Scoliosis: When to Seek Treatment and What to Expect

Scoliosis

I previously had an X-ray taken at a hospital that showed my spinal curvature at 22.2 degrees (while another hospital reported it as 30 degrees).
However, at Chang Gung Memorial Hospital, I was advised that correction is recommended for curves over 50 degrees, and at Cathay General Hospital, they suggested correction for curves over 45 degrees.
Despite this, doctors at these hospitals have told me that my condition is not serious and does not require intervention.
On the other hand, during a visit to a traditional Chinese medicine practitioner at Taipei Provincial Hospital, the doctor recommended that I see an orthopedic specialist for further examination.
The TCM doctor mentioned that my curvature is significant and has a slight spiral.

Given my age, will undergoing correction be effective? I have been experiencing difficulties with prolonged sitting and standing, and I find that intense physical activity often leads to chest tightness and lower back discomfort.
Should I take the advice of the doctors at Chang Gung, who claim that correction would not be effective and that my condition is not serious, or should I consider the opinions from the national hospital that suggest my condition is more severe?

Xin, 20~29 year old female. Ask Date: 2007/07/20

Dr. Wang Shouji reply Orthopedics

In general, an X-ray angle between 20-30 degrees indicates that you are 23 years old and your skeletal development is complete, so the chance of further deterioration is low.
The symptoms you mentioned are somewhat related to scoliosis.
When it comes to correction, surgery is likely the only option left.
Most physicians would recommend conservative treatment (including medication, physical therapy, and strength training) for angles between 20-30 degrees, as surgery may not completely resolve your pain and could lead to issues with back stiffness.
It is advisable to visit a spinal surgery department for further evaluation.
Wishing you a speedy recovery.

Reply Date: 2007/07/20

More Info

Scoliosis is a condition characterized by an abnormal lateral curvature of the spine. The degree of curvature is typically measured in degrees using X-rays, and treatment recommendations can vary significantly based on the severity of the curvature, the age of the patient, and any associated symptoms. In your case, with a curvature of 22.2 degrees, the general consensus among some healthcare providers is that it is not severe enough to warrant immediate intervention. However, the differing opinions you've encountered can understandably lead to confusion and concern.

When considering treatment for scoliosis, it is essential to evaluate several factors:
1. Curvature Degree: Generally, curves less than 20 degrees are considered mild and may not require treatment. Curves between 20 and 40 degrees are often monitored, while curves greater than 40 degrees may necessitate bracing or surgical intervention, especially if the patient is still growing.

2. Age and Growth Potential: The effectiveness of treatment can depend on the age of the patient and whether they are still growing. In younger patients, especially those who are still in their growth spurts, bracing can be effective in preventing further curvature. In adults, especially after growth has ceased, the focus may shift to managing symptoms rather than correcting the curvature.

3. Symptoms: If you are experiencing symptoms such as chest tightness, back pain, or difficulty with prolonged sitting or standing, these may warrant further investigation. While scoliosis itself may not directly cause these symptoms, associated musculoskeletal issues could be contributing factors.

4. Multidisciplinary Approach: It may be beneficial to consult with a multidisciplinary team, including orthopedic surgeons, physical therapists, and possibly even chiropractors or acupuncturists, to develop a comprehensive treatment plan tailored to your needs. Physical therapy can help strengthen the muscles around the spine, improve posture, and alleviate discomfort.

5. Regular Monitoring: Even if immediate treatment is not necessary, regular follow-ups with a healthcare provider can help monitor any changes in the curvature or symptoms. This is particularly important if you notice any worsening of your condition or if new symptoms arise.

6. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or yoga. While these may not correct the curvature, they can help manage pain and improve overall well-being.

In summary, while your curvature of 22.2 degrees may not be deemed severe by some practitioners, it is crucial to listen to your body and seek further evaluation if you are experiencing significant discomfort or functional limitations. If you feel that your concerns are not being adequately addressed, seeking a second opinion or consulting a specialist in scoliosis may provide you with the clarity and reassurance you need. Remember, the goal is to maintain a good quality of life and manage any symptoms effectively.

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