Back pain: how to detect and treat scoliosis?

Juline Garnier 6:36 p.m., March 03, 2022

Some will say that back pain is the evil of the century.

And one of these evils is now more easily detectable: it is scoliosis.

This disease is a deformation of the spine that occurs during childhood and adolescence.

There are several kinds with each specificity, as explained by doctor Jean-François Catanzariti, specialist in physical medicine and rehabilitation at the University Hospital of Lille and doctor at the scoliosis home in the program

on Europe 1.

Who is usually affected by scoliosis?

"It is a pathology that occurs especially during adolescence, because it is the moment when there is growth that is most important", begins the specialist.

Due to too rapid growth, the spine tends to twist.

The most common image given to children to explain this disorder is that of the spiral staircase and if the scoliosis is seen from the front, that of the "S".

Adults can also be affected by scoliosis but it is generally those who have grown up with it.

"However, it is not the growth that creates scoliosis but it is the growth that reveals it", specifies the doctor.

Thanks to the care, the scoliosis stabilizes.

However, it happens that it still evolves in adulthood.

According to Health Insurance, scoliosis affects on average 0.5 to 2% of 8-15 year olds and girls are statistically eight times more affected than boys.

A difference that currently has no sure explanation.

"Researchers from the Cotrel Foundation who work on this theme think that boys have protection, perhaps in relation to their hormones, especially testosterone. It may be protective of the development of scoliosis. But that's only "a hypothesis. For the moment, it is still unclear. It is a disease that remains quite mysterious", adds Jean-François Catanzariti.

What are the techniques to detect it?

To detect scoliosis, it suffices to observe the posture of the child.

A lower shoulder, for example, can be a good indicator.

If the child has scoliosis, he will have a "gibbousness" when he leans forward, that is to say a shift, or even a bump.

But the first reflex must remain screening with a doctor or physiotherapist.

Then if there is any doubt, the child has a total spine x-ray, ie a face and profile x-ray.

If it is easy to detect scoliosis, Jean-François Catanzariti denounces a lack of screening, especially in schools.

"I remember that very well during my childhood. We were in a row of onions and we passed behind us and we were asked to lean forward. The doctors looked at whether we had a humpback and it took twenty seconds", says doctor.

But this kind of screening has become rare over time.

"It's still part of what school medicine should do. The problem is that there are no more school doctors. And not many more school nurses so if we give them this mission, they will still be less available," he said.

The Cotrel Foundation recommends screening from the age of eight, the earlier the better.

Untreated scoliosis can have serious long-term consequences.

The spine is the pillar of the posture, and therefore what will allow you to be vertical.

This is also what will give support to the rib cage.

"Any pathology of the spine will act on your posture, will act on the rib cage, will deform it and will risk creating a limitation of the respiratory capacity, which is the main risk", explains Jean-François Catanzariti.

In adulthood, people with scoliosis risk having earlier wear, osteoarthritis and more significant herniated discs. 

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Treating scoliosis with exercise

According to the doctor, beyond bad postures, it is the lack of physical activity that aggravates scoliosis.

A recent study shows that in Western countries, there has been a very strong decrease in physical activity among adolescents for twenty years and France is 18th in the ranking.

It is therefore very bad.

"When you have scoliosis, you have to do sports to strengthen the muscles around the spine. For a long time, sports were contraindicated. There are a lot of false beliefs. You can do all sports, including so-called asymmetrical sports. Studies show that there is no more risk when you have severe scoliosis of playing tennis at a high level than swimming for example", explains the specialist.

However, he specifies that two sports can be dangerous at a high level: gymnastics and classical dance.

But only if they are practiced more than ten hours per week.

If the scoliosis is more severe and treatment through physical activity is not possible, other methods exist.

Physiotherapy sessions, possibly helped by other educators such as occupational therapists, podiatrists can help treat the pathology.

Finally, for the most serious cases, wearing a corset to effectively reduce the curvature of the spine.

According to the doctor, other methods are being studied and research continues on this mysterious pathology.