Sit up straight. Put your shoulders back. You have probably heard these commands at one time in your life from your mother, grandmother or well-meaning teachers. But what if you can’t sit up straight or put your shoulders back? What if you are one of the millions who have been diagnosed with scoliosis? We asked our friends at OrthoCarolina to educate us on scoliosis, the signs, and what it means to live with and overcome scoliosis. We also spoke with two brave young women and their mothers regarding their journey with scoliosis.
Scoliosis is a condition where the spine develops a curve that is greater than 10 degrees looking face to face. According to Dr. Todd “Matt” Chapman with OrthoCarolina, “The spine has a natural curve if you look at it from the side, but looking at it straight on, it is supposed to be straight.”
Scoliosis affects 2-3% of the population, and there is an increased rate of scoliosis in women relative to men. Dr. Chapman and his colleagues at OrthoCarolina treat more women than men with scoliosis.
Dr. Chapman gave us a rundown of scoliosis facts, what to look for, what treatment may look like and we compiled them in a list below.
- Scoliosis comes in many forms. Patient’s can be born with it (congenital scoliosis); develop it early in life (early onset scoliosis); develop it in adolescence (adolescent idiopathic scoliosis); or develop it later in life (degenerative scoliosis).
- Scoliosis can develop from reasons that are not clearly understood yet (idiopathic), be associated with genetic or neuromuscular conditions (neuromuscular scoliosis), or can develop from degenerative changes and conditions of the spine (degenerative scoliosis).
- For idiopathic scoliosis which is the most common kind of scoliosis, young women have higher rates of adolescent idiopathic scoliosis and older women have higher rates of degenerative scoliosis. With adolescent idiopathic scoliosis, young women are affected at a rate of 1.5-3 per 1 male with adolescent idiopathic scoliosis.
- Patients with a family history of scoliosis have a higher rate of scoliosis as well, though not everyone with a family history of scoliosis will develop scoliosis.
- The signs and symptoms of scoliosis are variable and it can be completely asymptomatic. For adolescent idiopathic scoliosis patients tend to notice rib cage asymmetry and asymmetry about the waistline. Some may notice that one shoulder or one hip is higher than the other. The majority of young women with scoliosis are asymptomatic and do not have pain in the back or leg associated with scoliosis. Some patients will have back and/or leg pain. Back and leg pain tends to be more associated with degenerative scoliosis than adolescent scoliosis. These patients with degenerative scoliosis may also notice that they are hunching forward more or lean off to one side more so than they previously did.
- The diagnosis of scoliosis is made through a combination of history and physical exam as well as x-rays.
- The treatment plan of scoliosis varies depending on the severity of the curvature, as well as the type of scoliosis. There is a different course of treatment for each patient specific to his/her needs. Young women with adolescent scoliosis are usually managed with observation or bracing during their growth. For degenerative scoliosis we tend to start initially with conservative management including physical therapy, injections, medications, lifestyle changes, and evaluation of other medical problems. For all scoliosis patients, surgery remains an option but we try our best to avoid surgery, if at all possible. Surgery for scoliosis is a major undertaking and is reserved only for patients who are unable to achieve an acceptable quality of life through conservative options.
Denise Kent’s daughter, Olivia, now 17, was diagnosed with scoliosis when she was eight years old during a ‘well check’ with her pediatrician. After noticing the curve of Olivia’s spine, her pediatrician recommended that Denise take Olivia to a pediatric Orthopedist at OrthoCarolina.
“Olivia was diagnosed with a Chiari Malformation and Syringomyela a few months before she was diagnosed with scoliosis,” says Denise. “About 25% of Chiarians will develop scoliosis. My heart sank when her scoliosis diagnosis was confirmed. I had researched Chiari Malformation and Syringomyela and the effects of the disease and I knew what we were faced with.”
“When I found out about my scoliosis, my emotions were all over the place,” says Olivia. “Even though I was extremely upset and a confused about everything, I knew I had to stay strong and positive during that time.”
Olivia’s treatment included being fitted for a Providence brace, numerous x-rays and visits to OrthoCarolina several times a year to monitor her curve, but in 2012, it was decided Olivia would need spinal fusion surgery.
“A lot of girls are afraid of surgery, which I totally get because what young girl wants to have surgery,” says Olivia. “But if it comes down that surgery is a must, I would love girls to realize that surgery is not a terrible thing. After recuperating from my own surgery, I am so happy I decided to have it at the time I did! It really does help you with a major decrease in pain and just living a simpler life.” Olivia will be attending the University of South Carolina in the fall.
Ann Rorrer’s daughter, Mickeshia, now 15, was 10 when her pediatrician noticed her posture during a check-up. Living in Pennsylvania at the time, Mickeshia went to see a specialist and was diagnosed with scoliosis. She was fitted with a brace and the doctor who fitted her told her that the brace would give her an hourglass figure. This wasn’t the case. When the brace was removed, her curvature had increased. The Rorrers moved to Charlotte in 2014 and once settled, Ann sought help for her daughter. After doing her research, Ann found OrthoCarolina and read about Dr. Chapman. After meeting with Dr. Chapman, Ann found him to be very “honest” and felt comfortable listening to his advice. Since Mickeshia’s curve was so severe, it was decided that surgery would be best for her case. She had an osteotomy, where they break the spine and correct the spinal alignment. Her curve was 156 degrees, and now her curve is 60 degrees.
“I was sad and afraid [when diagnosed with scoliosis],” says Mickeshia. “Having people look at you like you are a freak made my confidence in myself low. I just wanted to be like every one else. We moved down here and we found Dr. Chapman. He made me feel comfortable and hopefully that I might look better as well as be able to breathe better. I had the surgery, I was scared but in the end it was worth it. I can breathe better and my posture is so much better. I actually look like every one else! My advice to other girls is scoliosis doesn’t have to keep you down. There is help.”
Help for Olivia came in the form of the Charlotte chapter of Curvy Girls, a support group for girls living with scoliosis.
“We spread awareness of scoliosis as well as aim to provide ease and comfort to girls going through their scoliosis journey,” says Olivia who led the Charlotte chapter this past year. “My advice to other girls would be to not panic. Even though it feels like your life is crumbling more and more each day, stay positive. Also, it is okay to ask for help. Go to a school counselor or your doctor, or even go to Google! Curvy Girls will probably come up, and we’ll be waiting for you with open arms because we’ve got your back.”
Ann and Denise have some final thoughts for parents.
“My advice to parents is to ask questions and feel comfortable with the doctor and procedure,” says Ann. “I would recommend Dr. Chapman 100 percent.”
“Awareness is key,” says Denise. “It is important to make certain you continue to have your children’s annual pediatric check ups. Don’t be afraid to ask questions and be proactive in your child’s healthcare. For me dealing with Olivia’s diagnosis meant that I needed to educate myself about her condition… the causes, treatment and outcome. Educating myself was beneficial and necessary for me to cope and help Olivia with her diagnosis.”
Dr. Chapman wants to stress that a diagnosis of scoliosis is not the end of the world. He encourages patients to remain as active as possible and even creates an exercise regimen specific to each patient. You can still be active and live the fullest life.
“Patients with scoliosis are not obligated or doomed to a life of back pain and discomfort,” says Dr. Chapman. Patients with scoliosis are able to live happy, healthy, full, complete lives without significant restrictions or limitations. At the OrthoCarolina Spine Center we pride ourselves on taking care of patients with scoliosis and other spine problems with the goal of getting them back to the healthy, happy, active lifestyle that they desire.”