About Scoliosis

Here is what you need to know…

It is natural and healthy for the spine to curve from front to back. When it becomes an abnormal curvature, also referred to as a sideways curvature of the spine, it becomes an issue.

Scoliosis is a malformation of the bones or “vertebra”. It 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 looks more like an “S” or “C” rather than a straight line.

There Are 5 Types of Scoliosis:

• Idiopathic Scoliosis is the most common form of scoliosis, accounting for approximately 80% of all cases. Traditionally, it has been labeled as having “no known cause,” with an onset typically occurring between ages 10 and 15. However, recent research has revealed that most cases of idiopathic scoliosis are linked to genetic variations, as well as hormonal and neurotransmitter imbalances. These groundbreaking insights now offer a clearer understanding of not just why scoliosis develops, but also if – and to what extent – it may worsen over time. What was once like steering a ship without a compass is now more like navigating with a GPS. We finally have direction in identifying risk and guiding treatment.
• Congenital Scoliosis: meaning ‘born with the condition’. As the spine formed before birth, it started to develop by the vertebrae incorrectly forming or separating improperly. Individuals with this type may also have other conditions related to the heart or kidneys.
• Neuromuscular Scoliosis: In this case, it affects the nerves and muscles. It is generally caused by conditions such as cerebral palsy, muscular dystrophy, and spinal cord injuries.
• Degenerative Scoliosis: This type 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 is caused by a problem in another part of the body, such as a difference in leg length or muscle spasms.

It is considered a common condition. 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 treatment. It is important to monitor the spine during the average age of onset from 10 to 15 years of age.

If it is diagnosed and treated early, there are many more options available for treatment. If it’s diagnosed and treated too late, treatment options may be more limited.

Are You Born with Scoliosis?

In about 20% of scoliosis cases, the cause is identifiable and linked to structural abnormalities such as congenital spinal defects, bone damage, or neuromuscular disorders. Conditions like spina bifida, cerebral palsy, and spinal cord injuries can all contribute to scoliosis development. However, the majority – more than 80% – of cases are classified as idiopathic scoliosis, meaning the exact cause remains unknown. While individuals with neuromuscular conditions have a higher likelihood of developing scoliosis, many cases arise without an apparent underlying condition.

Researchers have studied adolescent idiopathic scoliosis for decades, uncovering various contributing factors. However, it remains unclear why some children’s spinal curves worsen rapidly while others experience minimal or no progression.

According to the National Institutes of Health (NIH), adolescent idiopathic scoliosis may result from a combination of genetic and environmental influences. Several factors have been linked to scoliosis development, including:

• Hormonal imbalances
• Irregular bone or muscle growth
• Nervous system dysfunction
• Complex genetic interactions

Is Scoliosis Genetic or Hereditary?

Scientific studies confirm that scoliosis has a genetic component and often runs in families. Researchers have recently identified 28 genetic markers associated with scoliosis. This discovery improves the ability to predict:

• When spinal curvature may begin
• Whether the condition will worsen
• How certain nutrient-based treatments may help manage progression

According to the NIH, multiple genetic variants are linked to adolescent idiopathic scoliosis and optimal bone health. Some genes may contribute to the initial onset of scoliosis, while others influence the severity and progression of the spinal curve. While extensive genetic research has been conducted, only a few genes have shown strong correlations with scoliosis in early adolescence. 

What Causes Scoliosis?

Both genetic variations and imbalances in hormones and neurotransmitters play a significant role in the development of scoliosis. Interestingly, even identical twins can have differing risks, highlighting the complex nature of the condition. Rather than being caused by a single gene mutation, scoliosis stems from the intricate interaction of multiple genes. This interplay can lead to deficiencies in nutrients or enzymes, as well as hormonal and neurotransmitter imbalances. These disruptions interfere with critical biochemical processes, particularly during rapid growth phases, making it harder for the body to maintain proper postural balance – ultimately contributing to the development of spinal curvature.

At-home genetic testing using a simple saliva sample can help identify a genetic predisposition to scoliosis. Certain neurotransmitter patterns may indicate a higher likelihood of severe spinal curvature. For children and adults at greater genetic risk, additional urine testing can help detect neurotransmitter imbalances, offering insights into whether surgical intervention may be necessary as the condition progresses.

In most people, there is no known cause for scoliosis, and therefore it is commonly known as idiopathic scoliosis. When the doctor is unable to find any other condition that is causing the curvature, it is considered idiopathic.

It is the most common type seen in children, however, it can present in people of all ages. It can be found in very young children from the time of standing to walk, 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. 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.

Can It Be Prevented?

Whether or not you develop scoliosis primarily depends on your genetic makeup.
Although it can’t be prevented, there are aspects of the condition that you can control.
You can control how early it is diagnosed, by monitoring the spine during the average age of onset, 10 to 15 years of age. If it 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 treatment. If it 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, 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 it.

It 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 It Change with Age?

Yes, it 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, it usually worsens, as kids experience growth spurts.
Adults who 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 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. Gravity will always win when it comes to it. The quicker we act, generally there are more options regarding the outcomes.
• Bracing: braces such as our SpineCor Dynamic Bracing System are frequently suggested as a way to stabilize or reduce the progression of the curve.
• 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 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.
• 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.

If you or a loved one are seeking a non-invasive, science-based approach to scoliosis care, contact us today to learn how we can help you achieve a healthier spine and a better quality of life. Stay Ahead of the Curve!