Pain Relief From Sherman's Disease

Sherman's disease, or Scheuermann's disease, is an exaggerated rounding of the upper back. The condition---also called Scheuermann's kyphosis---typically begins between the ages of 12 and 15, and it affects girls more frequently than boys. Pain is a main symptom in as many as 50 percent of Scheuermann's patients. Methods for relieving this pain vary with the physical maturity of the patient and the degree of discomfort present.

Understanding the Condition

• According to the American Academy of Orthopaedic Surgeons, Scheuermann's disease most commonly occurs in the thoracic vertebrae (upper back), but it may also occur in the lumbar vertebrae (lower back). Any pain associated with the condition typically occurs at the central point of the spinal curvature. This pain may be worsened by physical activity or by prolonged periods of sitting or standing.

Nonsurgical Treatments

• If your child's Scheuermann's disease is diagnosed before skeletal maturity occurs, the standard method of treatment is to use a back brace designed to reverse the abnormal curvature. This will have the simultaneous effect of lowering your child's pain level and improving the chances of proper spinal growth. The length of time needed for this therapy will be determined by your child's doctor and may extend from one to two years. Determining factors in the time needed for bracing include your child's age, the severity of the spinal curvature and its rate of progression.

  During the first year of treatment, your child will probably need to wear a brace 24 hours a day. Be aware that the brace may be both physically and socially uncomfortable. As treatment comes to a close, your child will be gradually weaned from the brace, and the amount of daily time spent in it will decrease accordingly.

  Bracing for Scheuermann's disease is typically ineffective past the age of 16, when spinal maturity occurs. In these cases, the standard treatment for pain is physical therapy centered on exercises designed to strengthen your child's back and stretch the hamstrings. Your child's doctor may also recommend use of analgesics or nonsteroidal anti-inflammatory (NSAID) medications. Physical therapy may also be used in combination with bracing.

Surgery

• Surgery for Scheuermann's disease is usually performed when curvature of the spine is severe, or when neurological problems occur. However, surgery may also be performed to relieve pain that is not addressed through other means. Typically, your child's surgical procedure will involve removing the spinal discs in the affected area and fusing the vertebrae together with a bone graft. To hold your child's back in place while bone fusion occurs, the surgeon performing the procedure will temporarily implant supporting wires, bars or screws. Because there is little natural motion in the thoracic spine, this form of surgery does not typically cause serious restrictions of movement.

Treating Adult Cases

• If you suffer from the effects of Scheuermann's disease that was not diagnosed or treated in childhood, you may gain pain relief from NSAIDs or surgery. Consult your doctor for a discussion of the available options.