Teenagers & Scoliosis

Here's your game plan for peak performance and healthy spine development

As parents of active teenagers, you understand the importance of optimizing their health for peak performance. This goes beyond just physical fitness; it encompasses fostering a healthy brain-body connection for success in academics, sports, and overall well-being. One potential hurdle in this journey is scoliosis, a sideways curvature of the spine that can affect growing adolescents.

Understanding Scoliosis: A Curvature in the Spine

Scoliosis is a relatively common condition affecting 2-3% of adolescents. It presents as a sideways curvature of the spine, accompanied by rotation of the vertebrae. There are several types of scoliosis, but the most common in teenagers is idiopathic scoliosis, meaning the cause is unknown. Other types can be linked to congenital spinal malformations, neuromuscular disorders, or injuries.
While any teenager can develop scoliosis, there are some risk factors to be aware of. Family history is a significant factor, with children of parents with scoliosis having a higher chance of developing it.

Who Develops Scoliosis?

• More Common in Girls: Research consistently shows a higher prevalence of scoliosis in females. A 2023 study looking at data from more than 270,000 individuals showed females are affected at a rate of 1.45 times higher than males [7].
• Usually Presents Around Puberty: Scoliosis most commonly presents during the adolescent growth spurt, typically between 10-15 years old.

Some studies also showed potential connections between a retained Spinal Galant Reflex (one of our primitive reflexes) and the development of scoliosis. This connection is potentially linked to altered movement patterns and asymmetries through the spinal musculature due to the persisting immature reflexes [11,12].

Early Detection is Key
Scoliosis often progresses silently, with minimal initial symptoms. However, early detection is crucial for effective management. Here's what to watch for:

• Uneven shoulders or hips
• One shoulder blade appearing more prominent than the other
• A rib cage that appears higher on one side
• A noticeable lean to one side when standing

Regular checkups with your child's chiropractor or paediatrician and keeping a close eye on growth and development at home are vital for early detection.

When Does Presentation Matter?
The age of presentation can influence the severity of scoliosis. Here's why:

• Earlier presentation (before 10 years old): Early-onset scoliosis, though less common, can be more aggressive and require closer monitoring or intervention due to the longer growth period remaining.
• Presentation during peak growth spurt (between 10-15 years old): This is the most common time frame for scoliosis to appear. Early detection and management during this window are crucial to prevent significant curve progression.

Diagnosis

While the above signs are helpful in early detection of scoliosis, x-rays are crucial for having a definitive diagnosis. They provide a clear image of the spine and allow us to assess for any abnormal curvatures and measure their severity. Knowing where the curves are located and how severe they are allows your healthcare team to make the best plan for management options. X-rays can also be used to track the progression of scoliosis over time.
One of the newer methods of using x-rays to assess for scoliosis is called EOS imaging. This is a very low radiation form of x-ray that allows us to view the whole spine in a standing position. The much lower dose of radiation is especially beneficial when multiple x-rays are needed to track progression of abnormal curves.

Long-Term Effects
While mild scoliosis may not present immediate problems, unmanaged curves can have long-term consequences. This is especially true the more severe the scoliosis gets. These long-term effects may include:

• Chronic pain and discomfort
• Difficulty breathing due to restricted lung function (in more severe cases)
• Uneven posture and appearance
• Increased risk of degenerative changes in the spine [3]

The good news: with early intervention, the progression of scoliosis can be significantly reduced, if not halted altogether. 

The Power of Proactive Management
Fortunately, a multi-pronged approach can effectively manage scoliosis in teenagers. Here's how various healthcare professionals contribute:

• Chiropractic Care: Chiropractic care can be a valuable part of a comprehensive scoliosis management plan. As chiropractors, we focus on the neuromusculoskeletal system and can help improve posture, flexibility, and joint function through spinal adjustments and targeted exercises [4,5]. A 2018 study published in the Journal of Chiropractic & Manual Therapies found that chiropractic adjustments combined with exercise therapy may be more effective in managing adolescent idiopathic scoliosis than exercise therapy alone. A 2017 study suggests that chiropractic adjustments, alongside other therapies, may improve curve progression in individuals with scoliosis [8]. A 2016 study looking at young boys from 13-14 years old showed curve reduction with 8 weeks of chiropractic management [9]. Chiropractors can also play a role in identifying potential risk factors for scoliosis and recommending appropriate exercises. Although more research is needed, these studies provide a good basis for clinical decision-making and trial of care.
• Physiotherapy: Physiotherapists may design specific exercise programs to strengthen core muscles and improve posture, which may help prevent the progression of scoliosis. A literature review on scoliosis-specific exercises highlights the effectiveness of tailored physiotherapy exercises in managing adolescent idiopathic scoliosis [10].
• Exercise Physiology: Exercise physiologists can create personalized exercise routines that not only address scoliosis but also optimize overall fitness and performance for active teenagers. These routines may incorporate specific stretches, strengthening exercises, and activities like swimming, yoga, or Pilates, which promote core strength and flexibility.
• Scolicare: The team at Scolicare reviews your child’s x-ray images and can work with you to provide a management plan depending on the severity of the scoliosis present. Management recommendations may include bracing, rehabilitation exercises, or surgery with the aim of improving quality of life. [6]

Complementary Approaches

• Bracing: In some cases, doctors may recommend wearing a brace to prevent further curvature.
• Nutrition: Maintaining a healthy diet rich in calcium and vitamin D is essential for bone health and development, which can support spinal health. One 2022 study looked at the effects of giving melatonin, calcium, and vitamin D supplementation to children with scoliosis. They found that the children in the supplementation group had a reduction in their cobb angle (measurement determining the degree of scoliosis) at the 1 year follow-up, whereas the test group had showed roughly 5 degree increase in the cobb angle [13].

The Role of Parents: Support and Encouragement
As parents, you play a crucial role in supporting your teen's scoliosis management journey. Here are some ways you can help:

• Encourage regular checkups: Schedule regular appointments with your child's healthcare providers to monitor the curve and adjust treatment plans as needed.
• Promote healthy habits: Ensure your teen gets adequate sleep, eats a balanced diet, and maintains a healthy weight – all of which contribute to proper bone and muscle development.
• Offer emotional support: Scoliosis can be a source of anxiety for some teenagers. Be understanding, listen to their concerns, and offer emotional support throughout the treatment process.

The Power of Teamwork: A Collaborative Approach
The best approach to managing scoliosis in teenagers involves a collaborative team. Coordinating care with your child’s paediatrician, chiropractor, physiotherapist, and potentially an orthopedist if bracing or surgery is deemed necessary. Having a team approach ensures your teen receives the most comprehensive and effective treatment plan for their specific needs.

Focus on Brain and Body Connection
As you prioritize your teen's physical health, remember the powerful link between brain and body. Good posture can enhance focus and cognitive function. Chiropractic adjustments aimed at improving spinal function can uplift brain function through improved nervous system communication [2]. Regular exercise, a key component of scoliosis management, also promotes cognitive health by increasing blood flow to the brain and stimulating the production of neurotrophic factors that support brain cell growth.

Conclusion: A Collaborative Journey
Scoliosis in teenagers, while a concern, is effectively manageable with early detection and a proactive approach. By working collaboratively with a team of healthcare professionals, including chiropractors, physiotherapists, exercise physiologists, and your child's pediatrician, you can empower your teenager to optimize their brain-body connection, achieve peak performance, and navigate their growth journey with confidence. Remember, early intervention is key, so if you notice any signs of scoliosis in your teen, don't hesitate to seek professional advice.

Are You Concerned About Your Teen’s Spinal Development?
Here at ACCC, taking care of your kids is what we do best! Our chiropractors have a special focus on how to best support growing brains and bodies. We do thorough examinations that include postural assessment, joint and muscle function tests, neurological checkups, and making sure your child’s overall growth and development are optimal.

If scoliosis is a concern for you, please reach out and book a free call with one of our amazing chiropractors to chat about your child and how we can play a role in supporting optimum function and development!

References:

American Academy of Orthopaedic Surgeons (https://orthoinfo.aaos.org/en/diseases--conditions/introduction-to-scoliosis/) or the Scoliosis Research Society

2. CHANGES IN EFFECTIVE NEURAL CONNECTIVITY FOLLOWING A CHIROPRACTIC ADJUSTMENT https://getd.libs.uga.edu/pdfs/sullivan_stephanie_g_201808_phd.pdf

3. Facet joint degeneration in adolescent idiopathic scoliosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686828/#:~:text=Our%20underlying%20hypothesis%20is%20that,joints%2C%20as%20reported%20in%20osteoarthritis.

[4]Improvements in Mood, Posture and Balance in an Older Patient Receiving Chiropractic Care: A Case Study http://align2nourish.com/pdf/Improvements%20in%20Mood,%20Posture%20and%20Balance%202015-1348_mood_posture_balance.pdf

[5]Reflex control of the spine and posture: a review of the literature from a chiropractic perspective
https://link.springer.com/article/10.1186/1746-1340-13-16

[6] https://scolicare.com/sydney-south/?gclid=CjwKCAjw_LOwBhBFEiwAmSEQAXqmZHm6F7deGS-AJUeX8B8EsUJhj4gBSduiQmMWfPOvDC2XTbOVEhoCXAIQAvD_BwE

[7] https://pubmed.ncbi.nlm.nih.gov/37803157/

https://www.srs.org/Patients/Conditions/Scoliosis

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264549/

[9] https://www.researchgate.net/publication/301707809_The_effect_of_chiropractic_techniques_on_the_Cobb_angle_in_idiopathic_scoliosis_arising_in_adolescence

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9368145/

[11] Trunk rotation due to persistence of primitive reflexes in early school-age children https://pubmed.ncbi.nlm.nih.gov/29558021/

[12] PERSISTENCE OF PRIMITIVE REFLEXES AND ASSOCIATED PROBLEMS IN CHILDREN https://inpp.info/wp-content/uploads/2021/05/Persistenceofprimitivereflexesandassociatedproblemsinchildren.pdf

[13] Controlling the Progression of Curvature in Children and Adolescent Idiopathic Scoliosis Following the Administration of Melatonin, Calcium, and Vitamin D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140159/#:~:text=in%20Cobb%20angle.-,Patients%20with%20idiopathic%20scoliosis%20may%20benefit%20from%20a%20novel%20treatment,%2C%20calcium%2C%20and%20melatonin%20levels.