Scoliosis Awareness Month: What Maryland Families Should Actually Know

You’re standing behind your 13-year-old in line for ice cream, and her tank-top strap is sitting noticeably lower on one side. Or you’re walking behind your dad on a beach trip and notice his back has started to lean a little to the right. You’re not sure if you’re seeing something — or just noticing for the first time something that has been there a while.

June is Scoliosis Awareness Month, and at The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division (OACM), we use it to answer the questions families ask us most: What is scoliosis? Who actually needs to be evaluated? And what are the modern, conservative-first options if a curve is found?

Featured provider: Oren G. Blam, MD, a board-certified, fellowship-trained orthopedic surgeon at OACM specializing in spine surgery.

What scoliosis is, in plain terms

Scoliosis is a sideways curvature of the spine that’s more than just a slouch — the spine itself has rotated and shifted out of its straight up-and-down alignment (AAOS OrthoInfo). Small curves are common and may never cause symptoms. Larger curves can affect posture, comfort, breathing, and — in adults — back pain.

Scoliosis tends to fall into a few groups:

• Adolescent idiopathic scoliosis is the most common form. “Idiopathic” means the cause isn’t fully known. It usually shows up during the growth spurt of late childhood and early adolescence (AAOS OrthoInfo; Scoliosis Research Society).
• Adult degenerative scoliosis is a sideways curve that develops later in life as discs, joints, and bone density change with age (AAOS OrthoInfo).
• Congenital and neuromuscular scoliosis are present from birth or related to neuromuscular conditions and are managed by spine specialists from a young age.

Signs worth a closer look

For adolescents, signs that may be worth an orthopedic visit include:

• One shoulder sitting higher than the other
• One shoulder blade more prominent than the other
• A waist that looks uneven
• A rib hump, or a “fullness” on one side of the back when the child bends forward at the waist
• Clothes hanging unevenly

For adults, signs may include:

• A visible lean or change in posture over time
• New or worsening low back pain, especially with standing or walking
• Leg pain that follows a nerve pattern (numbness, burning, or weakness)
• Loss of height

None of these signs alone diagnoses scoliosis. They’re prompts for an evaluation.

What an OACM evaluation looks like

A scoliosis evaluation at OACM is usually a conversation, a focused physical exam (including the “forward bend test” for adolescents), and — when indicated — a low-dose X-ray of the spine. If a curve is present, your provider measures it using something called the Cobb angle, which is the standard way spine specialists describe and track scoliosis over time (Scoliosis Research Society).

A few specifics on screening: in 2018, the U.S. Preventive Services Task Force concluded that the current evidence was insufficient to recommend routinely screening every asymptomatic adolescent in primary care for scoliosis — neither for, nor against (USPSTF 2018). That isn’t the same as saying screening is unhelpful. It means parents, school nurses, pediatricians, and orthopedic providers should make sensible, individualized decisions. If you’re noticing changes, an evaluation is appropriate.

Treatment options, by curve and by goal

The right step depends on the patient’s age, growth status, the size of the curve, and what’s going on functionally. In broad strokes:

• Observation. Small curves, particularly in patients who are still growing, are often monitored with periodic exams and X-rays.
• Physical therapy and exercise. A spine-trained physical therapist can address postural control, flexibility, and core stability. PT is available at OACM PT locations in Catonsville, Clarksville, Columbia, Eldersburg, Ellicott City, Fulton, Laurel, and Westminster.
• Bracing. For adolescents with moderate curves who are still growing, bracing may reduce the likelihood of progression (AAOS OrthoInfo; Scoliosis Research Society).
• Targeted procedures and injections (adults). For adults whose curves are driving nerve pain, image-guided injections or minimally invasive decompression procedures may help quiet symptoms.
• Surgery. Reserved for larger curves, progressive curves, or curves that are clearly affecting function. Modern spine surgery is more precise and less invasive than it used to be, but it is still a serious decision and one that the patient, the family, and the spine team make together.

Featured provider

Oren G. Blam, MD is a board-certified, fellowship-trained orthopedic surgeon at OACM specializing in spine surgery. He earned his medical degree at Washington University School of Medicine in St. Louis, completed his orthopedic surgery residency at Thomas Jefferson University Hospital in Philadelphia, and completed a spine fellowship at Mount Sinai Beth Israel Medical Center in New York City. His clinical focus includes spine disorders, spinal stenosis, spondylolisthesis, degenerative discs, neck and back pain, minimally invasive spine surgery, cervical disc replacement, herniated discs, and revision spine surgery. He sees patients at OACM’s Catonsville, Columbia, and Eldersburg clinics.

Hear it from Dr. Blam

Dr. Blam walks through how scoliosis actually presents — the visual cues parents and adults can spot at home, what the forward bend test shows, and what’s worth scheduling an evaluation for.

Schedule a scoliosis evaluation

If you’re noticing changes in your child’s posture — or your own — call (410) 644-1880 or (855) 4MD-BONE to schedule a scoliosis evaluation with Dr. Blam at our Catonsville, Columbia, or Eldersburg clinic. Online scheduling is available . To start with physical therapy, our PT team can be reached at (443) 478-4449.

Frequently asked questions

The information in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always speak with a qualified orthopedic provider about your specific symptoms and medical history. To schedule an appointment with Orthopaedic Associates of Central Maryland, call (410) 644-1880 or visit mdbonedocs.com.