A Comprehensive Guide To Scoliosis

A Comprehensive Guide To Scoliosis

If you’re battling with back problems, you might wonder if you have scoliosis.

This is a spinal disease that can be mild or serious, and could even overlap with other health conditions which makes it difficult to diagnose.

Here’s everything you need to know about it.

What is scoliosis?

It’s an incurable condition that results in a curving of the spine. It’s most common before puberty when teenagers experience a growth spurt. Most of the time, scoliosis is mild, although in some cases it can be quite severe.

There are important things to know about scoliosis. Here’s a comprehensive guide to this spinal condition and how it can be treated.

Common Symptoms Of Scoliosis

Illustration of Scoliosis

There are quite obvious symptoms related to scoliosis, but interestingly the condition isn’t always spotted in children by parents because it can be quite subtle.

In addition, scoliosis doesn’t usually cause pain, which can make it even more difficult for the child to notice that he or she has it.

With that in mind, here are some common symptoms that tend to present themselves, when it comes to adolescents, babies, and adults.

Let’s first look at scoliosis symptoms in adolescents because this is the period in one’s life when the disease will most likely present itself.

Adolescent Scoliosis Symptoms 

  • Shoulders that are uneven – one might be a little higher than the other
  • An uneven waist
  • A shoulder blade that’s more prominent than the other
  • A hip that’s higher than the other
  • The person’s head can be a bit off-center
  • The person’s clothes don’t hang properly off their body
  • Legs that are of uneven lengths
  • As the condition progresses, the spine will continue to rotate and this can cause the ribs to stick out.

Scoliosis Symptoms In Infants

In babies, symptoms can show up a bit different as compared to adolescents with the condition, and they can include the following:

  • A bulge that appears on the chest, usually on one side 
  • Problems related to the lungs or heart, such as pain and shortness of breath, which can signal a problem with the spine
  • It’s also worth noting if the baby always lies in a curved fashion on their side, as this can be a sign that there’s a problem with the spine being curved

Scoliosis Symptoms In Adults

Although it’s most often present in adolescents, scoliosis can affect people during adulthood.

So, what are the common scoliosis symptoms?

In adults, symptoms of scoliosis can include the following:  

  • Loss of height, perhaps because the person is bending to one side
  • Difficulty with standing up straight and having good posture
  • Difficulty when walking
  • Feeling tired
  • A bump in the lower back
  • Uneven shoulders
  • Uneven hips
  • A weak or numb feeling, or pain, in the legs
  • Tiredness
  • Feeling of breathlessness
  • Back pain, which is usually the first sign of scoliosis in adults

There are two reasons why scoliosis can show up in adulthood. 

  • One is that the person already had the disease since childhood but it was mild and so they only noticed it later on in life, perhaps because it worsened. 
  • Another reason is that scoliosis only occurred in adulthood. This can be the case for some people with the disease, and it’s often due to age-related wear and tear that can cause damage to the joints and bones that are in the spine. This, then, results in spinal curvature.  

What Is Scoliosis Caused By? 

Scoliasis Diagnose

Scoliosis is a bit of a medical mystery because the cause of idiopathic scoliosis, which is the most common type of the disease, is still unknown.

However, scoliosis seems to be linked to hereditary factors because the condition can run in families.

That said, many children who are affected by scoliosis don’t have a family history of the disease, as Mayo Clinic reports, which can make it even more difficult to know what causes it.

Other, less common, types of scoliosis can be linked to:

  • birth defects that affect how the bones and spine in the body develop
  • spinal injuries
  • spinal infections
  • neuromuscular conditions such as Marfan syndrome, which is a disorder of connective tissues; muscular dystrophy; and cerebral palsy.

There Are Three Main Types Of Scoliosis

There are many types of scoliosis, but the three main types are idiopathic, congenital, and neuromuscular scoliosis. Here’s more detail about them.

Idiopathic

This refers to the most common type of scoliosis. Idiopathic scoliosis doesn’t have a known cause and there’s no single cause for the disease.

Over 80 percent of people with scoliosis have this type and most of them are adolescent girls, as reported by Medicine Net.

Congenital 

This type of scoliosis tends to arise after a spinal defect that’s already present at birth. It’s often detected at a really early age, even during infancy.

Neuromuscular

This type of scoliosis develops because there’s already a muscular or neurological disease that’s present in the body, such as cerebral palsy or muscular dystrophy.

What makes neuromuscular scoliosis quite different from other kinds of disease is that it develops faster.  

What Are Risk Factors For Scoliosis? 

Doctor Examinating Boys Back

While there isn’t always a clear cause for the disease, there are some risk factors that can play a part in its development. Here are the most common ones:

  • Age – Since scoliosis tends to mainly target children, being between the ages of 10 and 15 is a risk factor for it.
  • Gender – Being a female does increase one’s risk of getting scoliosis. In fact, women have a higher risk of spine curvature that also worsens over time when compared to men.
  • Genetics – As mentioned earlier, some scoliosis cases can run in families, however, this isn’t always a direct link to the disease because many people with scoliosis don’t have a relative who also has it.

How Is Scoliosis Treated?

Although scoliosis doesn’t have a cure, the good news is that most cases of the disease are not severe.

Because of this fact, sometimes treatment isn’t necessary.

Doctors will usually just keep an eye on the condition if someone has scoliosis, such as by ordering regular x-rays every four or six months.

When it comes to deciding if treatment is really necessary, doctors will take the following things into consideration:

The person’s gender

Again, gender plays a role because females are more likely than boys to have scoliosis that gets worse over time.

So, if a young girl has scoliosis, doctors will want to check how fast it’s progressing. If there is disease progression, they’ll want to treat it.

How badly the spine curves

If there’s a large curve in the spine, this increases the likelihood that it will get worse. Doctors will differentiate between “S-shaped” curves and “C-shaped” curves.

“S-shaped” curves are more likely to get worse over time than “C-shaped” ones, as Medical News Today reports.

How the curve is positioned

It’s not just the size of the curve that matters, but also its position.

If the curve is in the middle part of the spine, it’s probably going to get worse than curves that are located in the upper or lower sections of the spine.

How much have the bones grown?

This is an important question that doctors need to ask when looking at a patient’s specific case of scoliosis, and it will influence the type of treatment that should be followed.

For example, if the person’s bones are still growing, then braces can be used to treat the condition more effectively than if the person’s bones have already developed.

However, that also means that the curvature is less likely to get worse because the bones are no longer growing, which is something to consider.

Treatment Options For Scoliosis

If a doctor has decided that scoliosis should be treated, there are different ways in which this can be achieved. Here are the most common lines of treatment.

Fitting A Cast

A cast that’s made of plaster of Paris is sometimes considered as a line of treatment for scoliosis, especially when it comes to infants.

This is because the cast helps to move the spine back into its healthy position as the person grows and develops. 

How it works is that the cast is worn around the person’s body and has to be worn at all times in order to work effectively.

Braces

Another scoliosis treatment is braces. This is usually the go-to treatment option for adolescents who are showing symptoms of moderate scoliosis. 

These braces will likely have to be worn all the time, even during sleep.

While a brace will prevent the curvature of the spine from getting worse, it, unfortunately, won’t be able to reverse any curvature that has already taken place.

However, if the condition has been diagnosed at an early stage, then damage to the spine can be minimal.

There are three types of braces that can be used:

Thoracolumbosacral orthosis (TLSO) braces

These braces are made of plastic and they fit around the curves of the body so they are not visible through clothing. They are worn underneath the arms and around the lower back and hips.

Milwaukee braces

These braces for spinal curvature consist of a neck ring that his chin rests as well as rests for the back of the head.

They’re usually only considered if the TLSO brace won’t be effective for the person in question, such as if the curve is higher up the spine.

In this case, a Milwaukee brace will be recommended.

Charleston Brace

This brace is only worn at night and it’s suitable for treating lumbar and lower thoracic curves.

Instead of pushing against the spinal curve to straighten it or at least prevent it from curving, even more, the Charleston Bending brace puts more pressure on the curve than previously-mentioned braces.

Therefore, it can only be worn at night. 

Although this brace has seemed promising in research so far, it hasn’t undergone as much testing as the other two braces, as the University of Maryland Medical Center has reported.

Surgery

In the presence of scoliosis, one might wonder about surgery to treat it.

Surely that would be the best way to correct the spine?

Well, the question of surgery isn’t always an easy one to answer.

Surgery isn’t always suggested as a form of treatment for scoliosis because it isn’t guaranteed to stop it in its tracks.

In children, if the spinal curve is greater than 40 degrees and the condition is progressing, then surgery will be seen as a viable option.

In adults, if the spinal curve is greater than 50 degrees and it has been causing other symptoms, such as nerve damage, then surgery will be required.

There are two types of surgery.

One makes use of the anterior approach (this is surgery through the side) or posterior approach (through the back), as reported by the American Association Of Neurological Surgeons.

Posterior approach

This is the most common surgery for adolescent idiopathic scoliosis. Incisions are made in the patient’s back so he/she will be lying on their stomach during the procedure.

Rods are used to straighten the spine and a bone graft is placed on the curved area. This helps to connect the vertebrae and allow the spine to remain straight.

This surgery can take many hours, but braces are not required after surgery, so it’s common for patients to go back to their normal lives within a month because recovery after the operation is good.

Anterior approach

This is scoliosis surgery that involves the incision being made on the patient’s side. Their lung will have to be deflated and a rib removed so that the surgeon can reach their spine. 

Technology has improved this surgery, thanks to video-assisted thoracoscopic surgery that makes it easier to see the spine with a camera.

Although it sounds more complicated than the posterior approach, the anterior approach to scoliosis surgery can improve the curvature more successfully and it results in fewer segments of the spine having to be fused. 

However, one of the drawbacks of the surgery is that patients will probably need to wear a brace for a few months after the procedure.

Minimally-Invasive Surgery (MIS)

In some cases, scoliosis surgery can be done with the use of smaller incisions, thanks to the use of technological advancements such as endoscopy.

Not all cases can be treated with MIS, as it depends on the person’s specific curvature.  

Will Scoliosis Surgery Work On Adults? 

In adults, treatment for scoliosis isn’t always focused on surgery.

In fact, correctional surgery for the condition is seen as a last resort.

The most important goal is to relieve pain if the specific type of scoliosis is causing discomfort, so medication is usually prescribed as well as healthy lifestyle habits such as an exercise regime. 

Can Scoliosis Be Prevented?

Man Sitting Properly And Girls Exercising

The only type of scoliosis that can be prevented is the one that’s linked to osteoporosis.

By lowering one’s risk of osteoporosis, this is thought to decrease the risk that scoliosis can develop.

When it comes to other cases of scoliosis, most of them can’t be prevented.

Although some information on the internet refers to preventative measures for the disease, such as maintaining good posture and doing exercises, these are not factual and should be considered with great caution.  

However, it’s worth bearing in mind that early detection of the disease can help to slow down or even stop its progression, as Harvard Health Publishing reports.

Therefore, if you’re a parent, you should check your child’s spine for any abnormalities and speak to your doctor about concerns you have, such as if your child’s clothing isn’t fitting properly.

If you’re an adult who’s been getting symptoms that could relate to scoliosis, prompt diagnosis is also key.

Related Questions

How common is scoliosis?

Scoliosis is a condition that affects between 2-3 percent of people, as reported by the American Association of Neurological Surgeons (AANS).

This means that approximately six to nine million people are affected.

How can you look after your spine?

Although scoliosis can’t be prevented, there are ways to increase your spine health. Don’t sleep on your stomach as this puts pressure on the spine.

Maintain a healthy weight and do daily exercise. Chat to your doctor if you’re experiencing back problems as these can worsen over time.

Conclusion

Although scoliosis can’t be cured, there are many ways in which it can be treated.

Since it often shows up during the adolescent years, early diagnosis is important to slow down disease progression and improve quality of life.

Treatment, such as braces or surgery, can help to prevent further damage to the spine.

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