Scoliosis involves an abnormal curvature of the spine. According to the American Association of Neurological Surgeons, about 2-3% of the population in the United States has scoliosis.1
Most spines have a slight backward or forward curve. Those with scoliosis may have an abnormal sideways curve, causing mild curves that do not require treatment. However, in some cases, scoliosis may lead to more extreme symptoms and complications, and treatment may be recommended.
What Causes Scoliosis?
Most scoliosis cases are caused by an unknown condition known as idiopathic scoliosis. Although anyone can develop scoliosis, certain things increase your risk, including:
- Family history: Scoliosis may have a genetic component, and having a family history may increase your risk. However, most children with scoliosis do not have a family history.
- Gender: Although males and females develop scoliosis at about an equal rate, gender may affect the severity of the condition. According to the Mayo Clinic, females are more likely to have worsening scoliosis, which requires treatment, than males.2
- Spinal injury: A previous spinal injury that affected the muscles or nerves of the spine may increase your risk of developing scoliosis.
Types of Scoliosis
There are multiple types of scoliosis:
- Congenital scoliosis: Congenital scoliosis is a rare spinal abnormality that presents at birth. It develops when the vertebrae misform during fetal development.
- Neuromuscular scoliosis: A curvature of the spine can develop due to a condition that affects the nerves or muscles in the spine, such as spina bifida, muscular dystrophy, and cerebral palsy.
- Degenerative scoliosis: Degenerative scoliosis develops in adults due to conditions that cause spinal degeneration, such as osteoarthritis.
- Idiopathic scoliosis: The term “idiopathic” means the cause is unknown. As the most common type of scoliosis, research continues to determine the cause.
Symptoms of Scoliosis
In many instances, scoliosis does not cause symptoms. However, when symptoms do develop, they may include:
- Back pain
- Weak core muscles
- Bad posture, including trouble standing upright
- Leg pain, weakness, or numbness
In addition to the symptoms above, individuals with scoliosis may present with the following signs:
- Visibly curved spine
- Shoulder blades that protrude
- Uneven shoulders
- Uneven waist
- Hips that are elevated on one side
- Uneven leg length
- Head that doesn't center above the pelvis
In some instances, individuals may notice scoliosis signs themselves. In other cases, they will be noted by a physician during a physical. The more severe scoliosis someone has, the more signs and symptoms they may exhibit.
Scoliosis Diagnosis
A scoliosis diagnosis starts with a medical exam from a healthcare provider. The doctor will take a medical history and perform a physical examination to look for signs of scoliosis, such as uneven hips or shoulders.
After a physical exam and a review of symptoms, your provider may order spine imaging tests. Imaging tests, such as an X-ray, CT scan, or magnetic resonance imaging, may help detect a curvature of the spine.
If your physical examination and imaging tests result in a diagnosis of scoliosis, your provider will discuss the degree of curvature and any recommended treatment.
Does Scoliosis Affect Different Parts of the Spine?
Although scoliosis can affect any part of the spine, some areas are more likely to be affected based on age. For example, the thoracic spine is usually involved in adolescent idiopathic scoliosis, while the lower back or lumbar spine is most often involved in adults. This difference in affected areas is often the result of aging conditions, such as disc degeneration and arthritis.
Does Scoliosis Vary In Severity?
Scoliosis varies in severity and is measured in degrees.
The severity of scoliosis is as follows:3
- Mild scoliosis is a spinal curve of 10 to 24 degrees
- Moderate scoliosis is a curve between 25 and 39 degrees
- Severe scoliosis is a curvature of more than 40 degrees
A physician will use a scoliometer to measure the spine's curves and an X-ray to determine the extent of the scoliosis curvature.
The curve progression may increase over time. For example, someone who has mild scoliosis when they are young may have curvature progression as they age, causing moderate scoliosis
If the scoliosis curve worsens, untreated scoliosis can lead to certain complications. A severe spine curve can affect lung expansion, posture, and overall quality of life.
Complications of scoliosis can develop and may include:
- Chronic back pain
- Physical deformity
- Organ damage
- Nerve damage
Scoliosis Treatment
Once someone is diagnosed, one of the first questions is often how to treat scoliosis. However, treatment is only needed if symptoms are present and bothersome. Treatment aims to reduce symptoms, prevent the curve from worsening, and improve functioning.
When doctors determine how to fix scoliosis, they may consider the severity of your curve, symptoms present, and underlying health conditions. Possible treatment for scoliosis includes the following:
Non-surgical scoliosis treatment
If treatment is needed, most treatment will be non-surgical, such as:
- Pain medication: Doctors may recommend over-the-counter pain medications, such as non-steroidal anti-inflammatory medications.
- Exercise: Regular exercise, such as swimming, walking, and yoga, may help prevent the curvature from worsening.
- Physical therapy: Physical therapy may also help improve posture or strengthen the muscles supporting the spine. As muscles become stronger, the curvature of the spine may decrease.
- Back brace: Wearing a back brace may support the spine and decrease pain. The time a person needs to wear a scoliosis brace depends on their severity, age, and goals.
Surgical treatment
When non-surgical treatment is ineffective, scoliosis surgery may be an option. Surgery may reduce pressure on your nerves, stabilize the spine, and improve functioning. It may also be recommended for children with severe curvatures of 45 to 50 degrees or higher.4
Different surgical techniques may be recommended. For example, spinal fusion surgery involves fusing two or more vertebrae, which helps straighten the spine and prevent the curvature from progressing.
Another type of scoliosis surgery is an expandable rod procedure. This surgery involves inserting an expandable rod along the vertebrae to support a child's spine and help reduce the curvature as the child grows.
Surgical procedures continue to evolve. Newer procedures involve computer-assistive technologies, which provide a less invasive approach and faster recovery time.
Living with Scoliosis
Individuals with mild scoliosis generally do not experience any restrictions, limitations, or significant pain. However, people with more severe scoliosis may have to adjust certain activities that cause pain.
Most people with scoliosis can participate in regular activities, including sports. In fact, exercise may reduce the severity of symptoms. Depending on treatment, those with scoliosis may have temporary restrictions on certain activities.
Conclusion
Scoliosis involves an abnormal sideways curvature of the spine. Treatment for scoliosis may decrease pain, reduce spinal curvature, and prevent the condition from progressing. Untreated scoliosis can lead to chronic pain and interfere with quality of life.
If you have any questions about scoliosis or its treatment, we are happy to help. If you would like to schedule a consultation, please call us at 480-573-0130
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References
- Scoliosis. American Association of Neurological Surgeons. (2024). https://www.aans.org/patients/conditions-treatments/scoliosis/
- Scoliosis. Mayo Clinic. (2024). https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716
- Scoliosis. Cleveland Clinic. (2024). https://my.clevelandclinic.org/health/diseases/15837-scoliosis
- American Academy of Orthopaedic Surgeons. Surgical Treatment for Scoliosis. (2024). https://orthoinfo.aaos.org/en/treatment/surgical-treatment-for-scoliosis/
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