importance of individualized diagnosis & treatment plans for scoliosis
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GOLD COAST BLOG
Dr. Paul Fisher
Receiving individualized healthcare is a top priority for patients today. Unfortunately, when it comes to scoliosis, too many patients are being given general core strengthening exercises, generic physical therapy and yoga or are told to simply “wait and see”. As a result in many cases the window to make significant improvements closes; or worse, the curve progresses. Every large curve started out small.
So why is an individualized diagnosis and treatment so important?
If a patient’s unique situation isn’t diagnosed with in-depth information, the fact that scoliosis could be a secondary symptom of another cause will be missed. Possible causes of scoliosis may include: syringomyelia, which is a fluid filled sac in the spinal cord; Arnold Chiari malformation where the brain sits too low in the skull; congenital or bony abnormality; neuromuscular, which encompasses a wide range; or traumatic. The most common reason is “idiopathic”, which means we don’t know exactly why (I will address current theories in a future post!).
After the proper diagnosis is made, you have to address the locations and magnitudes of the curves, the sagittal (front to back) and coronal (side to side) balance, the bone age of the individual, stage of puberty and identify any competitive activities in which they currently participate. Combining all of these is CRUCIAL for developing an individualized treatment plan that will have the best possible outcomes. For example, a 9-year old girl who hasn’t begun menstruating with a 15 degree curve, has an extremely high risk of curve progression (it is actually almost guaranteed to progress) whereas a 30-year old man with that same curve is unlikely to progress significantly at that stage in his life. So, based on this example alone, treatment approaches should differ case-by-case.
The young girl would benefit best from a corrective brace, scoliosis specific exercises, spinal remodeling and chiropractic. The brace is essential because as she grows, the curve has the chance to worsen or improve. If untreated, or if the “wait and see” approach is used her curve will get worse. Conversely, if she is properly braced, instructed in the individualized exercises, spinal remodeling and chiropractic she has an excellent chance of improving or at least significantly decreasing the progression. As for a 30-year old man with the same curve, a brace isn’t nearly as imperative. The risk of progression is minimal and he will likely respond very well to specific exercises, spinal remodeling and chiropractic.
Scoliosis is a complex condition of the spine that will worsen over time if not treated correctly. No one-size approach should fit all when it comes to choosing your healthcare. We should always expect individualized treatment plans and scoliosis is no exception to this rule.
Dr. Paul Fisher