Scheuermann’s disease – symptoms, causes, and therapy options

Scheuermann’s Disease (Adolescent Kyphosis)

Scheuermann’s disease is a spinal disorder which often occurs in adolescents during the pubertal growth phase. As yet unexplained causes lead to the formation of wedge vertebrae, which cause a Curvature of the spine. Most often, the thoracic spine is affected, which can lead to a Hyper-kyphosis to the formation of a round back. But other deformities of the spine are possible. Affected often suffer from back pain. In most cases, a rather mild course, however, is expected to halt the disease in adulthood. Various forms of therapy are available to improve the condition and prevent a possible consequence of complaints.

Table of contents

  • The double S shape of the spine
  • Mark and the emergence of the Scheuermann’s disease
  • Physical therapy and sports
  • Orthopedic Technical Measures
  • Drug Therapy
  • Operation

A brief Overview

The following summary provides a quick Overview of the Scheuermann’s disease, which is the most common spinal disorder in adolescents. For further information and to know Details are listed in the following article.

  • Definition: Scheuermann’s disease is also called juvenile kyphosis or adolescent kyphosis is a spinal curvature in adolescence describes. In the case of a corresponding expression of a hump or other spinal deformities are starting to show.
  • Symptoms: The most common Symptom is back pain, caused by the existing poor posture and the related tension and blockages.
  • Causes:The causes are still largely unknown. A certain genetic component is assumed, whereas other assumptions, such as Incorrect loading and Overloading in the youth as a proven apply. A certain minimum load capacity of the spine, due to different diseases, may favor the Occurrence.
  • Diagnosis: Often an incidental finding, as there is no discomfort or visible changes in the spine are present. In addition to the anamnesis and clinical examination, x-rays of the entire spine for a precise diagnosis is essential.
  • Treatment: Conservative is Scheuermann’s disease with physical therapy, exercise and, where appropriate, with a supporting corset to be treated. Drugs are used to combat pain. Only in rare, very severe cases, surgery is considered.
  • Naturopathic treatment and alternative cures: the most Important pillar of a complementary treatment to form the osteopathy and chiropractic. In addition, homeopathy can assist with the application of Calcium carbonicum therapy.

Definition

Under the Scheuermann disease (also Scheuermann’s disease) is a growth disorder of the spine, in the youth’s age appearance and a painful spinal deformity (juvenile kyphosis) can lead to. It is now recognised that an imbalance in the growth of the base and cover plates of the individual vertebral body, draw the reason for the characteristic eddy’s attitudes deformities and the resulting failure.

Scheuermann’s disease is the most common spinal disorder in adolescence, the concern of the female and male gender alike. Most susceptible to the adverse developments on the spine of the teenagers during the growth spurt in puberty (and boys around twelve to seventeen years, girls are already about eleven to fifteen years). That more young men are affected than women, is now regarded as a misconception, possibly due to diagnostic difficulties.

The naming follows the Danish orthopedist and radiologist Dr. Holger W. Scheuermann (1877-1960) lodges, who described the disease in the year 1920, for the first time.

The double S shape of the spine

In addition to the protection of the spinal cord is the second main function of the spine, to allow the people an upright posture and an upright posture. Looking at the spine from the front or the rear, it appears to be in healthy condition straight. Seen from the side a curved shape, the so-called double-S-Form shows, however. This structure captures the daily loads in the best way possible and distributed to the entire vertebral body.

In the normal condition, the vertebrae of the neck and lumbar spine towards describing a slight curvature to the front to the chest or to the abdomen (lordosis) and the thoracic vertebrae, and the vertebrae in the area of the sacrum and Coccyx to point a curvature to the back-to-back (kyphosis).

Mark and the emergence of the Scheuermann’s disease

In the case of Scheuermann’s disease excessive curvature (Hyper-kyphosis) in the thoracic vertebrae area is in the vast majority of cases (Thoracic type). This can first of all fix reversible, but in the further course and, in the case of existing Congestion. This can result in the Affected also to a curvature of the back (hump) with the compensatory education an additional Überkrümmung in the lumbar area (hyperlordosis), which is also referred to as a reinforced hollow back (thoraco lumbar-type).

A rather rare Form of Scheuermann’s disease affects primarily the lumbar spine (Lumbar type). This leads to a reduction of the natural lordosis (flat back) to an oppositely oriented kyphosis in the lumbar area. Concomitantly, it can also lead to instabilities of the spine with spondylolisthesis.

It is assumed that, as a result of stress, in youth, to damage to the cartilage-bone Connections, and the localized growth zones of the vertebral body. As a result, the front (ventral) and posterior (dorsal) to grow vortex areas is not uniform and there is a vortex shape that resembles a wedge instead of a cylinder. In the case of Scheuermann’s disease several to be found this so-called wedge vertebrae on top of each other, the cause of the abnormal curvature of the spine. The present vertebral deformity in Scheuermann’s disease is by definition an asymmetry of at least five degrees.

In the damaged vertebral areas (restless vortex also has the small cavities (surfaces) caverns), in the surrounding disc material (disc break-ins). This, for the shy man’s disease typical appearance, it is called Schmorl’sche nodules or Schmorl cartilage nodules. In rare cases, it may even lead to a Collapse of the vertebral body cover plates.

While the disease comes to the body growth to a standstill, can cause the resulting bad posture of the spine in adulthood to further back problems.

Symptoms

The spinal curvature in Scheuermann’s disease differs based on the exact Position and severity. Therefore, different and varying degrees of symptoms. Thus, milder forms may remain symptom-free and up to a possible random finding undetected.

In the case of more severe forms of weigh-in can occur in addition to the above-described (visible) deformations of the spine in the first line pain in back. The pain often develop due to of motion and functional limitations, which form as a result of incorrect posture and Incorrect or Overloading. For example, muscle tension (muscle hard spun), blockages and stiffness in the back. These problems can afflict young people and adults develop. Mental stress can arise in young people, for aesthetic reasons, for example, if a turn back is clearly visible.

More serious forms with a deterioration of the curvature angle (Cobb angle), and other degenerative changes in the spine (osteochondrosis, herniated disc), as a late consequences in adulthood (Post-Scheuermann syndrome) are rare.

Respiratory problems due to the extreme flexion, and neurological sensory disturbances occur only sporadically. Usually, the prognosis is quite good and the parties Concerned with a proper treatment and without added health limitations no serious complaints.

Causes and possible risk factors

The exact causes are not yet known. It is believed a certain amount of genetic Disposition, as in certain families the disease occurs more often.

The assumption that the degree of Overload (e.g. high-performance sport) or improper loading, such as prolonged flexed sitting posture with lack of compensation, the reason for the development of Scheuermann’s disease, is not sufficiently investigated or confirmed. A certain minimum load capacity of the spine, due to different pathological disorders or vitamin deficiency syndromes, with implications in the area of the vertebral body, can play in disease formation.

Just as a muscle imbalance, an imbalance between Agonist and Antagonist can cause, the Scheuermann disease. Are your back and abdominal muscles are not trained equally, this reinforces attitudes certain to fail. Also load and the load capacity in imbalance, this can have particular consequences in the growth phase.

Diagnosis

Disease is not discovered Scheuermann, only random, but are looking for Affected due to certain the symptoms of medical advice, is a detailed investigation relevant to other possible diseases of the spine, to exclude. Frequent differential diagnoses are weaknesses, for example, other congenital or acquired Kyphosis, Posture or osteoporosis.

In the first line is first of all carried out a detailed medical history, which includes a survey of pain symptoms and any other complaints. For example, it dealt with the pain of the character and after the first Occurrence of the symptoms asked. Usually, information for the workplace and for leisure activities and everyday physical stress and athletic activity to be consulted.

Furthermore, it is then performed a clinical examination, which takes place in the majority of cases in orthopaedic practice. The deformation of the spine and their effects are recorded in the best possible way. In the further course of an x-ray examination then closes. In General, lateral Thorax made recordings from the thoracic vertebrae area. To diagnose the Scheuermann’s disease safely, and to describe in more detail, it must be the whole of the spine in the x-ray image visible. With the help of these images, the wedge vertebra with the corresponding angle of curvature can be measured. The Schmorl bodies and the opposite so-called Edgren-Vainio-characters can be displayed on the x-ray images of the bone structure.

Rarely, other imaging procedures, and additional laboratory investigations for the diagnosis of hedge used.

Treatment

As the goal of therapy is the prevention of a Fort first screams of the spine deformation, and in the best case, a correction of this Curvature ends. There are pain, are pain reduction or elimination of complaints are important treatment basics. According to the expression and severity of the accompanying symptoms, different therapeutic measures are considered. As a rule, conservative therapy is in the foreground, and only in the case of serious disease and the corresponding medical indication is carried out an Operation.

Physical therapy and sports

The most important therapeutic measure consists of regular physical activity and physiotherapy to strengthen the Affected by compensation Exercises and movements, particularly the anti-kyphosierende muscles. In addition, the flexibility of the spine is to be improved and maintained over the long term. For the effectiveness of physiotherapy, it is important that the Exercises are carried out in everyday life. In the hours of Therapy will put together a customised training programme.

Even with slight variations, which do not cause any discomfort and do not require treatments are General Exercises to maintain the health of the Back is advisable. The sports should also be back-friendly.

Orthopedic Technical Measures

After a certain degree of Curvature (from about forty-five degrees), and a correspondingly serious incorrect posture, the spinal support is recommended by means of a corset, to an exacerbation of the condition counter. In the first year of treatment, the corset should be worn permanently, later, the Wear can be limited on the night.

Although there is good therapy are a consequence, is rejected this type of therapy is often, especially by young people, the fear of stigma. In any case, this type of treatment with physiotherapy is not to accompany, in order to reduce the mobility.

Drug Therapy

The use of drugs serves only a symptomatic treatment and focuses on the relief occurring pain and tension by analgesics and muscle relaxants. The General mobility can not be improved by these drugs, but according to a Troubleshooting.

Operation

In rare cases, a severe curvature in adults, from about sixty degrees and a severe symptoms, a surgical intervention can be considered. This should always be done under a careful consideration to the possible complications, and late effects (such as a Spinal fusion).

In the case of the costly surgical affected intervertebral discs are replaced with action and with the body’s own bone material. The spine is also by means of other auxiliary materials and stabilized. Often Sufferers have to carry on for months after the Operation a corset. And also the post-operative physiotherapy is an important part of a successful therapy, the robustness and flexibility of the spine after a procedure like this to rebuild.

Naturopathic treatment and alternative healing methods

In addition to physiotherapy, the osteopathy and chiropractic can help to alleviate the possible consequences and discomfort due to tension and poor posture.

Concerned should make sure that no additional burdens for the spine to elicit, such as, for example, by strenuous, back harmful activities (heavy Lifting) or by being Overweight.

Is complementary to the already mentioned forms of therapy, possibility in the field of homeopathy is one of the most commonly used agents as an alternative treatment to the use of: Calcium carbonicum. This is a large proportion of oyster shell lime and is often used for the development of disorders of the skeletal system, such as spinal curvature, to the application. (tf, cs)

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