What is Scheuermann’s disease?
Figure 1: Back Pain - Scheuermann’s disease - Physio Frenchs Forest, Physio Macquarie Park
Scheuermann's disease is a common condition, and it affects millions of people. In this guide to the spine-chilling condition that may or may not be plaguing your teenage son or daughter, we'll share everything you need to know about what it means to have Scheuermann's disease. You know what a vertebra is, right? If you don't, it's the bone that makes up your spine. Here's how Scheuermann's works: As kids grow into adults, their bones (including their spines) grow unevenly—not just in length but also in shape. In Scheuermann's disease, something goes wrong with the way these bones grow as we age. Instead of growing straight up and down like normal vertebrae should do, they curve forward towards the front of our bodies at an angle that can be anywhere between 15° (mild) to 50° (severe). The result is spinal curvature which may or may not cause pain depending on where along the spine it occurs and how severe it gets over time!
Figure 2: Back Pain - Scheuermann’s disease - Physio Frenchs Forest, Physio Macquarie Park
What are the symptoms of Scheuermann’s disease?
The most common symptom of Scheuermann's disease is back pain, which may be made worse by activities involving spine flexion (bending over), such as sit-ups. The pain may also be worse in the morning or when sitting for long periods of time.
Figure 3: Back Pain - Scheuermann’s disease - Physio Frenchs Forest, Physio Macquarie Park
How is Scheuermann’s disease diagnosed?
On physical examination:
Large curvature (hyper-kyphosis) in the middle of the spine and poked neck (refer to image 2)
Positive forward bend test (refer to image 3)
On an x-ray or EOS scan we find the following:
Schmorls nodes
> 40 degrees kyphosis
Ventral wedging >5 degrees in 3+ vertebrae
Irregular end plates
How is Scheuermann’s disease treated?
Scheuermann's disease is a congenital condition that will may worsen with time without treatment. If you want to avoid surgery, there are some exercises you can do to help with pain management and posture. These exercises aim to help re-align the spine as much as possible and improve range of motion. These exercises are similar to the exercises used in scoliosis management. These exercises are called ‘Schroth’ exercises and have shown to improve posture by reducing the hyper-kyphosis. Please refer to our Schroth physiotherapy education page for more information on these exercises.
In some severe cases bracing or surgery may be recommended. This is where the Physiotherapist and Orthopaedic Surgeon work together to ensure the child achieves the best possible outcome.