Schuermann’s Disease

Scheurmanns Disease is a condition that affects the discs and vertebrae of the Thoracic Spine (mid back), though the low back is also less commonly affected. Normally, a vertebra is rectangularly shaped, but in Sheuermanns disease, three or more consecutive vertebrae are wedge shaped at the front, which makes the curve increase.

It occurs in puberty, with boys and girls equally affected, and the incidence is below 10% of the population. The causes are unknown, though there is often a family history. Some of the mechanisms thought to be responsible are as follows:

• Disruption in the growth of the endplate of the vertebra due to collagen faults.
• Growth spurt stresses on the cartilage surfaces causing failure of the anterior part of the vertebral body (front part) to grow evenly with the back
• Tightness or thickening of the Anterior Longitudinal Ligament ( a long ligament running down the front of the spine)

Symptoms generally begin in puberty, with aching, weakness and postural faults being common. In adults, degenerative changes usually result in thinning of discs, general back ache and increased observable curve when bending forward.

Conservative management usually involves improving strength and flexibility of the back through exercises. Chiropractic care can help rehabilitate the spine through stimulation and improving muscle tone and joint function. Soft tissue massage is often taught to family members to relieve stress in the muscles and to relieve pain.

In severe cases, bracing is occasionally used, though this does not fix the problem. Surgical insertion of rods into the spine is also performed, though this should only be performed in severe cases, and only after extensively trying Physiotherapy and Chiropractic options as well as self care strategies to strengthen the back.