This month I have a special guest blog by my classmate and scoliosis expert Dr. Chris Gubbels who practices in Fort Collins, CO. Dr. Chris specializes in non-surgical options for scoliosis correction and management.

Scoliosis is a three-dimensional spine deformity that involves both a lateral bending and rotational components of the spine. 3% of adolescents under the age of 16 are affected by scoliosis. The most common type of scoliosis is idiopathic scoliosis. Idiopathic means there is no known cause. The onsets of idiopathic scoliosis is likely multifactorial with both genetic and environmental triggers. Although the exact cause of idiopathic scoliosis is unknown, the progression of scoliotic curves is well documented and understood. Curve progression is related to both age and degree of curvature.

Scoliosis Screenings

In 2015 the SRS (Scoliosis Research Society) came out with a position statement in support of scoliosis screenings recommending girls be screened twice at the ages of 10 and 12 years and boys be screened between the ages of 13-14 years. Early detection leads to early and more effective conservative treatments and better patient outcomes. Chiropractors are typically the first line of detection of scoliosis and understanding what to look for is key.

What to Look For

Unlevel Shoulders

Uneven Scapula (Shoulder Blades)

Humping in the Ribs or Lumbar Spine

Uneven Waist

Uneven Hips

Obvious Curves

The most common test used to detect scoliosis is the Adams Test. The Adams test done by having the patient place their hands together and then bending over. The healthcare provider uses this to look for humping in the thoracic or lumbar spine. Humping is caused by rotation of the spine which cause the ribs to forma hump in the thoracic spine. Because the lumbar spine does not have ribs, humping is less obvious and more difficult to detect. Using a scoliometer increases the accuracy of scoliosis screenings. A scoliometer is a tool used to measure the amount of rotation in the spine while doing the Adams test. 6° of rotation and 4° of rotation detected using a scoliometer indicates scoliosis and further evaluation is warranted.

Scoliometer

The gold standard for scoliosis detection and diagnosis is radiographs and when scoliosis is suspected full-spine x-rays are warranted.

Does Scoliosis Cause Pain

Scoliosis in adolescents frequently causes a low grade ache, which may prompt a parent to bring their child to a chiropractor. Intensive spinal pain and/or night pain is a red flag and may indicate an underlying pathology.

Treatment Options

Non-surgical treatment options included: 1) Observation, Scoliosis Specific Exercises, Scoliosis Intensive Rehabilitation Programs and 4) Bracing. Traditional physical therapy, massage, yoga and chiropractic adjustments have not been found effective in slowing the progression or improving scoliosis curve however they can play an important part in scoliosis treatments. Chiropractic adjustments can increase spine mobility and decrease pain, making scoliosis treatments more effective. Additionally, chiropractic techniques such as Chiropractic BioPhysics and CLEAR have published research showing their effectiveness in improving scoliosis curve in adolescents and adults. Many chiropractors are trained in scoliosis specific rehab methods in addition to traditional chiropractic techniques. Many chiropractors who are not trained in scoliosis specific techniques have working relationships with chiropractors that specialized in scoliosis.

The Chiropractic Advantage

Specializing in scoliosis, the vast majority of scoliosis patients I see have seen other healthcare professions before arriving at my office. Patient’s that went to a chiropractor for help with scoliosis are frequently encouraged to seek treatment early on to work to improve the curves. Conversely, I have also found that patients that seek the advice of a pediatrician or spine surgeons are more frequently advised to observation or “watch and wait” to see if the curves progress. I have found that chiropractors tend to be much more connected to specialist within their profession and seek the help and advice or refer to experts in non-surgical treatments at much higher rates than general practitioners, pediatricians and orthopedic spine surgeons. Even if your chiropractor does not specialize in scoliosis he/she can likely refer or work with someone that does.

Dr. Chris Gubbels is Fort Collins Chiropractor specializing in non-surgical treatment of scoliosis and scoliosis bracing. He has published research on non-surgical treatments of spine deformities and presented cases at international research conferences on non-surgical treatment of scoliosis.

Visit https://squareonehealth.com/ to learn more about non-surgical scoliosis treatments and scoliosis bracing.