Ross Hauser, MD
Scheuermann kyphosis, also known as Scheuermann disease, juvenile kyphosis or juvenile discogenic disease, is a condition of hyperkyphosis that involves the vertebral bodies and discs of the spine identified by anterior wedging of greater than or equal to 5 degrees in 3 or more adjacent vertebral bodies. The thoracic spine is most commonly involved, although involvement can include the thoracolumbar/lumbar region as well. Most commonly, diagnosis is made in adolescents aged 12 to 17 years who present after their parents notice a postural deformity or “hunchbacked” appearance. Pain in the affected hyperkyphotic region may also be the cause of initial evaluation
Scheuermann’s disease, also known as adolescent kyphosis, Scheuermann kyphosis, juvenile kyphosis, or juvenile discogenic disease is a condition related to the curvature of the spine. While the normal curvature of the thoracic, or upper, spine is between 20 and 50 degrees, a curvature of more than 50 degrees constitutes Scheuermann’s disease. Adolescents 12 to 17 years old are most typically affected. As the disease progresses, the curve in the back may become exaggerated and the child will look as if he is slouching or is very round-shouldered. An obvious “hunchbacked” appearance and pain is what leads parents to bring their children to a doctor’s evaluation. Seemingly the worst symptom is self-perceived body image.
Causes of Scheuermann’s disease
The cause of Scheuermann’s disease is unknown but is thought to be due to a growth abnormality of the vertebrae, in which the growth plate in the front of the vertebrae stops growing while the posterior part of the growth plate continues to grow. Some attribute the disease to trauma to the growing spine or hormonal and nutritional deficiencies.
It is also influenced by spinal instability, which in turn is affected by ligament weakness and/or laxity. The spacing between the vertebrae is also affected. Individuals who do not have this condition have relatively uniform and rectangular-shaped spaces between their vertebrae. Individuals with Scheuermann’s disease, on the other hand, have spaces that become wedge-shaped. Scheuermann’s disease usually lasts for six months to three years. Any long-term effects are usually minimal, and if they do occur, they are usually helped with exercises.
Scheuermann’s disease treatments
Traditional treatment for Scheuermann’s disease usually involves a brace and physical therapy to deal with both the pain and the deformity that often results. Exercise has also been suggested to help relieve the pain, as has weight loss and the use of a rigid bed. In extreme cases, such as for spinal curvatures of 60 degrees or greater, patients may be referred to a surgeon. At this point, surgery usually can only address the deformity and not the accompanying pain. A spinal fusion may be suggested to insert rods and screws to straighten out the spine.
Prolotherapy for Scheuermann’s Disease
Our approach is to strengthen the surrounding ligaments of the affected vertebrae with Prolotherapy. If the vertebral wedging has progressed to an advanced stage, Prolotherapy treatments will relieve the pain, but the deformity will continue. In the event that a deformity has developed, kinesiotherapy, such as the CORE program, can be used to correct any musculoskeletal abnormalities.
When patients are having chronic, unresolved pain, it may be appropriate to consider Prolotherapy for strengthening the lumbar vertebral ligaments and preventing the progressive degeneration of the intervertebral discs that occur with age. Prolotherapy addresses pain caused by Scheuermann’s by strengthening the weakened vertebral ligaments, including the ligaments above and below the affected vertebrae.
A Case of Scheuermann’s Disease
In recent years we treated one woman with pain from Scheuermann’s disease. Diagnosed at age 11, she had struggled with pain most of her life. Now at age 36, she was in search of a new treatment to help with her pain. When she first saw us, she was having pain in her thoracic spine and low back pain. She also had knee pain. She had a bad habit of popping or cracking her back up to five times a day and had severe burning in parts of her spine. Prolonged sitting caused great pain in her back and knee. Although she had had ACL repair at 18 years old, her knee was a big problem at this point in time.
As mentioned in the video, people with Scheuermann’s disease often need Prolotherapy to just half of their thoracic or low back. In other words, Prolotherapy addresses the weakened ligaments plus the few above and below the affected vertebrae.
For this patient’s first treatment she received 20 injections to half of her thoracic spine, 50 injections to half of her sacroiliac joint, and 60 injections to her knee. When she returned one month later she said she was “doing amazing” and even endured the two-hour flight home with no pain at all. She no longer felt the need to pop her back (and had made an effort to stop, per instruction) and was feeling close to normal.
Over the next few months, she started feeling much better and returned to working out. While doing some isometric exercises she began to feel some numbness and pain in her coccyx.
The patient was treated, half of her low back and thoracic spine, with a strengthened Prolotherapy solution and gave her specific instructions for her workouts. Within 5 months, she was almost 100% pain-free. She received a fourth and final treatment and was told to follow-up as needed.
She returned a few more times over the next few years for various minor injuries – her ankle, wrist, and shoulder. As she increased her workouts she experienced a few “tweaks” here and there and knew to come to Caring Medical right away to take care of the injury before it escalated.
This case is just one example of the simplicity and effectiveness of Prolotherapy for any joint condition. Conditions that affect a person for their whole life may need just a few Prolotherapy treatments to better stabilize the area, relieving excessive stress on the ligaments, and alleviate pain.