LETTERS: It is time again for children to lug their heavy bags when schools reopen on Jan 20. For many years, the issue of heavy school bags has been hotly debated in the media.
The long-standing health issue related to heavy school bags is scoliosis, a common spine deformity characterised by a side-way bending of the spine by more than 10 degrees.
The majority of scoliosis cases are due to unbalanced muscles, ligaments from unhealthy postures, and these eventually progress into bony deformities.
The most common symptom of scoliosis is chronic back pain, which may eventually lead to disc prolapse and nerve compression. Studies suggest that scoliosis affects two to three per cent of the Malaysian population — between 600,000 and 900,000 people.
It is usually first diagnosed among girls in their teenage years. It progressively deteriorates during adolescence, slows down during adulthood before worsening again in old age when osteoporosis sets in.
So, it is important to diagnose this early. Otherwise, spinal surgery will become imperative.
During the early stages, physiotherapy comprising stretching and muscle-strengthening exercises offers one possible option. However, that can sometimes fail to correct the deformity.
Given their lack of scientific knowledge, desperate parents of scoliotic children often end up spending lots of money on alternative therapies, including those not approved by the Health Ministry, before ending up with surgery.
Another variant of physiotherapy for scoliosis is similar to that of orthodontic treatment for malalignment of teeth.
Here, exercise therapy is used to strengthen specific muscles to slowly correct the bony deformities. When correct muscles at specific positions are properly trained, they may significantly improve the outcome of scoliosis management.
However, such treatment has its limitations. Poor patient compliance and a standard regime for a relatively wide range of scoliosis contribute to a poor prognosis.
To overcome this, we offer suggestions to spare the patients from pain and agony.
FIRST, public authorities such as the Education and Health Ministries and interest groups should undertake massive public campaigns to instil and enhance public awareness on scoliosis.
Correct information will help with the early detection of any deformities. They can then make informed decisions based on available treatment options.
Such knowledge gathered from these awareness campaigns should also augur well for patient compliance with the treatment, so that sufficient time is accorded for the physiotherapy to show positive results.
SECOND, health authorities — public and private — should boost a collaborative partnership between the orthopaedic surgeon and the physiotherapist in the management of scoliosis.
The orthopaedic surgeon, as a specialist, should be placed at the top of the hierarchy in the management of scoliosis because the surgeon has the requisite knowledge and skills to treat patients better, and not just because they have a licence to perform invasive surgery.
THIRD, the government and the private sector should ensure maximum availability of knowledge, resources and tools to health professionals so they can make an accurate diagnosis.
This will ensure more objectivity in assessments and better customisation of specific and targeted exercises for scoliosis patients.
Also, both public and private sectors should galvanise expertise from other fields by enhancing collaboration across health disciplines.
FOURTH, universities should forge greater partnerships with the private sector so that they can have access to better tools which will enable physiotherapy to be carried out effectively.
Information and resource-sharing coupled with public-private partnerships should enable the public to obtain a leap in value at a relatively low cost in the treatment of scoliosis.
Associate Professor Dr Yu Chye Wah, dean;
Associate Professor Dr Chew Heng Hai, adjunct research & innovation consultant, Faculty of Allied Health Professions, AIMST University, Malaysia
The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times