Scoliosis is an abnormal, sideways curvature of the spine, which normally curves front to back. It’s most often diagnosed in childhood and continues into adulthood. While many cases of scoliosis are mild and need no treatment, some cases can be severe and require physical therapy, a back brace, or surgery.
Healthcare professionals typically categorize scoliosis by the suspected cause. The three main types of scoliosis are:
- Idiopathic scoliosis: Most times, the cause of scoliosis is idiopathic (unknown), though experts note it tends to run in families.
- Congenital scoliosis: This rare condition occurs when a baby’s vertebrae (bones) of the spine don’t develop correctly in the womb.
- Neuromuscular scoliosis: This type of scoliosis is caused by abnormalities in the muscles and nerves surrounding the spine. It occurs most commonly with medical conditions like cerebral palsy or muscular dystrophy.
Other times, healthcare professionals categorize scoliosis by age at diagnosis:
- Infantile scoliosis: Younger than age 3
- Juvenile scoliosis: Ages 4 to 10
- Adolescent scoliosis: Ages 11 to 18
- Adult idiopathic scoliosis: Any age after 18
Most cases of scoliosis are mild and don’t cause any symptoms. But if you do have symptoms, they may include:
- Back pain
- Difficulty standing upright
- Weak abdominal muscles
- Numbness, pain, or weakness in the legs
The signs of scoliosis may include:
- Uneven waist
- Uneven shoulders
- Leaning to one side
- A shoulder blade that sticks out
- Imbalanced legs and hips
- Head isn’t centered above the spine
- A bulge on one side of your back
- Changes in skin appearance
If you notice these signs or symptoms in yourself or your child, it’s important to see a doctor.
As mentioned, the cause of scoliosis is idiopathic (unknown) most times. Other common causes of scoliosis include:
- Birth defects that affected the way your spine developed in utero
- Certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy
- Chest surgery as a baby
- Spinal injuries, infections, or tumors
Scoliosis is usually diagnosed in your doctor’s office after a physical exam. Your doctor may ask you to stand up straight to assess your hips, shoulders, and waist. They may then ask you to bend forward and touch your toes so they can assess the shape of your spine.
Your doctor may also complete a neurological exam to check for:
- Muscle weakness
- Numbness
- Reflexes
Your doctor will ask about any symptoms you’re experiencing and whether they’re causing problems for you, such as back pain, bladder issues, or bowel problems.
If your doctor suspects scoliosis, they may order scans to help diagnose the condition and severity. Tests may include:
Not all cases of scoliosis need treatment, but some severe cases do. To determine if you need treatment, your doctor will consider:
- The type of scoliosis you have
- Age
- Family history of scoliosis
- The number of years you have left until your bones are done growing
- Degree of spinal curvature (the greater the curve, the more severe your scoliosis)
Treatment for scoliosis often focuses on symptom relief and stopping the curve from progressing, not necessarily straightening the spine. Treatments fall into two categories: conservative (nonsurgical) and surgical.
Conservative Scoliosis Treatments
Conservative treatments for scoliosis include:
- Physical Therapy A physical therapist can help you learn exercises and stretches that strengthen your core muscles and improve flexibility. Exercises may include the use of a ball or dowel to improve muscle strength in the core and around the spine.
- Back Brace A back brace can support your spine if your spinal curvature is greater than 25 degrees to keep it from reaching 50 degrees. It can also be beneficial for children who are still growing.
- Pain Relievers Ask your doctor for recommendations for over-the-counter pain relievers or anti-inflammatory medications.
- Other Strategies Yoga, Pilates, acupuncture, and chiropractic care can also help, especially if you have back pain.
Surgical Scoliosis Treatments
Surgery may be needed for more severe cases of scoliosis to help with:
- Stability of the spine
- Balance
- Pressure relief of compressed nerves
There are two primary spinal operations used to treat scoliosis. They are:
- Spinal Fusion This surgery helps stabilize your spine by fusing your spinal bones and adding metal braces to your spine to help support it.
- Expandable Rod This surgery helps support a growing child’s spine. A rod is placed alongside the backbone, which can be made longer as the child grows.
Unfortunately, there’s no way to prevent scoliosis. But many cases of scoliosis are mild and don’t require treatment. If you have a more severe case, treatment may help relieve symptoms and improve your quality of life. Your healthcare provider may also recommend stretches and exercises to help strengthen your back muscles and prevent your scoliosis from worsening.
Because many cases of scoliosis are mild and require no treatment, many live a typical life with this diagnosis and can participate in sports or other physical activities, which can boost core strength and flexibility and help improve symptoms. But if you experience pain during exercise, listen to your body and stop.
Sometimes symptoms may appear or worsen because of the natural degradation of the spine over time as you age. If this happens to you, it’s important to see your doctor so they can help you manage your symptoms.
Scoliosis may also affect the way you look, depending on the degree of curvature of your spine. For some people, this change has an emotional impact. If your scoliosis is negatively affecting your mental health, talk to your doctor. They can connect you with a mental health professional who can help.
Mild forms of scoliosis usually don’t cause any complications, though more severe cases may result in pain, visible curvature, or trouble breathing.
- Trouble Breathing This occurs in cases of severe scoliosis, when the rib cage presses against the lungs, limiting your ability to take a deep breath and making breathing more difficult.
- Back Problems Chronic back issues and pain can develop as you age, especially if your spinal curvature is large or if left untreated.
- Emotional Stress As you age, scoliosis can worsen, causing more noticeable physical changes in your hips, shoulders, waist, and other areas, which may impact your body image. If it does, talking to a mental health professional can help.
Scoliosis affects about 2 to 3 percent of the U.S. population (six to nine million people).
While it can affect you at any age, it is most commonly diagnosed in childhood or adolescence between ages 10 and 15.
Scoliosis can also develop in people who experience degeneration of the spine, such as those with arthritis or
osteoporosis.
