How Can Scoliosis Be Treated? Causes, Symptoms, and Risk Factors

Scoliosis is an abnormal curvature of the spine, usually diagnosed in childhood or early adolescence. This condition can affect any part of the spine, but it most commonly appears in the upper spine and lower back. It occurs more frequently in women than men and is not always easily noticeable. Some individuals with scoliosis may develop uneven shoulders or a misaligned lower back, causing them to lean to one side.

The severity of the curvature varies, ranging from mild to severe. Medical professionals classify a spinal curve as scoliosis when an X-ray shows a deviation of more than 10 degrees from normal alignment. When visualized on a graph, the curve typically takes the shape of a “C” or “S.”

A healthy spine naturally curves in the cervical, thoracic, and lumbar regions, keeping the head aligned with the pelvis and minimizing mechanical stress during movement. These natural curves exist in the sagittal plane. In contrast, scoliosis causes an abnormal spinal curvature in the frontal, or coronal, plane.

What is Sagittal and Coronal Plane?

The coronal plane runs vertically from head to feet, parallel to the shoulders, dividing the body into front (anterior) and back (posterior) sections. The sagittal plane splits the body into right and left halves. The axial plane is perpendicular to the ground, intersecting both the coronal and sagittal planes, and runs parallel to the horizon.

Although the degree of curvature is measured in the coronal plane, scoliosis is a more complex three-dimensional problem involving the following planes:

• Coronal plane
• Sagittal plane
• Cross-section

Types of Scoliosis

Scoliosis is classified into three main types:

• Idiopathic scoliosis is the most common form, with no known cause. However, research suggests a genetic link, as it often runs in families.
• Congenital scoliosis is a rare spinal abnormality present at birth. It develops when the vertebrae fail to form correctly during embryonic growth.
• Neuromuscular scoliosis results from muscle and nerve abnormalities that support the spine. It often occurs alongside conditions like cerebral palsy, spina bifida, muscular dystrophy, or spinal injuries.

When scoliosis develops in adulthood, healthcare providers may refer to it as adult-onset scoliosis or degenerative scoliosis. Some individuals may have had mild scoliosis throughout their lives without a diagnosis. As the body ages, symptoms can emerge or worsen due to weakening spinal discs, joint degeneration, or decreased bone density (Osteoporosis), leading to a late diagnosis.

Idiopathic scoliosis is further classified based on the age of diagnosis:

• Infantile scoliosis: Diagnosed before age 3.
• Juvenile scoliosis: Diagnosed between ages 4 and 10.
• Adolescent scoliosis: Diagnosed between ages 11 and 18.
• Adult idiopathic scoliosis: Diagnosed after age 18 when skeletal growth is complete.

Scoliosis affects approximately 2% of the global population, impacting over 6 million people in the United States alone.

Causes of Scoliosis

Clear causes exist for some forms of scoliosis. These curves are divided into structural and nonstructural categories.

• The spine seems to be curled but functions normally in nonstructural scoliosis.
• Having one leg longer than the other, muscle spasms, and inflammations like appendicitis are a few causes of this.
• Scoliosis frequently disappears when these conditions are treated.

The curve of the spine is rigid and unchangeable in structural scoliosis. some causes are:

• Cerebral palsy
• Muscular dystrophy
• congenital disabilities
• Genetic disorders such as Marfan syndrome and Down syndrome

Risk Factors of Scoliosis

• Age: Signs and symptoms often start during a growth spurt before puberty. You may notice your child’s hips are uneven or that their backpack straps easily slide off one shoulder.
• Gender: Females have a higher risk of scoliosis than males.
• Genetics: People with scoliosis often have a close relative with the condition because it is a genetic disorder.

Symptoms of Scoliosis

If you have scoliosis, you might lean to one side when you stand. You could also have:

• A visible curve in your back
• Your shoulders, waist, or hips look uneven.
• A shoulder blade that looks larger
• Ribs protruding more on one side of the body than the other

In addition to visible symptoms, scoliosis can result in:

• Lower back pain
• Back stiffness
• Pain and numbness in your legs (due to pinched nerves)
• Fatigue from muscle tension

Treatment for Scoliosis

If the scoliosis is mild, the person may not need treatment. However, your doctor might watch you and take X-rays to see if the problem worsens. If you or your child need treatment, your doctor may suggest:

Braces: For children who are still growing, wearing a torso brace can help prevent the spinal curve from worsening. Typically made of plastic, these braces are often worn 24 hours a day and remain discreet under clothing.

Spinal Fusion Surgery: This procedure involves placing bone grafts or similar materials between the spinal bones to help them fuse. Doctors use hardware to stabilize the spine until the bones grow together. The surgery improves spinal alignment and prevents the curve from worsening.

Spine and Rib-Based Growing Surgery: This procedure treats severe scoliosis in growing children by attaching metal rods to the spine or ribs. As the child grows, the doctor periodically adjusts the rods to accommodate spinal development.

Scoliosis Prevention

There is no way to prevent scoliosis from developing, and there is no evidence that childhood sports injuries cause it. Likewise, if your child is at school, you may be concerned about the textbooks’ weight; heavy backpacks can lead to back, shoulder, and neck pain but do not cause scoliosis.

Frequently Asked Questions