mild Cases can be taken care of with a non-invasive approach

Ever since the first scoliosis surgery was presented at a meeting in June 1960, at Hot Springs, Virginia, not much has really changed when treating scoliosis invasively. Today, with the advancement in medicine over the past ten years, doctors have developed non-invasive therapies that not only stop the progression of scoliosis but can correct the spinal curvature as well. The key is to treat mild cases of scoliosis with brace therapy that can fix the problem daily until the patient has finished growing. Many patients have avoided scoliosis surgery through early intervention therapies. 

Can scoliosis be cured? No, it cannot

Many have asked “Can scoliosis be cured?”. The answer is flat out “No”. Scoliosis is a chronic condition which a child is born with or develops as they get older. The objective of a parent is to prevent the progression and correct the curvature of the spine before the child fully develops. Once the bone makeup is complete, the window of correction closes, and surgery begins to come into consideration. Even with the most advanced scoliosis therapies, no one is saying that the scoliosis will go away. What scoliosis therapists look to accomplish is that one can live a normal life with no pain, no back deformity, and still have scoliosis. In fact, three million scoliosis cases are diagnosed each year, and many will go about their daily lives with no treatment at all. Any type of therapies, both invasive and noninvasive will help individuals better manage their scoliosis.

The brutal misconception of scoliosis surgery and it is cost

In severe cases such as congenital scoliosis and neuromuscular scoliosis, very often doctors have no choice other than surgery. This is the correct procedure, to help the child’s bones and organs develop properly. However, in a case of mild idiopathic scoliosis, when surgery is elected, it is often done as a quick fix. Western medicine has made great strides in cultivating the most sophisticated medical treatments, but often they are more inclined to operate if it can help the patient. Take an eighteen-year-old college freshman who had a flareup due to scoliosis and they wish to get back to their sports program as soon as possible. Chances are that they will elect scoliosis surgery over therapy. In most cases scoliosis surgery will fix only the lateral curve not the rotational curve.

A 2019 case study,in The American Academy of Orthopedic Surgeons states that physiotherapy scoliosis-specific exercises (PSSE’s) are just as effective as surgery. The challenge is to educate our “quick fix” mentality about a non-invasive approach to treating scoliosis. More often than not, one scoliosis surgery can lead to the next and does not always correct the problem depending on its severity. According to the ISASS, from 2006 through 2009, the average cost of a scoliosis surgery was $140,286. Ten years later, with the cost of healthcare on the rise, one can only speculate how much is the cost of a scoliosis surgery.

Emotional aspects of adolescents managing scoliosis

Besides for the complexity of having a child diagnosed with scoliosis, there is an emotional aspect as well. There are emotional issues of girls and boys who deal with scoliosis on a daily basis, like when going to a pool party, as they will be reluctant to take off their tee shirt to avoid the embarrassment of their peers seeing a shoulder deformity. It is important for parents and teachers to be sensitive to the emotional needs of a child as they go through this period of their life. Even with the Rigo-Cheneau brace, there is always a concern as to what their friends may think, when they find out that they are wearing a brace. If your teenager is having some difficulty or even getting upset with having to wear a brace for 23 hours a day, sit them down and explain the long-term benefits. Hear them out and listen to their concerns and fears. You will be surprised by what just plain-old listening can accomplish.

Final Words

Having a child diagnosed with scoliosis can be quite challenging. Should you treat or should you not? These are all great questions. But it would be in you and your child’s best interest if you are under the guidance of a scoliosis specialist. All it takes is an appointment. No ones telling you to treat, but it is recommended to be seen. The objective is to catch the scoliosis before the child fully develops. Once we are at the point of no return, the treatment options become less. What you want is clarity and the best for your child in managing their scoliosis. No, it won’t go away, but they will be able to go on with their life without anyone knowing that they have scoliosis, and this is really important to a teenage girl and boy.

Are you taking your child or teen for physical therapy for their idiopathic scoliosis, or is your child or teen going through brace therapy and along with these methods, he or she is experiencing back pain? Are there any effective pain management treatments out there to help your child or teen get through their therapies more easily and pleasantly?

Children with moderate idiopathic scoliosis (curves between 25 to 45 degrees) are generally treated with typical brace therapy. As the child grows, the brace will keep the spine in a straight position. Sometimes along with this therapy, the child or teen will experience pain which is sometimes due to the tenseness to the back muscles caused by wearing the brace.

Sometimes the curvature of the spine can stretch or squish the nerves causing irritation. Joints can become strained, causing them to become inflamed and worn. Muscles become tired and there is a lack of brain to body communication. The brain does not realize that the body’s posture is not aligned properly. The child’s brain fails to instruct the muscles to repair the curve causing crooked back growth and pain.

Medication for Scoliosis

The most common pain relievers are called NSAIDS, which are non-steroidal anti-inflammatory medications. These are used only for pain relief and not to cure the curvature of the spine.

They must be used in conjunction with other therapies such as bracing and/ or physical therapy. There is an enzyme that is produced by the body that causes inflammation but is helping the body heal from the therapy. At the same time there can be a lot of pain that goes with it. NSAID drugs block the enzymes and reduce the chemical, prostaglandin, throughout the body.

Some examples of these drugs are, Aspirin, Motrin, and Advil, which can be purchased over the counter. Then, there is a class of prescription drugs such as but not limited to Celebrex, Zorvolex, Indocin, Naproxen, Oxaprozin and Piroxicam. These can only be taken for a limited amount of time since there are side effects. The disadvantage of using these types of drugs is that they reduce prostaglandin, which protects the stomach from the damaging effects of acid and can cause stomach ulcers.

Another group of drugs are called tricyclicantidepressants. These have a direct impact on both pain and mood. Some examples of this group are, Diazepam and Amitriptyline. These drugs can be addictive long term, so they are not prescribed in most pain management clinics.

Scoliosis Massage

Patterns of body compensation in scoliosis therapy can cause muscle spasms which can be helped by massage therapy. A report published by the Journal of Bodywork and Movement Therapies, concurred on the positive effects of a massage twice a week for eight weeks. Both sleeping and general mobility of the scoliosis patient improved over the course of this treatment regimen. There are several recommended types of massage techniques that can be helpful for scoliosis patients.

1) Cranial Sacral Therapy – decreases stress and releases the tension in joints and muscles which improves elasticity and decreases stiffness.

2) Swedish Massage – is a light-handed type of relaxing massage which strengthens the immune system.

3) Deep Tissue Massage – intense pressure to loosen tight muscles and bolster blood circulation.

Yoga for Scoliosis

Elise Browning Miller is a well-known yoga teacher who works with scoliosis patients specifically. Elise herself had a severe Cobb curve of forty-nine degrees which is often treated with surgery. She reduced her curve to thirty-two degrees through her yoga practice. Yoga could be quite helpful in children and teens if they would have the patience for it. Yoga is a slow-moving vehicle for exercise and although adults find it relaxing and comforting, it may be too slow paced for the child and teen age groups.

Spinal Injections for Scoliosis

There are two types of injections to alleviate the pain of scoliosis in the nerves and joints.

1) Steroids are injected to serve as short term relief for acute pain. (Steroids include drugs used to relieve swelling and inflammation, such as prednisone and cortisone). These injections do seem to be helpful for patients, however, for people with scoliosis, which is a long-term condition, the relief eventually will wear off. When a person has a repeat of injections, the positive effect seems to lessen over time. Injections are used moderately by medical practitioners, since nerve damage, although infrequent, can be a possible side effect.

2) Spinal Cord Stimulation is the treatment where electrical wires are placed along the back. A small stimulator box is attached to the wires which are buried beneath the skin and are stimulated by remote control.

Acupressure and Acupuncture for Scoliosis

Acupressure and acupuncture are similar in the meaning and practical relief that they both give. The way the pressure points are assessed and selected are identical, only the tools that are used are different. An acupressurist uses her fingertips and hands and the acupuncturist uses special extremely thin needles for her craft.

Acupressure – The term pressure is deluding since this treatment mostly uses an exceptionally light touch. The correct location of the pressure point is more important than the amount of pressure. An acupressure practitioner will adjust the level of pressure depending on the person’s needs and preferences. For example, some people with tight muscles want strong pressure and others prefer light pressure. The benefits of this treatment have nothing to do with the amount of pressure, but with the accuracy of the practitioner’s finding the correct points.

Acupressure tries to balance the body’s energy. The body’s internal organs are connected to the external organs (muscles, flesh, and bones). Electric point finders can accurately locate the right pressure points. Energy and blood are closely related in Chinese medicine. When the practitioner feels a pulse under her finger, she will release the pressure. Increased blood flow to the surface causes the location to pulse. The indicator of effectiveness is the increase in the pulse which confirms that positive energy is now flowing.

There are different ways for the acupressurist to find twelve major energy channels. She can use mental indicators called tools to determine where to press. Some of these tools are, looking at the patient, checking his or her pulse, inspecting the tongue and questioning the patient. One of the responses that the practitioner is looking for is relaxation, so she will often start by using her hands with a massage called, Tui Na. This massage at the start of treatment prepares the body and increases the effectiveness of the accupressure.

Acupuncture – Dr. Teresa Shen is an acupuncturist in California, who specializes in relieving scoliosis related pain. She explains that a person gets used to putting up with so much pain that the relief they feel is so enormous both, physically and emotionally, when that pain is abated.

While undergoing Dr. Shen’s acupuncture treatment, her patients become so relaxed that they sometimes fall asleep during their treatment. This is far cry from what one would think would be the result of being poked with needles! As with acupressure, acupuncture opens the blocks all along the patient’s spine which increases the blood flow throughout the body. With the body’s metabolism regulated, the body finally can heal properly.

For thousands of years, thin, solid, metallic acupuncture needles were used penetrate the skin of the pain management patient. Pain management of idiopathic scoliosis using acupuncture is successful, however, from research studies it does not seem to necessarily help cure the curve itself.

Conclusion

Children and teens who experience pain with scoliosis have a two-pronged problem. Could it be the tension of the brace wearing or going through vigorous physical therapy sessions that is causing the pain? Holding muscle tension requires energy. Holding the back stiff during therapy or brace wearing could be the cause of acute back pain.

Often people will complain about chronic back pain and when checked by the doctor (including an MRI), there is no physical cause found. These people, when participating in relaxation techniques often have a decrease in their pain. Check if your child or teen is unhappy with their brace or therapy. According to Marion Rosen, there is a relationship between bodily tension and how we view ourselves psychologically. Chronic muscle tension is the body’s language to express feelings that are not necessarily conscious. The liberating of body tension leads to self-acceptance. By your child or teen verbalizing and accepting their brace or therapy, their back pain may eventually abate.

If not, make sure to check with your scoliosis therapy center to see if adjustments need to be made to the brace or to the physical therapy. Always trust your child that the pain is real. Never tell them that it is all in the head. That is for the consultant that you choose to evaluate, be it a yoga instructor, an acupressurist or another specialist who will help your child. The parent’s job is always to support and encourage their child at all costs. This will ensure a self-confident and happy child even with their temporary burden of scoliosis.