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Scoliosis Screening & Information
What is scoliosis?
Scoliosis is a condition affecting the spine causing curvature(s). The curvatures can be: an “S” shape curve from side to side causing a crooked posture, forward curve causing a hunch back, or rear curve causing a sway back.
Why worry about scoliosis?
Scoliosis does not typically affect a child's performance in daily activity and routines unless the case is severe. However as a child progresses through adulthood, scoliosis can lead to skeletal deformities, crippling, and organ crowding which can affect chronic health conditions in the elderly. Did I just say elderly? Yes I did. We are screening for scoliosis NOW to prevent your child from being crippled when they are old.
What is the procedure for scoliosis screening?
Screening is done during Physical Education class in a windowless room with more than one student present at a time. However, there is a divider for privacy during screening. The screener/nurse explains to the class what scoliosis is and why we check for it, as well as, goes over the procedure with the students.
In order to observe a child accurately for symptoms of scoliosis, the screener/nurse must be able to see the child's bare shoulders and bare back. Typically the screener stands four to five feet away from the student during screening. Boys remove their shirts. Girls drape their shirts in front of the chest. The procedure itself, is identical for boys and girls.
-First, students are observed while facing the screener.
We look for level shoulders and hips while the students' feet are together with hands at
their sides.
-Second, students are observed while facing away from the screener.
Again, we look for level shoulders and hips while the students' feet are together with
hands at their sides.
-Third, students are asked to spread the feet apart at least shoulder width, put the palms of the
hands together out in front of them, tuck the chin in to the chest, and bend over slowly.
Once this process is complete, the student is asked to put his/her shirt back on, and the next student is called over to be screened.
What signs/symptoms indicate that a child might have scoliosis?
1.Uneven shoulders and/or shoulder blades
2.Uneven hips
3.A crease in the waistline on one side of the body
4.A chest hump anywhere on the back upon bending over
5.General asymmetry (unevenness/crookedness) of the body
6.Uneven nipple line (this would only be noticed with the boys during screenings)
7.Noticeable curvature of the spine
What to expect if your child fails scoliosis screening
If your child does not pass the initial scoliosis screening, he/she will be re-evaluated by the school nurse at a later date. If your child does not pass the second screening, you will be mailed a referral letter.
The referral letter will contain a list of the symptoms exhibited by your child. Simply receiving a referral letter does not mean that your child has scoliosis. By law, nurses are not allowed to render a diagnosis. The ONLY way to be 100% certain that a person has scoliosis is to have an x-ray of the back performed.
How accurate is the scoliosis screening done at school?
I am very particular when it comes to scoliosis screening. I screen approximately 625-650 students annually, and if I had to guess how accurate my referrals are, I would say that I have approximately an 80% accuracy rate in reporting students suspected of having scoliosis.
Why? Because I take extra time to make sure that the screening procedure is followed to a “T.” If I feel a student has failed screening simply because he/she was not performing the procedure correctly at school, I work with them until I can get them to relax enough to do the procedure correctly. What does this mean? This means having the students do some deep breathing in order to relax, actually showing them what they are doing wrong, and showing them the correct way to do what I need them to do. Therefore, the results I get are generally very accurate. There are times, however, when a student may fail screening, but have a normal x-ray. This is typically because of growth. Children do not always grow symmetrically, meaning they can grow unevenly from one side to the other. Therefore, a student could fail one year, and pass the next two years, and then fail again the following year. It just depends on when they are having a growth spurt.
What should you do if you get a scoliosis referral sent home?
Contact your child's physician for an appointment. When you have the appointment, take the referral letter along so that the physician can look for the symptoms seen at school. If the doctor feels there is no need to do an x-ray, ask if you can do one anyway. It's a painless procedure, and it never hurts to have a baseline to start from. It's like I always tell the kids when they ask me, “Do I have scoliosis?”, I say, “I'm not Superman, I don't have x-ray vision. I can see that you have a sign or two of scoliosis, but I can't see under your skin.” Guess what, the doctor doesn't have x-ray vision either, so don't be afraid to ask for that x-ray.
If my child has scoliosis, what happens next?
Depending on the severity of scoliosis, treatment may or may not be recommended. Treatment could be in the form of exercises for the back, it could be a brace, it could be surgery. You won't see a brace or surgery unless the degree of curvature is pretty severe. Scoliosis is not a death sentence, it is not an excuse to get out of gym or other activities unless the Orthopaedic Specialist says so. Scoliosis is just something to watch and deal with as life goes on NORMALLY.
What causes scoliosis?
There is no rhyme or reason to scoliosis. Scoliosis can happen to anyone at any stage in life, and is often hereditary. Scoliosis is more common in females than males. A child can have congenital scoliosis which means they are born with scoliosis. Scoliosis can also develop as a result of neuromuscular problems, uneven leg lengths, poor posture-such as slouching. Scoliosis can also be idiopathic, which means there is no known cause.
How can you help prevent scoliosis?
Scoliosis cannot be prevented. However, you can instill some good practices in your child which will help keep the back and shoulders strong. Encourage good posture for your child at all times. Girls should always wear supportive bras. Encourage your chid to stay active whether or not they are athletic. Discourage carrying backpacks or books on the same side all the time. Encourage a diet rich in calcium to maintain bone strength. Avoid overweight and obesity.
Where can you get more information on scoliosis?
For more information on scoliosis, Google search “Scoliosis.” There are multiple sites that can give you information. One site that I found to be very useful is iscoliosis.com.