Episode Transcript Excerpt

Dick. HOST: What symptoms should parents look for in their children?

DR. DICK: The visual signs are the starting point. Parents should look for uneven shoulder height — one shoulder sitting higher than the other. A prominent shoulder blade on one side. Uneven waist height or hips that don't appear level. The Adams forward bend test is a simple screen: have the child bend forward from the waist with arms hanging down. If there's a rib hump — where one side of the back is higher than the other — that warrants evaluation with a weight-bearing X-ray.

HOST: Should parents wait until after puberty to begin treatment?

DR. DICK: Absolutely not. The adolescent growth spurt is actually the highest-risk period for curve progression. Waiting until puberty is over means you've missed the most critical window for conservative intervention. The earlier we identify a progressing curve and intervene, the better the outcome.

HOST: What about adults — what symptoms should they look for?

DR. DICK: In adults, scoliosis is more commonly symptomatic. Chronic back pain, one hip riding higher than the other, difficulty standing straight for extended periods, fatigue. As the curve progresses in adults, nerve compression becomes more of a concern — radiculopathy, leg pain, numbness.

HOST: What's the connection between the nervous system and scoliosis?

DR. DICK: The spine houses and protects the spinal cord and nerve roots. As scoliosis alters the structural position of the vertebrae, it changes how load is distributed and can create pressure points on the nervous system. This is why scoliosis is not just a cosmetic issue — it has functional consequences that extend beyond the back itself.

Frequently Asked Questions

What symptoms should parents look for in children that might indicate scoliosis?

Visual signs to monitor include uneven shoulder height, a prominent shoulder blade on one side, uneven waist or hip height, and rib prominence on one side when the child bends forward — the Adams forward bend test. Any of these findings warrants a weight-bearing spinal X-ray evaluation.

Should parents wait until after puberty to have a child evaluated for scoliosis?

Absolutely not. The adolescent growth spurt is the highest-risk period for curve progression. Waiting until puberty is over means missing the most critical window for conservative intervention. Earlier detection increases the chances of successful treatment and reduces the risk of reaching surgical thresholds.

What are the symptoms of scoliosis in adults?

In adults, scoliosis is more commonly symptomatic than in adolescents. Chronic back pain, one hip riding higher than the other, difficulty standing straight for extended periods, and fatigue are common. As the curve progresses in adults, nerve compression becomes more of a concern — producing radiculopathy, leg pain, and numbness.

What goes on with the nervous system in scoliosis?

Nerves branch off the spinal cord like limbs of a tree. Even if a nerve is irritated at its root in the spine, its effects can radiate throughout the body. When the condition develops along the lumbar spine, sciatica can become a symptom of scoliosis in adults — pain felt along the pathway of the sciatic nerve into the lower back, buttock, and leg. Headaches reaching migraine status can also be a scoliosis symptom in different age groups.