Around two to three percent of the U.S. population is afflicted with the chronic medical condition known as scoliosis,1 a type of abnormal curvature of the spine that usually develops in its sufferers during childhood. The effects of scoliosis vary widely in severity; in the most serious cases, the condition can impose major lifestyle challenges on those who suffer from it.
Despite its prevalence among the general population, scoliosis remains a mystery to the majority of people, as few have more than a shadowy idea about what this disorder is. If you’ve been diagnosed with scoliosis, or you know someone who has, you owe it to yourself to learn about this often uncomfortable condition. Let’s take a closer look at scoliosis and the ways that it can negatively impact an individual’s day-to-day life.
What Is Scoliosis?
First, you need to be clear on what a “normal” spine is supposed to look like. Contrary to what many believe, a healthy spine has several natural curves, each corresponding to a distinct region.
When viewed from the side, the human spine assumes a rough “S” shape:
- It curves slightly outward at the neck—the area known as the cervical spine.
- It curves slightly inward at the middle—the area known as the thoracic spine.
- It curves slightly outward toward the bottom—the area known as the lumbar spine.
Below these regions are the sacrum (hip) and the coccyx (tail bone).
These curves in the spine provide us with a degree of flexibility and the capacity to absorb bodily stresses.
When examined from the rear, the spine appears straight—if it is healthy. In persons suffering from scoliosis, though, the spine bends noticeably to the left or the right. These abnormal curves generally appear in the thoracic or—less commonly—the lumbar region.
Generally, the curvature of the spine must reach at least 10 degrees to qualify for a diagnosis of scoliosis. As a rule of thumb, the greater the curvature, the more severe the complications that result from it. Mild scoliosis is often no more than an intermittent inconvenience that requires little or no medical intervention. People with substantially more pronounced curvature, however, can develop multiple health issues.
Complications of Scoliosis
Scoliosis can result in a number of physical abnormalities, including uneven shoulders and/or waistline. In advanced cases, the curvature of the spine may cause it to twist, leading to an uneven appearance around the ribs as one side projects further outward than the others.
Scoliosis is often detectable from alternations in the patient’s normal gait, as the misalignment of the hips creates an uneven walking pattern. Sometimes clothing will fit poorly.
It must be understood that scoliosis can cause issues that go far beyond affecting one’s outward appearance. Scoliosis sufferers sometimes report recurring issues with back pain, although, in many cases, this is mild in nature. In older patients, back pain can be more serious. Even simple everyday tasks can lead to significant discomfort—tying shoes, lifting groceries, sitting in chairs, and so on.
Due to the deformation of the spine, scoliosis patients can even develop breathing and heart disorders as the rib cage presses into the lungs. Potentially life-threatening complications like these are extremely uncommon, but they can happen.
Because scoliosis tends to develop at an early age, it can lead to serious self-esteem issues in growing children, who may become the target of teasing from their peers. They may become insecure about their appearance and develop a poor self-image. That’s one reason why it is important to ensure that afflicted children get medical attention as soon as possible. Another reason is that early treatment may prevent serious complications that require more drastic measures.
Types of Scoliosis
Scoliosis can occur at any age, but it usually develops between the ages of ten to fifteen—often immediately prior to puberty. It arises with equal frequency in boys and girls, but it tends to be more serious in girls and more likely to require medical intervention. Scoliosis can be particularly stressful in adolescents, who must cope with the stresses of growing up in addition to their medical disorder.
In approximately 80% of cases, scoliosis has no knowable cause. Where this holds true, it is said to be idiopathic (“of unknown cause”) in origin.
Scoliosis can be caused by neuromuscular disorders such as Marfan syndrome and muscular dystrophy. This is known, appropriately, as neuromuscular scoliosis. When this disorder is traceable to a defect present at birth, such as an improperly formed spine, it is referred to as congenital scoliosis.
So-called degenerative scoliosis is the type associated with older adults. Degeneration of the spine as the result of aging—osteoporosis is often a contributing factor, here—can interfere with the spine’s capacity to retain its normal shape. This type of scoliosis tends to appear in individuals over the age of 40.
Causes of Scoliosis
As we have indicated, scoliosis usually develops without any apparent cause. However, there are a few risk factors that may significantly increase the likelihood of developing this disorder.
Scoliosis seems to run in families—someone with a parent who has this affliction has a greater than average chance of suffering from it as well. According to the Scoliosis Research Society, “About 1 in 3 children whose parents have scoliosis will develop scoliosis.”2 The disorder is believed to have a genetic component but, at the present time, the specific genes involved have yet to be conclusively identified. Parents who have scoliosis need to be especially attentive to physical changes in their children that might indicate the presence of this disorder.
By the same token, it is important to understand what does not cause scoliosis. Given that it so often arises in childhood, many parents worry about the potential effect of a child’s physical activity, like playing sports, in the development of scoliosis, but there is no reason to fear; scoliosis does not stem from playground injuries or anything of that nature. Likewise, bad posture does not lead to scoliosis—although it may be a symptom of an existing condition.
If you suspect that your child is stricken with scoliosis, do not hesitate to seek medical attention. Scoliosis can worsen with age, and it is essential to seek treatment as soon as possible to prevent major complications down the road.
The most commonly used diagnostic test for scoliosis—though it is not sufficient in itself to reach a diagnosis—is the Adams Forward Bend Test. Many people first become aware of their disorder when a medical practitioner at school leads them through this test.
The test is simple: The patient bends forward at the waist, with arms dangling down until their upper body is at a 90-degree angle. This position enables the medical practitioner to spot asymmetrical features that may indicate scoliosis, such as uneven shoulder blades. Sometimes the practitioner uses a simple screening device called a scoliometer to help detect these irregularities.
If scoliosis is suspected, it will be necessary to undergo x-rays for a closer look. The practitioner will analyze the x-rays and calculate the degree of curvature with the Cobb angle measurement. The Cobb angle score will largely determine the recommended treatment for the scoliosis patient. When it is low—indicating relatively mild curvature—the patient will likely require routine monitoring to ensure that the condition does not worsen, but no further treatment will likely be necessary. This is the case for most individuals diagnosed with scoliosis. In children and adolescents, it is particularly vital to continue monitoring the spine because the patient’s skeleton is still growing, and a mild case could develop into a more serious one.
If the curvature of the spine is more advanced, there are several treatment options available:
- Back Brace – This is a common option for adolescents with moderate scoliosis. The brace keeps the condition of the spine from worsening, to forestall the need for surgery. Typically, the patient will have to wear the brace for most of the day until they reach physical maturity.
- Surgery – In more serious cases, surgery may be necessary. There are several types of surgeries to correct or stabilize scoliosis. The most common one involves fusing two or more vertebrae together, which can markedly improve the patient’s condition with only a small degree of lost mobility. Alternatively, fusionless surgery involving growing rods, vertebral stapling, and similar techniques may achieve positive results as well.
Scoliosis can cause serious difficulties to children and adolescents who are afflicted with this disorder, but help is available. Don’t wait to seek out treatment—call a qualified medical professional today.