5 Common Scoliosis Myths — Debunked

  1. Scoliosis does not worsen or occur after you are done growing  

It is true that adolescent idiopathic scoliosis (scoliosis that starts after the age of 10) has the highest risk of worsening during rapid growth. However it is a myth that scoliosis remains stagnant after skeletal maturity. Although the risk of scoliosis progression is much lower after a child is done growing, scoliosis can still progress after bone maturity. In patients with untreated scoliosis, research suggests that curve progression occurs at the rate of approximately one to three degrees a year in adulthood. This can add up over time.

Another myth is that scoliosis only occurs in children. In fact, not only can childhood scoliosis worsen in adulthood, but scoliosis can actually begin in adulthood. When this occurs, it is called “de novo” scoliosis, which is a totally scoliosis than adolescent idiopathic scoliosis. A 2005 study published in the U.S. National Library of Medicine suggests that 68 percent of people over the age of 60 show signs of degenerative scoliosis – scoliosis due to age related “wear and tear” on the spine. Adult onset scoliosis can also be related to the bone density changes seen in osteoporosis.

The “take home message”  is that children with scoliosis should continue to care for their condition into adulthood, and adults should understand even if they never had scoliosis as a child, age related spinal changes may cause scoliosis later in life.

  1. Bracing is outdated and does not work

When thinking about scoliosis back braces, many people have visions of the antiquated, metal braces of the 1950’s that come up under a person’s neck. In fact, most scoliosis braces are now made of thermoplastic materials easily concealed under clothing. The concealed nature of braces may be feeding a perception that scoliosis braces aren’t used anymore – which is not true. Braces are still used for treatment to control scoliosis in children that are still growing.

Another myth is that bracing doesn’t work. Whereas it is true that past research has not fully supported the use of braces, a study published in October 2013 reported clear evidence that bracing helps prevent surgery in the majority of growing children with moderate severity curves.  

The “take home message” is that bracing should now be considered standard of care for preventing curve progression in skeletally immature children with curves between 20-40 degrees.  

  1. Scoliosis does not cause pain

One reason scoliosis can go undiagnosed in children is because it is often pain-free. It can “sneak up on us” as a child develops. But just because scoliosis doesn’t always cause pain, it doesn’t mean that it never causes pain.

In fact, scoliosis can often lead to painful symptoms in children that require medical care. Pain can come from curve-related biomechanical stress on the surrounding soft tissues such as joints, discs, ligaments, tendons, and muscles. In adulthood, if scoliosis is accompanied by more degenerative age-related changes, pain can also come from compression of nerves or a condition called spinal stenosis – a narrowing of the space where the nerve exits the spinal column.  

The “take home message” is that back pain can be related to scoliosis. The painful symptoms of scoliosis can be improved with conservative treatment such as physical therapy by treating both the soft tissues and joints of the spine and any biomechanical compensations related to the postural asymmetry.

  1. Exercise does not help scoliosis

The key to addressing this myth is understanding the goals of scoliosis-specific exercise therapy. Critics will often state exercise can’t help scoliosis because it is a structural condition. In truth, scoliosis has a structural (or rigid) component as well as a postural (or flexible) component.

The  “Cobb angle” – which is the x-ray measurement of scoliosis – actually represents the sum of both the postural and structural components. The aim of exercise is to affect the postural component of the curve, and through improved posture, the patient can better achieve multiple additional goals, such as: controlling curve progression, improving torso shape, improving respiration, and reducing pain.  

The “take home message” is that scoliosis specific exercise is aimed at improving the overall quality of life the patient through improved control of the postural element of their curve.

  1. Scoliosis screening  isn’t beneficial  

The provision of scoliosis screenings in the US public schools has been on the decline, despite the American Academy of Pediatrics and Orthopedics recommending screening for kids between ages 10 and 15. The lack of screenings may be due to a potential belief that screenings are not worth the costs, and a misunderstanding that nothing can really be done to treat scoliosis in the early stages of detection.  

In truth, screenings are quick and easy to perform, and can be done at a relatively low cost. If a child screens positive for scoliosis, an early x-ray can be done to catch a curve when it is mild. Early detection will facilitate effective early intervention. Without screenings, curves may go undetected until they reach higher degrees of severity. More severe curves are more difficult to treat, or may require surgery.

The “take home message” is screening for scoliosis is worth it. If school budgets don’t allow for in-school screening, parents can seek screenings from physicians and physical therapists in the community.  Parents can learn more about self-screening their children here.