Scoliosis is an abnormal sideways or side-to-side curvature of the spine, often appearing as an “S” or “C” shape, and can occur at any age, but is most common in children and teens. Scoliosis is fairly common, affecting an estimated 10% of the global population, with over 3 million cases in America per year alone. Signs and symptoms typically begin in adolescence, and while both boys and girls can develop mild scoliosis at the same rate, girls have a higher risk of the curve worsening and requiring treatment.
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Scoliosis is a condition where the spine, which normally runs straight down the back, curves abnormally to one side, creating a sideways curvature. Most cases are mild, but severe cases can be disabling. Some children may develop spine deformities that become more severe as they grow, with some requiring a brace or surgery while often in others no treatment is necessary.
It is not clear what causes the most common types of scoliosis, although it appears to involve some hereditary factors. Some of the less common types of scoliosis may be caused by certain neuromuscular conditions, birth defects affecting bone and spine development, previous surgery on the chest wall as a baby, spinal cord irregularities, and infections or injuries of the spine.
Many people may have had mild undiagnosed scoliosis throughout their lives with symptoms increasing as they age, resulting in late diagnosis which is referred to as adult-onset scoliosis or degenerative scoliosis.
Adult-onset cases are generally identified when the patient goes in for a check-up complaining of back pain and issues relating to their disks and joints weakening, when examination and testing is done to check for bone density loss. Over time these patients may notice height loss and an uneven alignment of their pelvis and hips.
Measuring Scoliosis
The curve of the spine is measured in degrees, rating the severity based on the degree of the curve:
- No scoliosis diagnosis: Less than 10 degrees.
- Mild scoliosis: Between 10 to 24 degrees.
- Moderate scoliosis: Between 25 to 39 degrees.
- Severe scoliosis: More than 40 degrees.
The rating is similar to how angles are measured with a protractor in geometry, using a scoliometer device to measure the curve by placing the tool on the back alongside the spine. Sometimes an X-ray is also ordered to help measure the curve of the spine.
Types
- Idiopathic scoliosis: The most common type, where the cause is unknown.
- Congenital scoliosis: Occurs when there’s a problem with the spine’s development before birth.
- Neuromuscular scoliosis: Caused by conditions affecting the nerves and muscles that support the spine, such as cerebral palsy or muscular dystrophy.
Symptoms
- Uneven shoulders
- One shoulder blade appears more prominent than the other
- Uneven waist
- One hip appears higher than the other
- One side of the rib cage jutting forward
- Back pain
- Difficulty standing upright
- Core muscle weakness
- Leg pain, numbness, or weakness
- Head doesn’t center above the pelvis
- Constant leaning to one side
- Uneven leg length
- Changes in skin texture/appearance along the spine
Diagnosis
- Doctors often screen for scoliosis during physical exams, particularly in children and teens.
- The Adams Forward Bend Test, where the patient bends forward with straight knees, can help identify unevenness in the hips, ribs, or shoulders.
- X-rays are used to measure the degree of spinal curvature.
Complications
- Breathing problems: In some cases, the rib cage may press against the lungs making it more difficult to breathe.
- Back problems: Those with scoliosis may be more likely to have chronic back pain as adults, especially if their curves are large and/or left untreated.
- Appearance: As the condition worsens if left untreated, it can cause more noticeable changes and physical deformity, including uneven hips and shoulders, prominent ribs, and a shift of the waist and trunk going to one side.
- Mental health: Those with scoliosis can become self-conscious about their appearance
- Pain: Without treatment, some cases, especially severe cases can lead to long-lasting pain.
Without treatment, some cases, especially severe cases can lead to organ damage, nerve damage, arthritis, and spinal fluid leakage.
Surgery
Those who don’t respond well to a treatment plan may require surgery to help stabilize their spine, restore balance, and relieve pressure on their nerves. There are different types of scoliosis surgery, including spinal fusion with instrumentation (rods and screws), as well as newer “fusionless” options like vertebral body tethering (VBT) and ApiFix. The type of surgery depends on the severity of the curve, age, growth potential as well as surgeon experience, and the recovery times will vary depending on the type of surgery.
- Spinal fusion: Stabilizes your spine, your surgeon will fuse the bones of your spine together. Then, they’ll use metal braces to hold your spine in place.
- Expandable rod: A surgeon will insert an expandable rod along the vertebrae to support a child’s growing spine. They’ll adjust the length of the rod as a child grows.
Advances in medical technology are making less invasive approaches possible and recovery time quicker. Although surgery is generally a safe procedure there are possible complications such as bleeding, blood clots, nerve damage, infections, and limited movement. As such, surgery is generally reserved for after all other avenues are exhausted whenever possible.
Treatment
Treatment depends on the type of scoliosis, the degree of the curve, the patient’s age, family history of the condition, and how much growth is expected until skeletal maturity.
- Mild curves may require regular check-ups, while more severe curves may need bracing or surgery.
- Treatment focuses on relieving symptoms and not necessarily straightening the curve with the goal of decreasing symptoms, slowing curve progression, and improving spine function.
- Most often frequent stretching and exercises are recommended to help strengthen core muscles, improve posture, and improve flexibility.
- Sometimes back braces are recommended to help support the spine.
Playing most sports won’t make scoliosis worse, rather participating in physical activities that promote core strength and flexibility such as dance, gymnastics, and swimming can help to reduce symptoms.
It is important to note that while routine movement can help to reduce the severity of symptoms and progression of the curve if any activity causes pain, listen to your body and stop.
Physical Therapy
There is no cure for scoliosis, but physical therapy may also be recommended to help strengthen muscles and relieve pain. Physical therapy helps to provide additional physical activity guidance and daily stretching movements to help improve your posture and could involve a variety of low-impact exercises such a s swimming or yoga.
If you are worried that the treatment or physical therapy isn’t helping and symptoms are getting worse please contact your healthcare provider.
Stretches For Scoliosis
For scoliosis, consider incorporating stretches like cat-cow, latissimus dorsi stretches, and hip flexor stretches, which can help improve spinal mobility, strengthen core muscles, and alleviate pain.
Cat-Cow Stretch
This dynamic stretch helps improve spinal mobility and strengthens core and back muscles.
- How to do it: Start on your hands and knees, maintaining a straight back and tight abdominals.
- Cat: Inhale, round your back, and relax your neck.
- Cow: Exhale, lower your chest towards the floor and look slightly upward.
- Repeat: Alternate between the cat and cow positions, focusing on engaging your core and back muscles.
Latissimus Dorsi Stretch
This stretch targets the latissimus muscles, which can feel tense with scoliosis.
- How to do it: Stand with feet shoulder-width apart and slightly bent at the knees.
- Reach: Reach overhead and grab your opposite wrist.
- Bend: Bend at your side until you feel a stretch along your trunk.
- Hold: Hold for 5-10 seconds, then return to the starting position and repeat on the opposite side.
Hip Flexor Stretch
This stretch can help alleviate muscle imbalances associated with scoliosis.
- How to do it: Start in a lunge position, with one knee on the ground and the other leg extended forward.
- Engage: Tighten your abs and glutes first.
- Shift: Shift forward slightly until you feel a stretch in the front of your leg.
- Hold: Hold for 15-30 seconds, then repeat on the opposite side.
Seated Spinal Twist
This stretch enhances spinal mobility and releases tension in the back and hips.
- How to do it: Sit on the floor with legs extended in front of you.
- Twist: Twist your torso to one side and reach your arm towards the opposite side.
- Hold: Hold for a few seconds, then repeat on the other side.
Additional Exercises
Consider incorporating Pilates, yoga, swimming, Tai Chi, Qigong, and low-impact aerobic exercises, which can help strengthen the core and promote overall body alignment.
Important Considerations
- Consult a Professional: Before starting any new exercise program, it’s essential to consult with a healthcare professional or physical therapist to ensure the exercises are safe and appropriate for your specific condition.
- Listen to Your Body: Pay attention to your body and stop if you experience any pain.
- Consistency is Key: Regular exercise and stretching can help manage scoliosis symptoms and improve overall well-being.
This article was written by Tamsyn Julie Webber at the WHN News Desk
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN does not agree or disagree with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement. Additionally, it is not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything. These statements have not been evaluated by the Food and Drug Administration.
