What is Scoliosis?
It is natural and healthy for the spine to curve from front to back, but when it becomes an abnormal curvature or also referred to as a sideways curvature of the spine, it becomes an issue.
Scoliosis is a malformation of the bones or “vertebra” that causes one side of the vertebrae to be longer than the other. The vertebrae in a scoliotic spine are wedge-shaped, tall on one side and short on the other. On an x-ray, the spine of a person with scoliosis looks more like an “S” or “C” rather than a straight line.
There Are 5 Types of Scoliosis:
- Idiopathic Scoliosis: in this case, the cause is unknown. It is the most common type of scoliosis, representing about 80% of all cases. The onset of idiopathic scoliosis generally happens between the ages of 10 to 15.
- Congenital Scoliosis: meaning ‘born with the condition’. As the spine formed before birth, scoliosis started to develop by the vertebrae incorrectly forming or separating improperly. Individuals with congenital scoliosis may also have other conditions related to the heart or kidneys.
- Neuromuscular Scoliosis: in this case, it affects the nerves and muscles. Neuromuscular scoliosis is generally caused by conditions such as cerebral palsy, muscular dystrophy, and spinal cord injuries.
- Degenerative scoliosis: This type of scoliosis occurs as a result of wear and tear on the spine over time. It is most commonly seen in older adults.
- Functional scoliosis: This type of scoliosis is caused by a problem in another part of the body, such as a difference in leg length or muscle spasms.
Scoliosis is considered a common condition and it affects about 3 % of the population or roughly about 8 million people in the United States.
Early diagnosis is the most important factor in scoliosis treatment, so it is important to monitor the spine during the average age of onset from 10 to 15 years of age.
If scoliosis is diagnosed and treated early, there are many more options available for treatment. If scoliosis is diagnosed and treated too late, treatment options may be more limited.
What Causes Scoliosis?
In most people, there is no known cause for scoliosis, and therefore it is commonly known as idiopathic scoliosis. It is considered idiopathic when the doctor is unable to find any other condition that is causing the curvature.
It is the most common type of scoliosis seen in children, however, scoliosis can present in people of all ages. It can be found in very young children from the time of standing to walking, but it is most common in those over 10 years of age.
Congenital scoliosis is caused by a birth defect that affects the development of the bones in your spine, and neuromuscular scoliosis is caused by certain conditions involving the nerves and muscles, such as cerebral palsy, muscular dystrophy, and spinal cord injuries.
Scoliosis can also run in families, so there can be a strong genetic component to the origins of most scoliosis. Therefore, a child who has a parent, or siblings with idiopathic scoliosis should be regularly screened for scoliosis.
Can Scoliosis Be Prevented?
Whether or not you develop scoliosis primarily depends on your genetic makeup.
Although scoliosis can’t be prevented, there are aspects of the condition that you can control.
You can control how early the scoliosis is diagnosed, by monitoring the spine during the average age of onset, 10 to 15 years of age. If scoliosis runs in your family, there is a 25% chance that it will affect other members of the family as well.
Early diagnosis is the most important factor in scoliosis treatment. If scoliosis is diagnosed early, there are many more options available for treatment.
What Are the Most Common Signs and Symptoms?
Depending on the severity, and symptoms of scoliosis, the most noticeable signs are physical asymmetries caused by spinal curvature, including:
- shoulders are different heights
- one shoulder blade sticks out more than the other
- the head is not centered on the body
- hips are different heights
- one hip sticks out more than the other
- one side of the rib cage sticks out more
- ears are not aligned with shoulders (when viewed from the side)
- one leg shorter than the other
- body leaning to one side
- back pain
In many cases, scoliotic curves alone will not cause pain, however, many patients tend to get worse as they age.
Scoliosis treatment should be designed to alleviate pain first (if there is pain present), stop curve progression, reduce curve size, and finally stabilize the curve corrections.
How is Scoliosis Diagnosed?
Doctors confirm scoliosis through an X-ray, spinal radiograph, CT scan, or MRI, but there is a simple at-home scoliosis exam you can conduct. It checks for visible postural signs that may indicate scoliosis. However, a full exam must be conducted by a scoliosis specialist to properly diagnose scoliosis.
Scoliosis is usually diagnosed by a primary care doctor, pediatrician, or chiropractor.
The doctor will perform certain tests to help identify the severity of your condition.
These tests may include “Adam’s Forward Bend Test”, an X-ray, CT Scan, or an MRI.
From these tests, the doctor will calculate your “Cobb Angle”.
Your Cobb Angle is calculated by the degrees or angles of your curvature shown on your spine’s x-ray. This will help the doctor understand the severity of your scoliosis and the treatment options that will be available to you.
Your doctor may also do a skeletal maturity assessment by using a scoring system, such as a “Sanders” or “Risser” score. This helps us understand how much growth you have remaining. If your Cobb Angle is larger than 15 degrees, a treatment will be recommended and may vary, depending on how much growth you have remaining.
Does Scoliosis Change with Age?
Yes, scoliosis may change with age.
Young children may experience limited pain but may experience symptoms associated with their physical appearance or interruption of their normal active lifestyle.
During puberty, scoliosis usually worsens, as kids experience growth spurts.
Adults that had an onset of idiopathic scoliosis in their younger years may experience more symptoms associated with pain as they age. This is generally due to degenerative changes in the spine.
Scoliosis can also onset as an adult even if it wasn’t present as a child.
This is called adult degenerative scoliosis and happens due to wear and tear of the spine and aging, which can lead to the natural degeneration of discs. This type of degenerative scoliosis is often found in the lower back (lumbar spine).
How is Scoliosis Treated?
There are a variety of scoliosis treatments, including:
- Watching and waiting: is often the first option suggested by many doctors, particularly in cases where they are not aware of non-surgical methods to stabilize and correct the issue. Patients may be told to wait until the curve gets worse before taking any action. The “Wait and See Approach” is a bad idea with scoliosis. Gravity will always win when it comes to scoliosis. The quicker we act, generally there are more options regarding the outcomes.
- Scoliosis bracing: braces such as our SpineCor Dynamic Bracing System are frequently suggested as a way to stabilize or reduce the progression of the curve.
- Scoliosis exercises: There are a variety of specific exercise programs available, however, there is limited evidence suggesting that exercise alone can halt the progression of scoliosis curves due to the available research which is not conclusive. The natural history of scoliosis varies among individuals, and factors such as age, curve magnitude, and skeletal maturity can influence progression. Exercise may have a role in reducing the risk of curve progression in some cases, but it may not be sufficient as the sole treatment method.
- Scoliosis surgery: when the curve gets above 40 degrees (Cobb angle), surgery is generally recommended. The most common type of orthopedic surgery is fusion, which involves permanently joining two or more vertebrae into a single section of the spine that is no longer capable of curving (or moving). Thankfully we have noninvasive technology like the SpineCor Dynamic Bracing System that is highly effective to treat scoliosis at any age.
There are multiple options available for scoliosis treatment.
Treatment options will vary depending on your age, the severity of the curvature, and how early the scoliosis is diagnosed.
The earlier your scoliosis is diagnosed, the more treatment options will be available to you.