Doctor Michel Guillaumat responds to common beliefs about scoliosis, as they distort the perception of the disease and jeopardize its care

Michel Guillaumat

If a child has poor posture, or carries a heavy school bag, will he/she develop scoliosis?

No behavior will trigger or aggravate scoliosis.

Some advice: Do encourage your children to move and practice some sports activities !

All studies are clear: Carrying a heavy bag does not provoke a scoliosis nor aggravate it. A backpack should be preferred to a rolling schoolbag, as this latter imposes an asymmetric pull on the back. A school bag should not exceed 10% of the weight of the carrier

 

Should children who have scoliosis be excused from practicing sports?

There is no contraindication to sports activities in the case of scoliosis. On the contrary, regular practice is recommended.

Sport helps children tolerate the discomfort of a brace, improves their respiratory functions and reinforces their back muscles. Some “risky” sports activities (gymnastics, wrestling, rugby…) are less encouraged, but nonetheless, all sports can be performed, even at a high level.

 

Is scoliosis a hereditary disease?

It has been confirmed that the origin of scoliosis is genetic. The risk of developing idiopathic scoliosis is multiplied by 10 if one of the parents has it. In 2011, a geneticist at CHU of Lyon, Professor Patrick Edery, proved the default of two genes – on chromosome 3 and chromosome 5- to be responsible for certain types of familial idiopathic scoliosis.

Research needs to be pursued.

 

Does excess weight lead to scoliosis?

On the contrary, it has been noticed that most serious infantile scoliosis develop with frail children. However, being overweight can make screening or treatments more difficult.

 

Could one prevent scoliosis with a good bedding ?

Spinal pain and poor bedding can be connected. The use of a bolster or a pillow are not recommended after a spine surgery. Scoliosis is a three-dimensional deformation of the vertebral column that no bad posture can be accounted for.

 

Can a brace really have a positive effect on scoliosis ?

Indeed ! The usefulness of a brace on the evolution of a scoliosis is strongly established. Moderate scoliosis (?20°) are generally not progressive but half of all idiopathic scoliosis are and should be treated. In order to anticipate the evolution, researchers are working on a severity index

Is surgery the best way to treat scoliosis?

Surgery is the “last resort” solution… in case of failure of wearing a brace or of a serious aggravation of the scoliosis (?50°). Surgery should never be seen by a patient as “the fast and easy way” to deal with scoliosis.

 

Can dental braces provoke scoliosis?

There is nothing surprising about a child in his growth phase showing both signs idiopathic scoliosis and problems of dental articulation. Orthodontists are in a very good position to help detect scoliosis but no correlation was ever established between dental braces and scoliosis.

 

Can physiotherapy correct scoliosis?

Physiotherapy is an accompanying therapy to the wearing a brace. It helps maintaining the muscle structure and good breathing. It can be replaced by regular practice of a sport. However, physiotherapists play an important role in detection. Awareness campaigns such “M’Ton Dos” “Love your back” provide free checkups for children between 8 and 11.

 

Can manual therapies help to reduce the effects of scoliosis?

Vertebral manipulations should be prohibited, as they are unsafe. They have no effect on the deformity itself. Stretching techniques of the hyper extended zones by a physiotherapist could eventually supplement the treatment.

 

Can orthopedic soles reduce scoliosis?

Only a scoliotic attitude can be reduced by orthopedic insoles that compensate for the difference in length of legs. One should be careful, as when they wrongly prescribed they can be harmful.

 

Is pain a sign of scoliosis?

No. Idiopathic scoliosis does not cause pain.

But, during growth period, a reoccurring sore back should be the occasion to test for a potential scoliosis. The screening is very simple, fast and easily done by parents.

All that it takes is having the child bend over forward and look out for see two signs : a gibbosity and a window shaped gap between the arm and body at height of the waist.

 

Can scoliosis treatment get in the way of normal growth?

No, to the contrary. Spinal deformation creates loss in height. In pulling up straighter, it lengthens. Surgery should not occur until after the major growth spurt.

 

Can high heel shoes worsen or provoke scoliosis?

High heels increase the lumbar lordosis and as a consequence, pain. But it does not trigger or worsen any anatomic or structural deformation like scoliosis. Otherwise, should we remind that wearing heels is not recommended for children 😉

 

Can you get pregnant with a scoliosis?

Other than some exceptional cases, scoliosis has never been a hindrance to the normal progression of a pregnancy, even in the case of major curvatures. Only a potential increase in the mechanical lumbago could intervene in the course of a pregnancy.

 

Could one have an epidural with scoliosis?

The anatomical conditions for an epidural are not ideal for a person with spinal deformity. It will sometimes be technically more difficult, the anesthesia will not be as deep, or sometimes there will be less symmetrical distribution.