Frequently Asked Questions

New July 2009

Definition
Signs of Scoliosis
Prevalence
Cause
Screening
Prevention and Treatment
Other Spinal Deformities

Definition

Q.  What is scoliosis?
A.  Scoliosis is a medical term describing a lateral curve of the spine.  Although most curves are small, progressive scoliosis can lead to disabling spine deformities.   

Signs of Scoliosis

Q.  I am a parent, and suspect my child has scoliosis.  What should I do?
A.  If you suspect a child may have scoliosis, the best thing to do is contact the child’s primary care provider.  If this is not possible, contact the school nurse or your local public health agency.      

Q.  What is the major sign of scoliosis?
A.  A scoliometer result of 6 degrees angle of trunk rotation (ATR) or greater is a sign of possible scoliosis.  These students should be referred to a primary care provider. 

Q.  What signs indicate that a curve is progressing?
A.  The most accurate sign is that, when standing X-rays are taken three to six months apart, they show an increasing curve.  It is almost impossible to note such a progression just by visually examining the back.

Prevalence

Q.  What percentage of people have scoliosis?
A.  Idiopathic scoliosis (scoliosis with an unknown etiology) prevalence varies by the severity of the curve:

  • Curves of 10 degrees or greater present in 2 to 3 percent of people
  • Curves of 20 degrees or greater present in 0.5 percent of people
  • Curves of greater than 30 degrees present in 0.2 percent of people

A health-care provider should evaluate children with a scoliometer reading of 6 degrees or higher.

Cause

Q.  Can poor posture cause scoliosis?
A.  No.  Poor posture does not cause scoliosis or have an effect on the way a curve progresses.

Q.  Can overuse of one side of the body cause scoliosis (e.g., carrying a backpack over one shoulder)?
A.  No. Overuse of one arm or leg will not cause scoliosis.

Q.  Do curves progress after the spine stops growing?
A.  After the spine stops growing (at approximately 14-16 years of age in girls) usually only severe curves progress.  That is why it is important to detect curves early and prevent them from increasing.

Screening

Q. Why should schools screen for scoliosis?
A.  Scoliosis is most likely to be identified early when schools screen for it.  Schools have a great deal of contact with adolescents, making them the ideal location for scoliosis screening.  Without a screening program, scoliosis may go undetected because:

  • Students are unlikely to receive physical exams at this age unless they have health problems. 
  • Scoliosis is essentially painless, producing no symptoms other than an abnormal curve in the back
  • Idiopathic scoliosis most often develops during preadolescence or early adolescence, when modesty may preclude parents from seeing their children unclothed. 
  • Long hair and loose clothing styles can conceal significant deformities.

Q. How can we make our screenings more accurate and prevent over-referring for questionable spinal deformities?
A.  For new programs, the most efficient way to obtain screenings that correlate with clinical results is to have help.

Invite someone who has helped with other screenings.  Experienced screeners, such as nurses who attend the Scoliosis Screening Seminar, are excellent resources.  The use of a scoliometer promotes accurate assessments and referrals.

Q.  Do I need to attend a training to conduct screening for scoliosis?
A.  While training is not required, it is available through Gillette Children’s Specialty Healthcare in conjunction with Shriners Hospitals for Children-Twin Cities, the Twin Cities Spine Center and the Minnesota Department of Health. 

Q.  Why is it not recommended to screen boys for scoliosis?
A.  In the past, screening boys in the eighth or ninth grade for scoliosis at school was recommended.  However, it is much less common for boys to have curves that require treatment.  Because the curves do not require treatment very often, screening for boys for scoliosis in schools is no longer recommended. 

Q.  If someone has scoliosis, is it important to evaluate family members?
A.  Yes. Heredity may be a factor in the most common type of scoliosis (idiopathic).  Therefore, all siblings of a child diagnosed with scoliosis should also be evaluated.

Q.  Can a difference in leg lengths mimic scoliosis?
A.  Differences in leg lengths may cause a variance in the sides of the back when a student bends forward, but the diagnosis of scoliosis is for a primary care provider to make.  Schools should screen the student using a scoliometer regardless of leg length differences and refer students with of 6 degrees ATR or greater for further evaluation.

Q.  Should a screener use blocks of wood for students with leg length discrepancy to prevent an unnecessary referral?
A.  No. Using blocks of wood is no longer recommended during the screening process.  Perform the standard screening with a scoliometer.  Refer students whose asymmetry measures 6 degrees or greater even if there is a leg length discrepancy.

Q.  Some children with disabilities cannot bend forward. How do we screen those children for scoliosis?
A.  Such children may need help undressing or bending forward.  They might need to sit on a tabletop, with their legs swinging free and apart.  Although screening children who have disabilities requires patience and additional time, it is critical to perform such screenings.  The incidence of scoliosis requiring treatment is higher among children who have disabilities than it is in others.

Q.  Is it necessary to keep a watch list or to rescreen students?
A.  No. Students with an ATR (angle of trunk rotation) of 6 degrees or greater should be referred to a primary care provider.  No further action is needed for students with an ATR less than 6 degrees. 

Prevention and Treatment

Q.  Is there any way to prevent scoliosis?
A.  There is no known way to prevent scoliosis from developing.  The best ways to prevent scoliosis from becoming a severe problem are by early detection and prompt treatment.   Treatment may include observation for mild curves, bracing for moderate curves, and surgery for severe curves.

Q.  Can chiropractors help treat scoliosis?
A.  There is no long-term study showing that chiropractic treatments and adjustments can stop scoliosis or prevent it from progressing.

Q.  Does exercise prevent mild scoliosis from getting worse?
A.  No. There is no evidence that physical exercise affects curves or prevents curves from progressing.

Q.  Does scoliosis treatment prevent women from becoming pregnant or having children?
A.  No, treatment for scoliosis will not prevent women from becoming pregnant or having children.

Other Spinal Deformities

Q.  What is kyphosis?
A.  Kyphosis (“roundback” or “hunchback”) is an abnormally convex curve in the thoracic area of the spine.  In most instances, it is caused by poor posture.  It also can be caused by Scheuermann’s disease.  Children with excessive kyphosis should see a primary-care provider for further evaluation.

Q.  What is lordosis?
A.  Lordosis (“swayback”) is an increased concave curve in the lumbar and cervical areas of the spine.  In adolescence, it is usually caused by poor posture.

For more detailed information, references and resources, see http://www.health.state.mn.us/divs/fh/mch/scoliosis/index.html