DETECTING AND DIAGNOSING SCOLIOSIS
Screenings and early warning signs can help detect scoliosis. A specialist will confirm the diagnosis with imaging.
DETECTING SCOLIOSIS
PHYSICAL SYMPTOMS
There are several different "warning signs" to look for to help determine if you or someone you love has scoliosis:
- Shoulders are different heights (one shoulder blade is more prominent than the other)
- Head is not centered above the pelvis
- Appearance of a raised, prominent hip
- Rib cages are at different heights
- Uneven waist
- Changes in look or texture of skin overlying the spine (dimples, hairy patches, color changes)
- Leaning of entire body to one side
Should you notice any one or more of these signs, you should schedule an exam with a doctor.
SCOLIOSIS SCREENING EXAM
The standard screening exam is the Adam’s Forward Bend Test. In this test, the patient leans forward at the waist 90 degrees with his or her feet together. From this angle, the examiner can easily identify any asymmetry of the back or any abnormal spinal curvatures.
The Adam’s Forward Bend test is popular because it can be administered at school by nurses or parent volunteers. Most schools test children for scoliosis in fifth or sixth grade. It should be noted, however, that this screening test can detect potential curves but cannot determine the precise degree of the curve or severity of the scoliosis.
CONFIRMING A SCOLIOSIS DIAGNOSIS
If the screening exam detects a possible spinal curvature, a clinician will confirm a scoliosis diagnosis with an x-ray, CT scan, MRI, or bone scan. Scoliosis curves are measured in degrees:
- Minor scoliosis: curve less than 25 degrees, treated through observation
- Moderate scoliosis: curve between 25 and 40 degrees, often treated with bracing
- Severe scoliosis: curve greater than 40 degrees, often requires surgical correction
DOES SCOLIOSIS CAUSE BACK PAIN?
The answer to this question is complicated, because it depends upon the amount of curvature of the spine and the amount of other degenerative changes, like arthritis, in certain parts of the spine. In general, most forms of scoliosis are not specifically painful.
Doctors believe that patients who have curves that are less than 30 degrees do not have any more back pain during their lifetime than someone who has a "normal" straight spine. However, very large curves can cause significant changes in posture that make it difficult to sit, stand, or walk for long periods of time. This condition is often called spinal fatigue pain and it is caused by the fact that the spine is not aligned correctly and the muscles that support the back are constantly straining to keep the person upright. The pain is usually dull and achy in nature, relieved by rest, and located in the muscles of the back.
Patients who have scoliosis can also suffer from the same back problems as everyone else. These problems include degenerative arthritis of the back, herniated discs, and spinal stenosis.