I saw my GP today who was lovely. But…
The over-arching view of the NHS at all levels from GP to Consultant Surgeon seems to be that ‘Nothing Helps Scoliosis’.
This position is adopted at all levels because there are no clinical trials to show whether or not conservative therapies actually work. And no one working in the NHS system can give a recommendation for a form of therapy that is not clinically proven.
OK, I can understand that position, but it also frustrates the hell out of me. Scoliosis treatment in Europe, America and China is viewed very differently and patients are quickly introduced to an exercise programme that will strengthen and rebalance their muscles, reducing curve progression and reducing the number of cases where spinal surgery is required. Why doesn’t that happen in the UK?
The difficulty with providing ‘evidence’ from controlled clinical trials is that it requires there to be a ‘control group’ who receive no physical therapy. Who would volunteer to be in that control group? As a parent I would want my child to be in the active exercise group as this gives them the greatest chance of controlling their curve.
The Gap in the NHS
There seems to be a gap in the NHS management of Scoliosis. To obtain a diagnosis you need to visit your GP. They will ask you to perform the ‘Adams’ forward bend test and if that shows an irregular ‘hump’ on one side of the spine they will give you a referral to…A SURGEON!! Surely there should be an intermediate step between GP and surgeon? The cost of spinal surgery is enormous – surely it would make sense to reduce the number of people needing surgery by providing a programme of physical therapy?
This is an issue that really bugs me and I will no doubt return to it!