Scoliosis

Among other memories of middle school, you might remember that once-a-year mysterious screening in gym class when a doctor took a cursory look at your back as you touched your toes. This simple, two-minute glance was to spot the early signs of scoliosis, a potentially devastating spinal condition that can progress if not diagnosed early. Here’s what you should know about this condition and related complications.

What is scoliosis?

Scoliosis is a condition involving an abnormal curve of your spine. The word itself comes from the Greek word skolios, meaning crooked, with the spine appearing to bend in a “C” to one side or, less commonly, an “S” shape.

Scoliosis affects between five and seven million people in the U.S. and can begin at any age. It occurs in between 1-2% of adolescents and in more than 50% of people over age 60. Girls and women are more likely to develop this condition, especially if they come from a family with a first-degree relative with the condition.

Scoliosis may be idiopathic, congenital, or occur as a consequence of another condition.

Idiopathic

A condition is idiopathic when no underlying cause can be identified. Most cases are considered idiopathic, as there is no clearly identified cause.

Congenital

Scoliosis that is present at birth occurs in less than one in every thousand births. This is a rare occurrence and is usually present with other conditions.

Scoliosis as a secondary condition

Scoliosis as a secondary complication of another condition may occur in concert with neuromuscular diseases such as:

Spina bifida
Cerebral palsy
Hereditary musculoskeletal disorders, including osteogenesis imperfecta, Marfan syndrome, Stickler syndrome, Ehlers-Danlos syndrome, and muscular dystrophies

Other less common causes include:

Physical trauma
Spinal stenosis
Bone collapse from osteoporosis

What are common scoliosis symptoms?

The main symptom of scoliosis is a visual curvature of the spine in one or two directions. However, before the spinal curve is visible, you may observe that clothes fit poorly or hang unevenly. There are few outward signs until the spinal curve becomes visible, at which point it’s important to work towards a formal diagnosis for treatment.

Other signs of scoliosis may include:

Uneven musculature on one side of the spine
Uneven hips
Different leg lengths
Imbalance
Prominent rib or shoulder blade caused by rotation of the ribcage

In severe cases, where the spine is curved at an angle of 25 degrees or more, patients may experience difficulty breathing, pain, and reduced functionality.

Left untreated, symptoms will continue to progress. Infections and damage may also occur in the heart and lungs due to friction of the rib cage against these vital organs.

How to get a diagnosis

Left untreated, scoliosis will worsen, resulting in a lower quality of life. The main diagnostic criterion for scoliosis is spinal curvature exceeding ten degrees in a single direction. This spinal curvature is measured by Cobb’s Angle using an X-ray.

Although a single plane establishes the diagnosis, scoliosis does occur in three different dimensions. This means that not only does the spine curve to the left or right (or both, in the case of an “S” curve), but it also moves either forward or back. These two directions are lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back).

5 potential scoliosis treatments

Although this condition can have a dramatic impact on overall quality of life, it can be treated with a variety of therapies that are usually delivered simultaneously. As with most medical conditions, early intervention can help treat the condition and prevent its progression.

Treatment depends on severity and location of the spinal curve and also considers the age of the patient. The following treatments can help minimize the impact of the spinal curvature, relieve any other symptoms, and prevent further curving.

Physical therapy: Physical therapy is for patients of any age and may occur in conjunction with a spinal brace. Physical therapy strengthens the muscles of the back and the abdomen to properly support a healthy spine.
Spinal braces: Braces are common for patients in adolescence. These help to direct the spine’s growth.
Chiropractic care: Chiropractic care can help correct misalignment in individual vertebrae.
Occupational therapy: Occupational therapy helps patients move properly through everyday activities to improve form and build muscle memory for the task.
Surgery: Surgery is usually reserved for patients with a curve of 45 degrees or more, or those who are likely to suffer physiological impacts from the curve (i.e., difficulty breathing)