What is Scoliosis? Causes, symptoms, treatment, prevention, and complications

Written by Nicolas Perez Diaz, May 24, 2023.

If you have scoliosis, your spine twists and curves to the side. It is most often diagnosed in children and adolescents, but it can also occur in adults. The spine is made up of many bones called vertebrae. The ligaments and muscles that hold these vertebrae together are stacked on top of one another. In scoliosis, the vertebrae twist and curve to one side forming a ‘C’ or ‘S’ shape.

The following information comes from nih.gov:

“Most people with scoliosis can have normal, active lives with treatment. Support groups can help.”

Causes of Scoliosis

The cause of scoliosis is unknown in most cases. Here are some examples of known/suspected causes:

• Genetics & environment

Experts believe that genetics and the environment are likely factors associated with the condition. People with a family history of scoliosis are more likely to develop the condition.

• Growth spurts

Growth spurts like those that occur during puberty make the condition more common.  This is because the spine is more flexible and likely to curve during a child’s teen years.

• Posture

Scoliosis can develop as a result of poor posture. Hunching places uneven pressure on the spine, which can cause it to curve.

• Sports

Sports that unevenly stress the spine can cause it to curve. Examples include gymnastics, cheerleading, javelin, tennis, squash, and skating.

According to scoiosisclinic.co.uk:

“Some practitioners suggest that activities which tend to asymmetrically load the body (most things with a bat or racket) should be avoided – however this approach is too broad in most cases and tends to cut off many of the most enjoyable sports! (this also serves to demonstrate the importance of individual patent-centered care!)”

“The risk with asymmetric sports is that over time, one side of the body (and of the muscle supporting the spine) becomes stronger and larger than the other side – this factor can then serve to worsen scoliosis. Assuming a proper warm up there is very little risk in actually participating in these kinds of sports.”

• Neuromuscular disorder

People with neurological conditions such as cerebral palsy or muscular dystrophy have a higher risk of developing scoliosis than the rest of the population. These conditions can damage the spine’s supporting muscles and nerves, causing it to curve.

• Degenerative

In older adults, curvature may occur because of the wear and tear of the spine, resulting in degenerative changes.

Signs and symptoms

Pain is a symptom but uneven shoulders is a sign. Why? Only the patient can feel, detect, or sense a symptom. With a sign, on the other hand, the patient and other people can see, observe, or detect it.

People with scoliosis may have the following signs and symptoms:

• A spine that is visibly curved.
• Uneven shoulders or hips.
• One shoulder blade that sticks out more than the other.
• On one side of the body, the ribs stick out.
• A hunched up back (hump on the person’s back).
• Back pain (more common with adults).
• Difficulty breathing.
• Uneven waist.
• When the person bends forward, a prominence on one side of their back is visible.
• Some people appear to have badly-fitting clothes because of the shape of their spine and the position of their shoulders, etc.

According to the Mayo Clinic:

“With most scoliosis cases, the spine will rotate or twist in addition to curving side to side. This causes the ribs or muscles on one side of the body to stick out farther than those on the other side.”

It is important to note that not everyone with scoliosis will experience symptoms. In mild cases, it may be asymptomatic (without symptoms).

Treatment of scoliosis

Treatment depends on how severe the patient’s condition is. In mild cases, no treatment is usually necessary. However, in moderate to severe cases, the patient will need medical help to prevent the curve from getting worse. The most common treatment options include:

• Bracing

Bracing is a common treatment option for people with scoliosis. A brace is a torso-encircling, rigid piece of plastic garment. It helps maintain spinal alignment and stops the progression of the curve. Doctors usually recommend bracing to people with curves between 25° and 45° degrees.

• Surgery

If bracing is not effective and the patient’s condition is severe, the doctor may recommend surgery. The surgeon fuses the bones of the spine together to straighten the curve. It is a major procedure and carries risks.

• Physical therapy

Physical therapy helps to improve posture and strengthen the muscles around the spine, which helps prevent scoliosis from getting worse.

• Exercise

Exercise may also help lead to better posture and stronger muscles around the spine.

• Maintaining a healthy weight

If your body weight is normal for your height, you are less likely to experience worsening symptoms compared to somebody who is obese or overweight.

• Avoiding smoking

Smoking can weaken the bones and make scoliosis worse.

• Wear a backpack that fits properly

Wearing a backpack that fits properly can help prevent the scoliosis from worsening.

It is very important to visit a doctor for a diagnosis if you think you or your child may have scoliosis. Early diagnosis and prompt treatment are vital.

Complications

People with severe or untreated scoliosis may experience:

• Chronic pain and discomfort. Chronic means long-term. A condition that is chronic lasts a long time (perhaps a lifetime).
• Reduced lung capacity and breathing difficulties.
• Self-esteem issues.

The following information comes from upmc.com:

“Does Scoliosis Get Worse With Age? Yes it can if your doctor didn’t treat idiopathic scoliosis when you were a child or adolescent. If your spinal curvature as an adolescent was less than 30° degrees, it’s unlikely to deteriorate. If it was over 50° degrees, it’s more likely to get worse.” 

Prevention

While it may not be possible to prevent all cases of scoliosis, there are a few steps individuals can take to promote a healthy spine:

• Maintain a healthy posture

Practice proper sitting and standing postures, as well as lifting techniques to avoid unnecessary strain on the spine.

• Avoid sitting for prolonged amounts of time

Prolonged sitting can weaken the back muscles and contribute to poor posture. If you have to sit for long periods, which is often the case with office jobs, get up periodically to stretch your legs and walk about.

• Have regular check-ups

Regular medical check-ups are crucial for early detection of scoliosis. Early checkups are key to preventing the progression of scoliosis and minimizing the need for extensive treatments.

Not all cases of scoliosis can be prevented. These preventive measures can help to promote a healthy spine and lower the risk of developing the condition. There are underlying genetic or developmental causes for some types of scoliosis, over which people have no control. However, by taking control of their spinal health, they can minimize the risk of complications and preserve general wellbeing.