Scoliosis: Symptoms, Diagnosis, and Treatment

Scoliosis is a common orthopedic condition, affecting between 6 million and 9 million people in the United States. While some people with the condition don’t experience any symptoms and can forgo treatment, those with extreme curvature and pain usually require medical intervention — whether a back brace, physical therapy or even surgery.

Fortunately, the condition is highly treatable. Learn what causes scoliosis and some possible treatment options you can pursue.

What Is Scoliosis?

Scoliosis is a condition that causes an abnormal sideways curvature of the spine. While it can develop at any age, it’s most commonly diagnosed during childhood or early adolescence, typically between 10 and 15 years old. The curvature can range from mild and painless to severe, causing significant discomfort and affecting posture and breathing.

What Does Scoliosis Look Like?

Scoliosis causes the spine to resemble an “S” or “C,” making the person appear as if they are tilting to the left or right. Some individuals with scoliosis might have a shoulder blade that sticks out more than the other, or one shoulder that sits higher than the other. Others may have one side of their rib cage stick out more when bending over.

Standard symptoms and visual signs of scoliosis include:

Uneven shoulders.
Protruding shoulder blades.
One hip appearing higher than the other.
One side of the rib cage pushing forward.
The entire body leaning to one side.
Head not centered directly above the pelvis.
Uneven waist.
Changes in posture.

Severe and progressing scoliosis can lead to back pain and, in some cases, breathing difficulties. Extreme curvature can affect the lungs, restricting their capacity.

How Do You Get Scoliosis?

In most cases, the exact cause of scoliosis is unknown. This condition is known as idiopathic scoliosis. Researchers are still exploring its possible causes, but they believe a combination of factors — including hormones, genes and changes in cell structure — may be at play. Idiopathic scoliosis can develop at any time, but most cases occur during puberty and growth spurts. It can also run in families.

In addition to idiopathic, scoliosis can fall into these classifications:

Medical condition-related: Some individuals develop scoliosis due to a preexisting medical condition that affects the skeletal system, such as cerebral palsy, muscular dystrophy, Marfan syndrome, spinal tumors or brittle bone disease. Scoliosis may also develop following a spinal injury.
Congenital: In some cases, congenital factors may contribute to scoliosis, meaning there were complications with spinal development before the baby was born. The condition may not be noticeable until the child has a growth spurt.
Degenerative: While scoliosis usually manifests during childhood or adolescence, adults can develop the condition, as well. Degenerative scoliosis can result from wear and tear on the joints and spinal discs.

How to Know if You Have Scoliosis

If you’re displaying symptoms of scoliosis, visit an orthopedic specialist. They will conduct a physical examination and evaluate your medical history. They may also ask about your family’s health since the condition can be hereditary. Doctors can typically diagnose scoliosis using a physical exam and an imaging test, such as an X-ray, a CT scan or an MRI.

Generally, any curvature that exceeds 10 degrees is classified as scoliosis. Using the Cobb angle, the doctor will likely measure the spinal curve using the following standard:

Mild curvature: Less than 25 degrees.
Moderate curvature: Between 25 and 40 degrees.
Severe curvature: More than 40 degrees.

How to Fix Scoliosis

Once your doctor confirms your diagnosis, they’ll work with you to develop a personalized treatment plan if needed. The ideal option will depend on your age, any other medical conditions you have, the cause of your scoliosis, if known, and the severity of the curvature.

Scoliosis looks different between patients. As such, treatment plans and strategies vary. They can be:

Conservative: Conservative scoliosis treatments include noninvasive options like physical therapy, bracing and pain relief medications. They aim to alleviate discomfort, improve flexibility and spine stability, and strengthen your core muscles.
Surgical: Severe curvature and pain may necessitate surgery to straighten and stabilize the spine. Generally, surgery is only considered if nonsurgical options are unsuccessful.

Here are some possible treatments for scoliosis.

Back Braces

Doctors often recommend back braces for growing children and teens with a spinal curvature exceeding 25 degrees. This can help prevent the curvature from progressing as the child grows. Although the spine is finished developing once a person reaches adulthood, adults can benefit from scoliosis braces, too.

For instance, you might start out wearing a corrective brace full-time, then transition to a supportive brace part-time to help ease back pain. Different types of braces exist, and based on your unique condition, an orthopedic specialist can help you determine the ideal type and how often to wear it.

Physical Therapy

Physical therapy is a natural, noninvasive way to manage scoliosis. A physical therapist can work with you to create a tailored exercise regimen to improve posture, relieve pain, boost flexibility and strengthen core muscles.

Medications

Medications like nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and acetaminophen can help reduce scoliosis pain. Sometimes, doctors may recommend nerve blocks or steroid injections for severe pain.

Surgery

In children, scoliosis surgery aims to stop the curve from worsening into adulthood. Surgery is often recommended when the curvature exceeds 40 degrees and is progressing. The procedure can involve anterior (front) incisions or posterior (back) incisions.

Adults may also require surgery in some cases, usually when:

The curve is greater than 50 degrees.
Nerve damage is present in the legs.
Bladder or bowel symptoms are present.

For adults with degenerative scoliosis, a few factors can increase the need for surgical intervention, including being overweight, smoking and having other health problems. Normally, adults take longer to recover from scoliosis surgery than children — full recovery can take up to 12 months. Specific types of scoliosis surgery include:

Spinal fusion: This procedure holds the spine in place with rods and screws to straighten it as much as possible. A bone graft fuses the vertebrae together and prevents the curve from worsening.
Decompression surgery: This procedure is often performed in conjunction with spinal fusion, particularly when spinal stenosis (nerve compression) is also present. It removes bone or tissue that is pressing on the spinal nerves.
Osteotomy: This procedure involves cutting, reshaping and realigning bones to correct severe spinal deformities. It’s often combined with spinal fusion for optimal results.

Keep in mind that scoliosis cannot typically be “cured” or “reversed.” Rather, scoliosis treatment aims to manage pain, prevent the curve from worsening and improve spinal alignment.

Find Scoliosis Relief With Spine INA

If you’re experiencing back pain and signs of scoliosis as an adult, seeking medical intervention as soon as possible is important to address the problem. At Spine Institute of North America, our experienced medical professionals can diagnose the issue and help you create a customized care plan. Serving patients throughout Central New Jersey, we can work with you to alleviate back pain and discomfort, helping you achieve the lifestyle you desire.