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col Anxiety a tragic symptom of mild scoliosis

By Dr. Allen Douma

Tribune Media Services

Q: My 14-year-old daughter has an S-curvature of her back, which the doctors call scoliosis. They say it's not bad enough to do anything about now and, in any case, it would be better to wait until she's older. But the doctors just don't understand how bad it is for her. She's afraid to go to the gym and I'm afraid of what it will do to her social life with boys. -- K.L., Virginia Beach, Va.

A: So many times I've wished I could wave a magic wand and get a person -- especially a child -- to stop worrying about what others think of the way she looks.

Because we live in a society that puts so much emphasis on physical image, most of us are conditioned to be concerned about something that doesn't, in the long run, really matter.

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I urge us all, in the aftermath of the great tragedy of Sept. 11, to re-evaluate our priorities. At bottom, we're more alike than different. We should focus on those things that bring us greater peace and harmony.

Scoliosis may be mild enough, as it is, perhaps, in your daughter's case, so that treatment will produce minimal benefit for the effort required. Let me explain.

The spine, or backbone, is a column of composed of many individual bones called vertebrae, with disks made of cartilage in between. Changes to or abnormalities of the vertebrae and disks can affect spinal curvature.

Scoliosis is the abnormal side-to-side curvature of the spine (typically an S-curve), as opposed to the straight-up-and-down spinal column (looking from the side, we all have curvature normally). It is usually seen in the middle and lower back (the thoracic and lumbar regions) and is associated with some rotation of the involved vertebrae.

Most scoliosis (75 to 80 percent) is idiopathic, which means we don't know what causes it. Idiopathic scoliosis is a disease of the young and usually identified by screening exams of young adolescents at school. It is much more common in girls. About 4 percent of children 10 to 14 years old have detectable scoliosis.

Scoliosis can also be congenital (inherited), but the incidence of this form is less common (5 to 7 percent) than that seen in older children.

Some scoliosis can begin later in life. This form can be caused by neuromuscular and other diseases, including polio, cerebral palsy and osteoporosis.

Also, physical trauma, if not treated properly, can cause damage to and changes in the vertebrae of the spine and thus affect curvature. Diagnostic X-rays should pick up evidence of spinal trauma.

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Mild scoliosis does not usually produce clinical symptoms. The major symptom of moderate scoliosis is fatigue in the back after standing and sitting for a long time.

The severity of back pain is related to the severity of the curvature. Also, the more severe the curvature, the more likely the condition will worsen. If the curvature does worsen, surgery may be very helpful.

If you are concerned that the psychological impact it too great, then meet with the doctor to discuss it more fully. Obviously, if you are still dissatisfied, consider another opinion from a health professional specializing in psychological issues.

The children of the world need so much reassurance as they grow and develop their own sense of identity. Now is an especially important time to help them.

Dr. Allen J. Douma writes a daily column on a variety of medical and health issues. Write to him in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1500, Chicago, IL 60611; or contact him at DRFamily@aol.com.

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