Scheuermann’s disease was first described in 1920 by Holger Werfel-Scheuermann after he examined a 16-year-old farmer who presented with a stiff and rounded upper back. Holger initially called the condition Osteochondritis deformans juvenilis dorsi. These days Scheuermann’s disease (SD) is also known as juvenile kyphosis.
Scheuermann’s disease can affect up to 8% of the general population, with symptoms becoming apparent most commonly between the ages of 8 and 16. It is believed SD occurs equally among males and females.
The condition is characterised by excessive rounding predominately of the upper back with increased curvatures of the spine above and below this region. The excessive rounding can worsen during growth spurts, however this does not occur in all cases. SD is the most common cause of rounded backs in adolescents and can be misdiagnosed as poor posture.
The exact cause of SD is unknown however a strong hereditary component has been linked with an autosomal dominant pattern of inheritance. Excessive loading of the spine and aseptic necrosis of the ring vertebral apophyses have also been thought to contribute to the condition.
SD can be pain free and individuals commonly seek treatment for cosmetic reasons (as a result of parental concern). Individuals may have stiffness of the upper back, which in turn can cause restrictions in sports and activities. The excessive rounding of the back can result in adaptive postures of the neck and low back, accompanied by weak abdominal muscles and tight hamstrings. In more severe cases individuals may experience neurological signs such as tingling or numbness.
SD is formally diagnosed with a physiotherapy examination and x-ray. The physiotherapist will rule out other potential causes of the presenting symptoms, while a scan will reveal irregular growth of the vertebrae (spinal segments).
Treatment of SD depends on the age of the individual, the severity of the condition and pain levels. Initial treatment involves reducing the excessive rounded back and associated symptoms with postural correction and exercises to strengthen the surrounding muscles. Stretching of the chest and associated regions may also be prescribed by your physiotherapist. More severe cases may require the use of a brace to restore proper alignment with surgery rarely required. Individuals with SD often make a full recovery with no future issues.