Scoliosis is not just bad posture

Tots to Teens

February 04, 1997|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,SPECIAL TO THE SUN

Our doctor just diagnosed my 13-year-old daughter with scoliosis. He told us she might need to wear a brace to correct it. My mother says back exercises would work just as well for her poor posture. Would there be any harm to trying the exercises for a year?

In answering your question, it is important to distinguish between scoliosis and "poor posture." The latter may certainly be amenable to back exercises whereas scoliosis most certainly will not. Some young people will slouch through habit or because they have weak back or abdominal muscles. This situation will respond to exercises directed at strengthening the muscles. We suspect some adolescent girls who are self-conscious about their breast development may slouch as well. Teens whose legs differ in length by more than 3 to 4 centimeters also may appear to have an abnormal posture.

Scoliosis is entirely different from than poor posture. Girls (most teen-agers with scoliosis are girls) have an as yet poorly defined abnormality of the vertebral bodies (bones) of the spine. The bones of the spine between the shoulder blades and/or above the top of the pelvis are the areas usually involved.

The abnormality has two components. If you think of an #i imaginary line running through the spine, scoliosis would involve a bending of that line, as well as the individual bones of the spine rotating a bit around that line. These changes are visible as a curvature of the spine (particularly when she bends forward) and as some asymmetry of the chest or back.

Because these abnormalities are in the bones or ligaments connected to the bones, muscle exercises will not work. Therefore, if your daughter truly has scoliosis, the trial period you asked is not warranted. It sounds as if you may need to talk with your doctor to make sure you better understand his or her diagnosis.

Whether your daughter will need a brace depends on a number of factors. The spine grows rapidly during puberty and most of that growth is completed by the time a girl begins to menstruate. If your daughter has a small curve, perhaps 5 to 10 degrees and is already menstruating, it is unlikely that her scoliosis will progress to the point she will require treatment.

On the other hand, if she has just begun her breast development, most of her spinal growth lies ahead of her and she will need frequent monitoring. If the size of her curve progresses, she will likely need a brace to prevent it from getting worse. Also, girls with bigger curves at the time they are detected are also more likely to progress unless treated.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

Pub Date: 2/04/97

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