Scheuermann’s Disease is a condition that affects the spine, leading to abnormal growth and development of the vertebrae. This condition is primarily found in adolescents and is most commonly seen in the thoracic (mid-back) area. It is characterised by a wedge-shaped deformity of the vertebrae, which results in an exaggerated forward curve of the spine, often causing a hunched or rounded back. Early diagnosis and intervention are essential in managing Scheuermann’s Disease effectively and preventing long-term complications. At Palms Physiotherapy & Allied Health, we specialise in providing individualised treatment plans for Scheuermann’s Disease to improve posture, reduce pain, and enhance overall function.
Scheuermann’s Disease – Causes, Symptoms, Diagnosis, and Treatment
What is Scheuermann’s Disease?
Scheuermann’s Disease, also known as Scheuermann’s Kyphosis, is a spinal condition that affects the growth plates of the vertebrae in the thoracic or thoracolumbar spine. Unlike normal spinal curves, the vertebrae in individuals with Scheuermann’s Disease are irregularly shaped, causing the spine to curve more than usual. This leads to an exaggerated thoracic kyphosis, which is often referred to as a "hunchback" or kyphosis. The condition usually develops during the growth spurt that occurs between ages 10 and 16 and is more commonly seen in males.
The deformity occurs when the front part of the vertebrae grows slower than the back, creating a wedge shape. Over time, this abnormality leads to a more pronounced curve in the upper back. While the condition is not typically life-threatening, it can result in significant discomfort, postural problems, and in some cases, complications such as back pain and difficulty breathing.
Causes of Scheuermann’s Disease
The exact cause of Scheuermann’s Disease is not fully understood, but it is believed to be related to a combination of genetic and environmental factors. Some of the possible causes include:
Genetic Factors:
There is a hereditary component to Scheuermann’s Disease, and it is more likely to occur in individuals with a family history of the condition. Some studies suggest that abnormalities in the growth of vertebrae may be inherited.Abnormal Growth of the Vertebrae:
The primary cause of Scheuermann’s Disease is an abnormality in the growth of the vertebrae during the adolescent growth spurt. This abnormal growth leads to wedge-shaped vertebrae, which result in an exaggerated curve of the spine.Poor Posture:
While poor posture does not cause Scheuermann’s Disease, it may exacerbate the symptoms and discomfort associated with the condition. A person with Scheuermann’s Disease may develop poor posture as they try to compensate for the spinal deformity.Mechanical Stress:
Repetitive or excessive mechanical stress on the spine during the growth years may contribute to the development of Scheuermann’s Disease.
Symptoms of Scheuermann’s Disease
The severity of symptoms can vary from person to person. Some individuals may have only mild symptoms, while others may experience more significant issues. Common symptoms of Scheuermann’s Disease include:
Kyphosis (Hunched Back):
One of the hallmark signs of Scheuermann’s Disease is an exaggerated forward curve of the spine, particularly in the thoracic region, resulting in a humped or rounded appearance of the upper back.Back Pain:
Individuals with Scheuermann’s Disease often experience back pain, particularly in the upper back. The pain is typically worse with prolonged sitting, standing, or physical activity and may be associated with muscle fatigue and stiffness.Postural Issues:
A person with Scheuermann’s Disease may have difficulty maintaining proper posture due to the spinal curvature. Over time, the abnormal posture may lead to discomfort and further musculoskeletal issues.Fatigue:
The abnormal spinal curve can place additional strain on the muscles of the back, leading to muscle fatigue and overall tiredness.Limited Range of Motion:
In some cases, the curvature of the spine can limit the range of motion, particularly in the thoracic spine, leading to difficulty in bending or twisting the upper body.Breathing Difficulty:
In severe cases of Scheuermann’s Disease, the deformity may impact the rib cage and lung capacity, leading to respiratory problems, such as shortness of breath.
Diagnosis of Scheuermann’s Disease
To diagnose Scheuermann’s Disease, your healthcare provider will begin with a thorough medical history and physical examination. Diagnostic procedures typically include:
Physical Examination:
The healthcare provider will assess your posture, spinal curvature, and flexibility. A physical exam will also check for signs of muscle weakness or fatigue associated with Scheuermann’s Disease.X-rays:
X-rays are essential in diagnosing Scheuermann’s Disease and assessing the severity of the spinal curve. An X-ray will help determine if the vertebrae are wedge-shaped and measure the degree of kyphosis. A curve greater than 45 degrees is typically considered significant.MRI or CT Scan:
In some cases, an MRI or CT scan may be used to assess the soft tissues of the spine, such as the spinal cord and nerves, to rule out other potential conditions.
Treatment for Scheuermann’s Disease
Treatment for Scheuermann’s Disease depends on the severity of the condition, the age of the patient, and the presence of symptoms. Treatment options can be divided into non-surgical and surgical approaches.
Non-Surgical Treatment Options
Physical Therapy:
Physical therapy is a cornerstone of treatment for Scheuermann’s Disease. A physical therapist will design a customized exercise program to strengthen the muscles of the back, improve posture, and increase flexibility. These exercises can help alleviate pain, reduce muscle fatigue, and prevent further deformity.
Key components of physical therapy include:Posture Correction: Exercises aimed at improving spinal alignment.
Strengthening: Focus on strengthening the back, shoulders, and core muscles to provide better spinal support.
Stretching: Improving flexibility to reduce stiffness and increase range of motion.
Bracing:
Bracing may be recommended for adolescents with Scheuermann’s Disease who are still growing. A back brace can help slow the progression of the curve and prevent it from worsening. The brace is typically worn during the daytime and may need to be worn for several months.Pain Management:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help relieve back pain associated with Scheuermann’s Disease. In some cases, your healthcare provider may recommend stronger pain medications or muscle relaxants.Activity Modification:
Individuals with Scheuermann’s Disease may be advised to avoid activities that place excessive stress on the spine, such as heavy lifting or high-impact sports. Maintaining proper posture and engaging in low-impact activities can help manage symptoms.
Surgical Treatment Options
In severe cases of Scheuermann’s Disease, particularly when the curve exceeds 70 degrees or causes significant pain or respiratory problems, surgery may be necessary. The most common surgical procedure for Scheuermann’s Disease is spinal fusion, which involves fusing the affected vertebrae together to prevent further progression of the curve.
Spinal Fusion:
Spinal fusion surgery involves the use of metal rods, screws, and bone grafts to fuse the affected vertebrae and stabilize the spine. This procedure helps to correct the curvature and prevent further spinal deformity.Vertebral Osteotomy:
In rare cases, a procedure called vertebral osteotomy may be used to remove part of the vertebrae and reshape the spine. This is typically only considered for very severe cases.
Rehabilitation and Recovery
After undergoing treatment for Scheuermann’s Disease, rehabilitation is essential to ensure proper healing and prevent future issues. This may include:
Postoperative Rehabilitation:
Following surgery, a rehabilitation program focusing on spinal strengthening, flexibility, and mobility will help restore function and reduce the risk of complications.Ongoing Monitoring:
Regular follow-up visits with your healthcare provider to monitor the curvature and overall spinal health are important, particularly for individuals with adolescent-onset Scheuermann’s Disease.
Conclusion
Scheuermann’s Disease is a condition that can cause significant discomfort and affect an individual’s quality of life if left untreated. However, with early diagnosis and appropriate treatment, individuals with Scheuermann’s Disease can manage the condition effectively and maintain a healthy, active lifestyle. If you or someone you know is experiencing symptoms of Scheuermann’s Disease, contact Palms Physiotherapy & Allied Health to schedule an appointment and learn how our physiotherapy and rehabilitation services can help.
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External Resources for Scheuermann’s Disease in Australia
Here are useful Australian resources for further information on Scheuermann’s Disease:
Better Health Channel – Kyphosis:
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/kyphosisHealthdirect Australia – Kyphosis:
https://www.healthdirect.gov.au/kyphosisSpine Australia – Scheuermann’s Disease:
https://spineaustralia.com.au/scheuermann-disease
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