Scoliosis (a curvature of the spine) is usually first noticed in childhood. We are not sure what causes childhood scoliosis. Usually, poor posture is a symptom of scoliosis. There is no evidence that poor posture is a cause of scoliosis. However, poor posture can lead to the same kind of complications caused by scoliosis.
What are the signs of scoliosis?
It is difficult to discern the development of scoliosis because symptoms develop slowly over time. Most of the symptoms show up in a person’s posture. In particular, a normal body is symmetrical (i.e. one side looks like the other).
An examining physician will direct the patient to bend forward because the outline of spinal curvature is more prominent. They will also observe the patient’s posture standing and walking. Asymmetric features include the following:
- A noticeably curved spine.
- One hip is higher than the other.
- One shoulder is higher than the other.
- One hip is higher than the other.
- Uneven waistline.
- One shoulder-blade is protruding more than the other.
- One hip is higher than the other.
- One side of the rib cage is protruding more than the other.
In addition to visible postural symptoms, some scoliosis patients develop back stiffness and low back pain, leg pain, and fatigue.
Other tests include
- X-rays of the spine
- MRI of the spine
- Scoliometer measurement of a spinal curve.
- CT scan.
Adolescent Scoliosis
The most common type of scoliosis (Idiopathic scoliosis) occurs in adolescents. It shows up especially during growth spurts.
Studies show that adolescent girls and boys are equally likely to have scoliosis. However, scoliosis in girls is far more likely to get worse as they grow.
A spine curvature of at least 10 degrees is considered to be scoliosis however that is not discernible without an x-ray. A curvature of more than 20 degrees could probably be observed by a parent.
Adolescents and young adults are not likely to experience pain from the most common idiopathic scoliosis by itself. However, it can cause associated issues that lead to pain.
Causes
Although we don’t know what causes common adolescent scoliosis, we have identified some causes of less common forms.
- Birth defects
- Neuromuscular conditions, like muscular dystrophy.
- Spinal injuries or infections
- Spinal cord abnormalities
What complications can stem from scoliosis?
Most cases of scoliosis present mild symptoms. However, some cases have worse complications as the patient ages.
- Poor posture can lead to breathing difficulty because a misaligned rib cage can impede lung function.
- Adults who had scoliosis as a child are more likely to develop back problems.
- The visible asymmetry of a person’s posture can be embarrassing.
Some of the complications are
- Low back pain.
- Breathing problems.
- Low self-esteem or embarrassment.
- Infections or other complications of surgery.
- Spinal cord nerve damage or irritation from curvature.
- Leakage of spinal fluid causing painful cysts.
Types of Scoliosis
Scoliosis presents in different types including
- Idiopathic scoliosis has no known cause and is the most common type. About 4 of 100 adolescents develop scoliosis between the ages of 10 and 18. Research has led to more educated theories of causes but further work is needed.
- Congenital scoliosis forms before birth when a baby’s spine bones or ribs don’t form properly.
- Neuromuscular scoliosis is caused by another spinal disorder including spinal cord injury, cerebral palsy, and spina bifida which weaken muscles that support the spine.
- Degenerative scoliosis often coincides with wear and tear on disks and joints as we age.
Scoliosis causes conditions that look like poor posture. But they can’t be corrected just by standing up straight. There are 4 types of curvature which give different appearances. The distinctions of the curves are made by where along the spine and in which direction the curves occur.
- Right thoracic curves bend to the right of the thoracic region (upper back).
- Right thoracolumbar curves bend to the right side starting in the thoracic region and ending in the lumbar region (lower back).
- Right lumbar curves bend to the right of the lumbar region.
- Double major curves have a right thoracic curve above and a left lumbar curve below.
Prognoses
Mild cases of scoliosis are usually successfully treated if needed with back braces with no long-term problems. With age, back pain is more likely.
Neuromuscular and congenital scoliosis can be associated with serious disorders like muscular dystrophy or cerebral palsy. The treatment of those cases varies with the treatment of the underlying cause.
Unfortunately, congenital scoliosis usually requires multiple surgeries.
Treatment of scoliosis
There is no known cure for scoliosis. Only the symptoms can be treated. Most symptoms of scoliosis are relatively mild and ordinarily are not readily discernible. However, mild postural abnormalities can develop into discomfort with aging and require treatment.
- Back brace A scoliosis patient who is still growing can be fitted with a back brace that might mitigate further curvature. They provide little help for congenital or neuromuscular scoliosis.
- Surgery. For severe scoliosis, surgery might help correct the curve with a spinal fusion. The spinal bones are reconfigured and held in place with metal rods. The rods are secured with screws until the bones are healed together.
- Physical therapy is prescribed to assist after surgery and/or with a back brace.
- Psychological counseling may be prescribed to deal with a scoliosis patient’s self-consciousness and self-esteem. Children, in particular, can experience low self-esteem, often as the brunt of kids’ teasing, and are in dire need of professional counseling.
Growing children with a propensity of scoliosis should be monitored and, if necessary, should receive treatment (e.g. back braces) early in the diagnosis. With the first indications of scoliosis, a parent should take their child to see a physician for an examination. Some school districts are providing or requiring scoliosis screening of children as they do for meningitis.