This is a picture of my daughter Natalie, now 15 years old, before she had surgery over a year ago. I wrote this post as the first in a series of posts all about treating scoliosis, including treatment options and our journey and struggles. The vast amount of research on bone health is largely what inspired my latest ebook, The Gelatin Secret. So let’s dive in to the details…
What is scoliosis
Most of us who went to public school remember the once-yearly trips to the nurse’s office where they’d make us lift up our shirts to expose our backs and bend over. This is how they checked us for scoliosis, a condition in which the spine curves from side to side, like the shape of a letter “S”. Now, keep in mind that the spine is flexible, so it is completely normal for it to curve during movement. The spine also has a bit of a natural front-to-back curve which is what gives our torsos and backs their distinct shape (like the dip in our back). In the case of scoliosis, the curvature cannot be straightened by simply improving posture. Some people with scoliosis have such a severe curvature that it puts their shoulders and hips out of alignment, making their bodies appear twisted and causing mild to severe pain and discomfort.
Conditions Similar to Scoliosis
Scoliosis isn’t the only condition in which the spine curves abnormally. These two common conditions involve curvature to the spine. But bear in mind that they are exaggerations/worsening of normal curvature whereas scoliosis is way abnormal.
- Lordosis: Lordosis is actually the term used for the normal inward curve of the spine which gives us a dip in the back. However, many often use the term lordosis to refer to the medical condition hyperlordosis in which the spine curves too far inwards. This condition is also called swayback or saddleback.
- Kyphosis: In this condition, the upper part of the spine curves too far outwards, creating a slight, moderate or severe hunchback.
Keep in mind that spinal deformities usually don’t occur just in one direction, so it is common for scoliosis to be accompanied by lordosis and/or kyphosis. When scoliosis and kyphosis occur together, it is called kyphoscoliosis. When scoliosis and lordosis occur together, it is called lordoscoliosis. (source)
How Is Scoliosis Diagnosed?
Those examinations that they gave in schools? It might sound antiquated but believe it or not they are still the best way to screen for scoliosis and what your doctor will likely do at your first visit.
Since scoliosis is so common in kids, all 50 states in the US have some sort of scoliosis screening program (though that doesn’t mean school scoliosis screening is mandatory in all states). If your kids are homeschooled or unschooled, then you should make sure they are getting screened for scoliosis during their annual checkup at your pediatrician. All parents should also be on the lookout for signs of scoliosis in their kids, like paying attention to whether their kids’ shoulders are in alignment.
You can also learn to do the screening test yourself. This is how I found that my daughter had scoliosis at age 7. I showed her pediatrician who wasn’t convinced but reluctantly referred me to an pediatric orthopedic surgeon. (Be persistent with your doctor; Scoliosis is no joke). The specialist diagnosed her with a very mild case of scoliosis which years later became severe and required surgery. (More on that soon!)
The official name for the scoliosis screening test is The Adam’s Forward Bend Test. It is really fast and simple to do. The child stands in front of the screener and bends over at the waist, like they are trying to touch their toes. The child should bend forward as much as possible. The screener then stands eye level with the child’s back. The screener will look to see if there are any abnormal curvatures in the spine or whether one side or hip is higher than the other.(source)
If a spinal curvature is seen, then the scoliosis will be confirmed with an x-ray. A doctor will use the x-ray to measure the degree of spinal curvature. The severity of the scoliosis is defined by the extent of the curvature:
- Mild Scoliosis: Curvature of less than 20 degrees
- Moderate Scoliosis: Curvature of 25-70 degrees
- Severe Scoliosis: Curvature of more than 70 degrees
- Very Severe Scoliosis: Curvature of more than 100 degrees
Please note that each doctor will measure the same exact X-ray slightly differently since it depends on what they consider the apex of the curve, etc.
Why Do So Many Cases of Scoliosis Go Undetected?
Since it is so easy detect scoliosis, even without medical training, then you might wonder why so many kids end up with serious cases of scoliosis.
The reason that so many cases of scoliosis go undetected until they become severe is because scoliosis (well, at least the most common form of scoliosis known as adolescent idiopathic scoliosis) usually develops in early adolescence — the same time kids start becoming shy about their bodies. Ask an 11-year old girl to lift up her shirt and show you her back and she will probably look at you like you are crazy! But it is really important that you do the regular screening for scoliosis and explain how important it is to your kids. Keep in mind that 1.5% of kids older than 14 have spinal curves of more than 10%. These spinal curves may just get worse, and when they do, they get worse very quickly. (source)
Types of Scoliosis
Keep in mind that scoliosis is just a term used to describe this type of spinal curvature. It isn’t a medical diagnosis! A doctor will look at the x-rays and diagnose the scoliosis based on:
- The cause (if it is known)
- The degree of curvature
- The direction and shape of the curvature
- The location of the curvature
Cause of Scoliosis
About 80-85% of scoliosis cases, including that of my oldest daughter, are idiopathic. This means that there is no known cause. Or, as my daughter’s doctor put it, “We are all idiots and have no idea what causes it.” I like that guy!
While there may not be one specific cause of idiopathic scoliosis (there are probably multiple factors which contribute to it), we do know that scoliosis is linked to nutrient deficiencies. Numerous studies have found that scoliosis can be induced in animals by depriving them of minerals.
While the experts have not pinpointed an exact cause of idiopathic scoliosis, there is evidence that scoliosis is linked to nutrient deficiencies, particularly in vitamin D and K2 deficiencies. Guess what? When I tested Natalie’s nutrient levels, she was deficient in vitamins D and K2 as well as vitamin E, C, copper, carnitine, manganese, and chrominum! There is also some evidence that scoliosis might be caused by pesticides in food. (source 1, source 2)
The rest of scoliosis cases have a specific known cause. Some are considered congenital scoliosis, in which the spine did not form properly during development in utero (usually in the first 6 weeks of pregnancy). There is neuromuscular scoliosis which is caused by nervous system or muscular system disorders, such as Cerebral Palsy or Muscular Dystrophy. Neuromuscular scoliosis can also be caused by damage to the spinal cord. Sydromic scoliosis refers to cases in which the spine curves due to a deformity, such as with Marfan syndrome. With thoracic insufficiency syndrome, the thorax is unable to support the respiratory system and can result in spinal deformities. (source)
In adults, scoliosis is also usually idiopathic. However, it can be classified as degenerative scoliosis when it is caused from the joints or discs of the spine degenerating.
Prevalence of Scoliosis
Now, keep in mind that scoliosis is just a term to describe a type of curvature in the spine. Having scoliosis does not necessarily mean that it will require treatment. In fact, mild scoliosis is actually very common. According to the University of Maryland Medical Center, about 10% of adolescents have some degree of scoliosis, but less than 0.3 to 0.5% of them have scoliosis which requires treatment. (source)
The reports vary slightly, but most put the prevalence of idiopathic scoliosis (cases with a curvature of 10 degrees or more) between 2 and 3 percent of the US population. The prevalence of severe scoliosis (curvature greater than 30 degrees) is 0.2% of the population. It’s not a lot, but still high enough of a number to make you sit up and take notice! Each year, about 38 thousand people have to endure spinal fusion surgery for scoliosis in the US alone. (source 1, source 2)
Scoliosis is generally thought of a kid’s condition, since scoliosis usually has its onset between the ages of 10 and 15 years old, when kids go through growth spurts. However, research is showing that older adults are also at risk of scoliosis. One significant study found that 9% of adults over the age of 40 have scoliosis. As the age rises, so does the prevalence of scoliosis. The findings vary, but studies generally show that the prevalence of adult scoliosis is around 20 to 25%. One study even found a prevalence of scoliosis of 68% in elderly volunteers. Women are much more likely to develop adult scoliosis than men. The scary thing is that the vast majority of these adult scoliosis cases go unreported. Scoliosis can cause back pain, and back pain is definitely one of the most common complaints of aging. It makes you wonder how much of this back pain can be attributed to scoliosis! (source 1, source 2, source 3)
Scoliosis Risk Factors
The biggest risk factors for idiopathic scoliosis are being young or being old. As for scoliosis in kids, about 12 to 21% of cases are in kids aged 3 to 10 years old. But most cases of scoliosis occur in adolescents aged 10 to 15. The incidence of scoliosis is the same for boys and girls. However, when girls get scoliosis, it is 10 times more likely that the curvature will get worse. (source)
There is also a seemingly genetic link to scoliosis. If someone in your family has scoliosis, then there is a 20% greater chance that your kids will get it. (source)
Recently, a genetic test was created to determine the likelihood that scoliosis will get worse. The test, which is called ScoliScore, uses DNA samples taken from saliva. The test uses 53 different genetic markers plus the patient’s spinal curve. With this information, it assigns a “ScoliScore” of 1 to 200. Scores of 50 or less are considered low risk of progression and scores of 181 or higher are considered high risk. The test has a 99% accuracy rate in identifying low-risk patients, so it can be very useful in helping you decide how to treat the scoliosis. (source)
How is Scoliosis Treated?
If your child is diagnosed with scoliosis, there is no need to panic right away. Remember, about 10% of adolescents have some degree of scoliosis but less than 1% of kids require treatment for their scoliosis. Depending on the severity of the scoliosis, where it is located, and whether the spine is still growing, most doctors will probably recommend one of these courses:
- Back Bracing
Even if your doctor says that scoliosis treatment isn’t needed right away, you’ll still need to monitor your kid’s back carefully because the curvature could get worse. This is especially true with females! (source)
I don’t know about you but, as a mother of a child with scoliosis I wasn’t just going to sit back and crossing your fingers in hope that the scoliosis doesn’t get worse. Since scoliosis is linked to nutrient deficiencies, this would be a good time to get your child’s nutrient levels tested. When I found out that Natalie’s was deficient in key nutrients (the main ones linked to scoliosis being vitamin D and K2), I immediately got to work supplementing her with fermented cod liver oil and butter oil and plenty of gelatin. In fact, our journey with my daughter’s scoliosis is what inspired the ebook, The Gelatin Secret.
You might want to consider one of these alternative treatment options as well.
- Clear Institute: This institute uses specialized chiropractic methods for realigning the spine. More on our experiences with Clear Institute here.
- Yoga: Yoga for scoliosis isn’t used for straightening the spine per se. Rather, it can help strengthen and lengthen the muscles around the spine. This can help relieve tension (and pain) and shift the weight of the body to the legs instead of the spine, both of which can helpprevent scoliosis from getting worse. This DVD is what helped us get started on yoga for scoliosis, which Natalie does to this day. If possible, I would recommend finding a yoga instructor who is certified in yoga for scoliosis. More on our experience with yoga for scoliosis here.
- Pilates: Pilates exercises strengthen back muscles which support the spine and can help prevent scoliosis curves from getting worse. However, it is crucial that you have a certified instructor! Doing the exercises incorrectly could even make your scoliosis worse.
Back Bracing for Scoliosis
In cases of scoliosis in which the curve is between 25 and 40 degrees and the child is still growing, it was very common to prescribe a back brace although that is becoming less and less prevalent nowadays. According to one report, about 30,000 children get fitted with a back brace for scoliosis each year. (source)
The idea behind the back brace is that it will support the spine and hold the body in proper posture, thus preventing the curvature from worsening. There is a lot of controversy as to how effective these back braces really are (if effective at all). Early studies found that back braces weren’t any better than no treatment at all. It is very difficult for researchers to actually study the effectiveness of back braces though, one reason being that many patients don’t wear them for the full prescribed time. Back braces have gotten a lot better over the years though and aren’t as bulky or uncomfortable, so it is more likely that kids will put up with wearing them. A recent study found that back bracing has a 74% success rate in stopping scoliosis from getting worse. (source) In our case, the 3 world renowned scoliosis specialists we saw in Los Angeles did not recommend back bracing for my daughter.
Note that there are some camps which are adamantly opposed to back bracing for scoliosis, such as the Clear Institute. Their belief is that back braces are ineffective, could worsen deformities, and can lead to muscle atrophy. Since back braces can be humiliating for kids to wear, many question whether it is even worth it. (source 1, source 2)
In severe cases of scoliosis in which the curvature is more than 40 degrees and child is still growing, surgery may be the only option. There are many different types of scoliosis surgery and a lot of different methods for doing it. Every year, there are 38,000 scoliosis surgeries in the US, which is more than the number of kids wearing back braces for scoliosis. (source 1, source 2)
Need more information on scoliosis? Download my ebook Treating Scoliosis to get comprehensive information on what causes scoliosis, how to manage it, and the best treatment options. You can buy it here.
Have you been dealing with scoliosis? I’d love to hear your experiences!
This post is part of a series on treating scoliosis. Read my post about Nutrition and Scoliosis and Does Bad Diet Cause Scoliosis. And sign up to my VIP email list to get updates on scoliosis news and info.