Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright October 5, 1988
Last week’s column discussed what scoliosis was (a curved spine) and the effects it could have on the body if it wasn’t caught early enough. Today I will discuss how to screen your own child.
Noticing an advanced scoliosis is easy. The child will have an obvious curve in his or her back. And they will almost always have some pain or problem with certain movements. But how does a parent detect a scoliosis in their child before it gets to that stage?
Have the child dressed in a pair of shorts and have them stand naked to the waist. (No, this is not a game to play at your next party). Stand behind them and tell them to stand straight and look straight ahead. Note the relative position of several landmarks, and note whether or not these are level in relation to the other side.
The landmarks are: the ears, shoulders, shoulder blades, elbows, hands, pelvis, hips, and back of the knees. Try to put a couple of fingers under the arch in their foot to see if they have flat feet. Notice any obvious curve, rotation, or tilt to their spine.
Have them bend from the waist to try to touch their toes. Watch the way their back moves. It should be a smooth, fluid motion. When they are bent over, look at their middle back and see if the ribs have “humped” on one side. This will look like a large, bony, lump on one side, similar to a camel’s hump.
Ask them to bend side to side and watch the way their spine moves. You should see a smooth curve in each direction. You might want to take a pen and mark a small dot on each of the spinal bones. When the child bends to the side these dots should all move and form a curved line. When bending forward these dots should all stay in a straight line and should separate. When bending backward, they should move closer together. With the child lying down on their stomach, you should feel the spinal bones to make sure there are no obvious curves.
Bend the legs up from the knees to see if the feet reach up to the same level. Then, with the child on their back, check that the bones on the inside of each ankle meet each other. This test detects any obvious leg length discrepancy which can cause scoliosis.
These tests are to be done at least once a year. If anything abnormal is seen, consult a doctor or chiropractor, or if you do not feel confident examining your own child, one of these experts can do it for you in a matter of minutes.
If something abnormal is found, do not panic. The great majority of abnormal findings either correct themselves as the child continues to grow, or turn out to be just a variant of growth that will never turn into a full blown scoliosis.
Panic will only make your child nervous, and will give them the fear that they are not “normal” like their friends. The approach that should be taken is calm, rational follow-up so that any positive findings can be fully investigated.
Remember, severe scoliosis, which actually causes pain or disability, is rare. The exam procedure described above will actually pick up even the very mild cases, and is to be used as a screening process. From there, only a professional can advise about further action.