Scheuermanns Disease

A 19-year-old male appeared in my office in March with complaints of pain in the middle and lower back with a curve in my back. The patient stated he wanted it straightened. The patient related that this attack started in February and that he had never had it before. The patient related a previous diagnosis of curved spine. The patient described his pain as a constant dull pain, with trouble sleeping and slight pain on inspiration. He related relief when he took a hot shower.

Examination of this patient revealed a well nourished, slightly overweight 19 year old male. Palpable areas of tenderness in the mid-back and low back. Chest expansion measured at 2 1/4 inches. Reflexes of UE and LE were +2 and equal, bilaterally. Valsalvas was positive on the left and right sides. Milgrams test was positive bilaterally. Dorso-lumbar ROM within normal limits without pain. Kemps test positive bilaterally. Cervical spine ROM within normal limits with pain on flexion and extension. Compression tests were positive on the left and right. Grip strength in this right handed individual was 95/85 on the right and 70/80 on the left. Due to the pain pattern described by the patient and the clinical findings, a computer enhanced muscle test was performed. Findings indicated elevated areas of tonicity (not muscle spasms) in the cervical area, the mid-back area and the low back area.

X-rays were taken of the patients thoracic spine and lumbar spine. Lateral view of the thoracic spine revealed loss of vertebral height from T6-T11 with moderate thoracic kyphosis. The patient and his parents were informed of my findings. I suggested the possibility of Scheuermanns Disease and advised the need for a bone scan to determine if the bone compressions represented an active bony lesion. The patient and his parents agreed.

I ordered a bone scan at a local diagnostic facility. Results indicated a very active area in the thoracic spine consistent with the x-ray findings. The radiologist suggested an MRI of the thoracic area. The patient and his parents were advised and I ordered the MRI. The MRI revealed findings consistent with the x-rays. There were no marrow lesions or any other significant abnormality. The diagnosis of Scheuermanns Disease was confirmed.

The patient and his parents were informed of all tests findings and the diagnosis. The patient was advised of his treatment options to include traditional medical approach and conservative chiropractic care. In addition, the patient was given nutritional advice to include minerals and antioxidants. The patient agreed to conservative chiropractic care.

The patients treatment began with work concentrated in areas above and below the bony lesions. The patient noticed immediate results in his complaints of constant dull pain. The patient related sleeping better the first night after treatment began. The patient was placed on minerals. A treatment plan was discussed with the patient and agreed upon.

The patient progressed with his treatment plan. He was very cooperative in his care and consistent with his appointments. The patient was placed on preventative care in June with instructions to continue exercise and supplements. He was to return in one month.

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