Everyone’s spine naturally curves a bit, but when you have scoliosis, your spine curves too much. Scoliosis can affect people of any age, from babies to adults, but it most often starts in children ages 10 to 15. We’ll take a closer look at this condition and share everything you need to know about scoliosis, from what it is to how it’s treated.
What Is Scoliosis?
Scoliosis (pronounced sko-lee-o-sis) occurs when the spine has a sideways curvature, resulting in a S or C shape. It can affect any section of your spine but is most often seen in the lower back and directly behind your chest.
Scoliosis can develop at any point from infancy to adulthood. It is most frequently seen in children who have yet to reach puberty, around 10 to 15 years old. Scoliosis sometimes coincides with a growth spurt and appears more often in girls than in boys. Treatment is not always necessary for mild cases, and most people are able to participate in activities and live active, fulfilling lives without complications.
There are several types of scoliosis:
- Congenital scoliosis: Occurs during fetal development, the spine forms abnormally
- Early-onset scoliosis: Seen early in life from birth until 10 years old
- Adolescent idiopathic scoliosis: The spine twists and curves as a young child grows
- Degenerative scoliosis: Seen in adults when the spine and bones have worn down or been damaged
- Neuromuscular scoliosis: Spine is affected by the muscular system, spinal cord, or brain disorders
- Scheuermann’s kyphosis: Causes abnormal growth of certain areas of the spine where vertebrae wedge forward during development
- Syndromic scoliosis: Refers to spinal abnormalities caused by genetic conditions or preexisting disorders
What causes scoliosis is not always easy to pinpoint; statistics show that the source is not identified in 8 out of 10 cases. These instances are referred to as idiopathic scoliosis and most likely linked to a genetic issue or underlying condition. Around 3 in 10 young adults with idiopathic scoliosis have the condition in their family according to the American Academy of Orthopedic Surgeons. As mentioned above, scoliosis may occur long before a baby is born, or develop much later in life because the spine has become worn and weak in places, causing it to twist and curve.
Signs of scoliosis are not always obvious at first and may gradually appear over time. Especially in young individuals, the condition is often missed until a growth spurt. In adults, many back issues may be blamed on other conditions like arthritis and an accurate diagnosis may be put off. Identifying scoliosis early is important for remedying the problem before it worsens and causes more serious issues and symptoms.
Scoliosis symptoms include:
- Protruding hip on one side
- Head is not centered, leans to the side
- Ribs are not even
- Shoulders or not balanced; one is lower than the other
- Clothes hang unevenly
- One leg is longer than the other
- Person leans to the side when standing
Typically scoliosis is not painful in the early stages, but it can cause some discomfort if you overcompensate for the parts of your skeleton that are off balance by standing or walking awkwardly. Back pain can become more persistent if the spine continues to curve and the condition worsens.
The earlier scoliosis is treated the better, but the exact plan of action depends on how old you are, the current condition of your spine, and whether your doctor believes the curve could worsen as time goes on. Mild cases can often be treated with certain exercises, like yoga and stretches, that strengthen the spine and surrounding muscles and support flexibility. Your doctor will also monitor your condition regularly to look for changes and to see if there is an improvement by incorporating self-care practices.
For cases of scoliosis that require more serious medical intervention than at-home exercises, your doctor may suggest a back brace to help slow the curvature from worsening. This method is helpful in younger patients whose skeleton is still developing. It does not change the shape of the spine but will stop further changes while the person continues to grow. Many braces need to be worn all day and night to reap the biggest benefits and removed only for bathing.
The braces available today are not too restrictive and are removable for certain sports and activities. One study found that when bracing is used on young adults with idiopathic scoliosis, it helped minimize the chances of the condition worsening or requiring surgical treatment.
In some instances, particularly in infants and young children, casting is used to help the spine move toward a straighter direction while allowing the lungs and chest to develop normally. Made from plaster, the cast is wrapped around the outside of the body and worn for a period of time and updated regularly as the child grows in size.
Surgery is often the last recourse and used when all other measures have been exhausted. However, there are times when the curvature has become too great or symptoms too disruptive and surgery is the best option. Surgical treatment varies and is determined based upon the shape of your spine, your height, and if other areas of your body are negatively affected by your spine’s shape and curve.
Spinal surgery typically involves:
- Bone grafts: Using new bone grafts, two or more of your vertebrae are fused together. Parts of your spine can also be held together by wires, screws, metal rods, or hooks to allow the bones to heal properly.
- Intensive care: After a 4- to 8-hour surgery, you are monitored in the ICU for 24 hours and receive medication to help relieve pain and IV fluid to keep you hydrated and encourage healing. For more serious conditions or complicated surgeries, your hospital stay may be extended.
- Recovery: Recovery time varies, but you can often return to normal activities within a month. Sports and other contact activities are typically postponed for at least a year to ensure the spine is able to heal properly. Your doctor may recommend a supportive back brace during the first few months following surgery.
In childhood cases, the rods will need to be extended every six months to account for growth. This does not require being admitted into the hospital and can be done during a daytime office visit. Once the spine is fully developed, the rods are removed via surgery.
If you suspect you or your children have scoliosis, a doctor will evaluate your spine, shoulders, head, ribs, and hips. An instrument called a scoliometer can measure the asymmetry of your spine in degrees. While bending forward, the doctor will place the scoliometer over the spine and take the measurement.
The most important approach to scoliosis is a proactive one by practicing regular exercises and working with your doctor to take preventative measures. It is possible to slow your spine curvature and minimize any symptoms you are feeling. Activities like yoga and pilates can greatly improve flexibility, strengthen muscles that support your spine, and enhance your overall health and wellness.