Scoliosis

Bend slowly forward from standing, let the arms hang, and look from behind at the same height: does one side of the ribs stand higher? If both stay level, there is no twist — the bend is then usually a compensation and not a scoliosis.

Curves increase in the growth spurt and afterwards mostly stand largely still. That is why checks are at short intervals during growth and rare in adults — not because it then does not matter, but because hardly anything changes any more.

In growing adolescents with a mid-range angle a brace prevented progression so distinctly that the corresponding trial was ended early. The effect hung closely on the hours worn per day — wearing time is here the actual dose.

Targeted physiotherapy by the recognised methods improves complaints and trunk strength at smaller angles; that it substantially changes the angle itself is contested. Sport is not forbidden and was never a cause — restrictions concern only individual cases after surgery.

For many parents the real message: school bags, carrying on one side, sitting posture and sport showed no connection with its arising in studies. The commonest form arises without a recognisable reason — and not from something that could have been done differently.

Low values over a long time cause a dull ache in bones and trunk-near muscles, morning stiffness and weakness when rising from a chair. This is often blamed on posture.

Scoliosis is seen and measured, not measured in blood: forward bend test, standing X-ray, Cobb angle. Blood values only come in when a cause is suspected — creatine kinase in a muscle disease, for instance.

In adolescents with scoliosis, average bone densities lower than in peers have been measured. Whether that is cause, consequence or circumstance is open. The value still belongs to follow-up during growth.

Only if a muscle disease is suspected — if the curve appears very early, progresses quickly or comes with muscle weakness. In ordinary growth scoliosis this value is not an issue.

Without vitamin D only a fraction of the calcium from food is absorbed. It is therefore not one nutrient among others but the doorman for the most important one.

The building material itself. What counts is not the single portion but the amount over years — bone is remodelled lifelong, with peak mass around thirty.

Activates the proteins that hold calcium in bone. It is in green leafy vegetables and fermented foods. On coumarin-type blood thinners the amount is kept steady rather than avoided.

The curve follows growth, not the plate. What matters on the plate concerns the bone underneath — and that is a matter of years, not weeks.

No preparation changes a Cobb angle. What counts here concerns bone: in adolescents with scoliosis lower bone densities were measured on average than in peers. Vitamin D and calcium are therefore company during growth — treatment of the curve they are not.

The growth spurt is when something shifts in the spine — and the time when it can still be influenced. After the growth plates close, the shape is largely set.

Growth scoliosis affects girls markedly more often and progresses mainly in the years around the first period. After that it usually comes to a stop. Why is not settled.

Scoliosis follows growth. What counts on the plate concerns the bone underneath — calcium and vitamin D during growth, reckoned in years and not weeks.

It is not the session that works but what continues at home afterwards. After four to six appointments you can judge whether anything is moving.

For everything to do with statics, the method with the most data. What matters is not the kind but that it happens at all, and regularly — the back holds what it does daily.

Manual methods contribute nothing to the Cobb angle — vertebral rotation cannot be put back. Against accompanying tension they may help; that is a different aim and should be named as one.