Scoliosis
Scoliosis is a sideways curvature of the spine that can occur in children, adolescents, and adults. While mild curves may cause no problems, more severe scoliosis can lead to pain, breathing difficulties, and visible deformity. Early detection and appropriate treatment can prevent progression and complications.
⚠️ Seek Emergency Care For:
- Sudden severe back pain with scoliosis
- Difficulty breathing or chest pain
- Sudden leg weakness or numbness
- Loss of bowel or bladder control
- Progressive neurological symptoms
- Severe pain not relieved by rest
- Signs of spinal cord compression
- Rapid curve progression
Definition and Overview
Scoliosis involves a lateral (sideways) curvature of the spine, often accompanied by rotation of the vertebrae. The spine may curve in a C-shape (single curve) or S-shape (double curve). Curves are measured in degrees using the Cobb angle method - curves under 10 degrees are considered normal variation, while those over 10 degrees constitute scoliosis.
Most scoliosis cases are idiopathic (unknown cause) and develop during adolescence. The condition affects 2-3% of the population, with girls more likely to have curves that progress and require treatment. While many cases are mild and require only monitoring, severe scoliosis can impact quality of life and organ function.
Types and Causes
Idiopathic Scoliosis
- Most common type (80%)
- Unknown cause
- Infantile (0-3 years)
- Juvenile (4-10 years)
- Adolescent (11-18 years)
- May have genetic component
Congenital Scoliosis
- Present at birth
- Malformed vertebrae
- Fused ribs
- Missing vertebrae
- Associated with other defects
- May progress rapidly
Neuromuscular
- Cerebral palsy
- Muscular dystrophy
- Spina bifida
- Spinal cord injuries
- Polio effects
- Muscle weakness
Other Causes
- Degenerative (aging)
- Traumatic injury
- Tumors
- Infections
- Connective tissue disorders
- Leg length discrepancy
Signs and Symptoms
Scoliosis may present with various signs:
- Uneven shoulders: One higher than the other
- Prominent shoulder blade: One more visible
- Uneven waist: Asymmetrical appearance
- Hip elevation: One hip higher
- Rib prominence: When bending forward
- Back pain: Especially in adults
- Fatigue: From muscle strain
- Breathing problems: Severe curves only
When It's Serious
Risk Factors for Progression
- Young age at diagnosis
- Large curve size (>25-30 degrees)
- Female gender
- Significant growth remaining
- Family history
- S-shaped curves
- Thoracic (upper back) curves
- Skeletal immaturity
Diagnostic Approach
Physical Examination
- Adam's forward bend test
- Shoulder height comparison
- Hip level assessment
- Gait evaluation
- Neurological testing
- Growth assessment
Imaging Studies
- X-rays: Standing full spine views
- Cobb angle: Curve measurement
- MRI: If neurological signs
- CT scan: Detailed bone imaging
- Bone age: Growth potential
- 3D imaging: Advanced assessment
Treatment Options
Observation
- Curves under 25 degrees
- Regular monitoring
- X-rays every 4-6 months
- Watch for progression
- No active treatment
- Most common approach
- Reassessment schedule
- Growth monitoring
Bracing
- Curves 25-40 degrees
- Growing children
- Prevent progression
- Various brace types
- Worn 16-23 hours daily
- Custom fitted
- Regular adjustments
- Compliance crucial
Surgery
- Curves over 45-50 degrees
- Progressive curves
- Spinal fusion
- Rod placement
- Curve correction
- Prevent progression
- Major procedure
- Long recovery
Other Treatments
- Physical therapy
- Schroth method
- Pain management
- Exercise programs
- Postural training
- Yoga/Pilates
- Chiropractic care
- Counseling support
Living with Scoliosis
- Stay active: Regular exercise maintains flexibility
- Good posture: Conscious positioning
- Core strengthening: Support spine
- Swimming: Excellent low-impact exercise
- Weight management: Reduce spine stress
- Ergonomic setup: Work and home
- Support groups: Connect with others
- Regular monitoring: Track progression