Scoliosis: What Parents Should Know and What to Look For

David Jeffries's picture

More often than not, when I am doing an initial evaluation of a patient for scoliosis, a parent will ask, “Is there something I could have done to prevent this from happening to my child?” The majority of the time the answer to the question is, “No.” That being said, I usually go on to explain the different types of scoliosis, what is happening to their child anatomically, and more importantly the types of orthoses designed to treat their specific type of scoliosis.

I have extensive training in being able to identify the different types of scoliosis and have taken many courses on the types of orthoses designed to treat scoliosis. Over the course of the last 2 decades I have successfully fit over 200 patients with an orthosis. Most of these cases resulted in positive outcomes, preventing further curve progression and the necessity for surgical intervention. In every case of diagnosed scoliosis I have treated, there have been clinical indications (which are asymmetries in the skeletal and muscular anatomy) that show signs that a scoliotic curve is present. Just by taking a close look at someone standing in front of me I can usually identify atleast 3 of these clinical indications. As they are pointed out to the parent during the evaluation, I almost always get a response of, “Oh yeah… Now I see it.” You do not necessarily need extensive training to identify these clinical indications, but just have the ability to ask yourself a few questions:

  1. Do I, or does my child walk with a limp? Having one leg longer than the other can cause scoliosis.
  2. When I look in the mirror, or when my child stands up straight in front of me, is one shoulder higher than the other? Does one shoulder blade stick out more than the other? Are the rib bones more pronounced on one side than the other?

While there are plenty of other things a trained eye can pick up on, these are some of the most common. If you notice any of these differences or deviations it may be worth looking into. Catching scoliosis early on leads to much more positive results in the outcomes. Most likely you will need to set up an appointment with your doctor or your child’s doctor to have these signs checked. He or she will send you to have x-rays taken if they feel that there is a chance of scoliosis being present. The aforementioned clinical signs are a good indicator that you or your child may have scoliosis but only an x-ray can verify the diagnosis.

When you or your child has been initially diagnosed with scoliosis, it usually comes as a shock and along with that comes many questions. Although I can’t begin to cover all of them in this article, I will hopefully answer a few questions so that your first appointment with a certified orthotist goes a little smoother.

Above: Example of a Scoliosis Brace

Q: What are you going to do at the first appointment?

A: You or your child will be evaluated for an orthosis. Many questions will be asked about your child’s activity level, how long have you been aware of the scoliosis, and what is the severity of the scoliosis (which can only be assessed by reading the x-ray), etc. Based upon the answers to these questions, the best treatment protocol and orthosis will be determined by the practitioner.

Q: How long will I or my child need to wear the orthosis?

A: That is a difficult question to answer. Depending upon the severity and how easily the scoliotic curves are correctable is what usually determines the time frame. I have had patients wear a brace for a few months and have favorable results, but the majority use a brace for 12-18 months.

Q: When do I need to wear the orthosis and for how long?

A: Most of the time we ask that the orthosis be worn as much as possible throughout the day. But we are also very realistic about a person’s tolerance for wearing them. We generally ask that you wear the orthosis for 8-10 hours a day. It just makes sense that the longer the orthosis is worn, the better it will work in preventing your scoliosis from getting worse.

It can also be very difficult to get someone to “accept” an orthosis as well. Patient compliance is the most challenging aspect to overcome when treating scoliosis. Most children are just beginning junior high school when their scoliosis is being treated, and it can be very difficult to get them to wear an orthosis that their friends may see.

We here at Sierra Orthopedic / CIRS are very sympathetic to those types of circumstances and work very hard to choose the best and most effective treatment path for you or your child. Hopefully this article provided a little knowledge and information that will help future outcomes. If you have any further questions or would like to set up an evaluation appointment, please feel free to give us a call.


Yours in health,

David Jeffries, C.O.
Clinical Director
707-939-7503