Scoliosis

Your spine is like a stack of building blocks with one block stacked on top of another. Normally, these vertebrae are stacked in a straight line. But if you have scoliosis, those blocks are twisted and turned, making the spine look more like the letter S or C instead of a straight line.

Your doctor will be able to tell if you have scoliosis by taking an X-ray and measuring how much the spine is curved. The curve can turn to the right or left and be in any section of the spine.

What is scoliosis?

While some sideways curvature in the spine may be natural, people with scoliosis have an extreme curve.

Scoliosis is most often diagnosed in children or teens; however, it can form in adults and tends to run in families. In more than two-thirds of cases, the cause of scoliosis is unknown. In the other one-third of cases, it’s caused by disc degeneration or neuromuscular conditions.

Types & classifications of scoliosis

Scoliosis can be seen in your spine in different ways. Your doctor will classify the type of scoliosis in one of four categories based on the location of the curve in the spine:

• Thoracic scoliosis: The curve is noticeable in the thoracic (middle) section of your spine.
• Lumbar scoliosis: The curve is noticeable in the lower section of the spine (lumbar spine).
• Thoracolumbar scoliosis: The curvature is noticeable where the thoracic and lumbar sections of the spine meet.
• Double curve scoliosis: There are two visible curves in the spine.

Moreover, there are four main types of scoliosis characterized by when it forms and the cause. Each type may require different approaches to treatment.

The types of scoliosis include:

• Idiopathic scoliosis: This is the most common type of scoliosis, and often develops during adolescence. "Idiopathic" means that the cause is unknown. It can occur in otherwise healthy individuals and may get worse during growth spurts.
• Congenital scoliosis: This type of scoliosis is present at birth and is caused by abnormalities in the formation of the vertebrae while the baby is developing in the womb.
• Neuromuscular scoliosis: This type of scoliosis is related to conditions that affect the muscles or nerves, such as cerebral palsy, muscular dystrophy or spinal cord injuries. These conditions can affect the muscles that support the spine, leading to curvature.
• Degenerative scoliosis: This type occurs in adults as a complication of conditions like arthritis or osteoporosis.

Can I live normally with scoliosis?

Many people with scoliosis live normal, active lives. The impact of scoliosis on daily life can vary greatly depending on the severity of the curve, any associated symptoms or complications and how well it responds to treatment.

Mild cases of scoliosis may not cause any noticeable symptoms or limitations, and you may not require any treatment beyond monitoring by your provider. You can typically participate in regular activities, sports and hobbies without significant hindrance.

In more severe cases of scoliosis, you may experience discomfort, pain or difficulty with certain activities. Treatment options such as bracing, physical therapy or, in some cases, surgery may be recommended to manage symptoms, prevent progression and improve quality of life.

Scoliosis symptoms

Each person may experience symptoms of scoliosis in different ways. Scoliosis symptoms can vary depending on the severity of the curvature of the spine and how far your scoliosis has progressed. The most common symptoms of scoliosis include:

• Obvious curve in your spine
• One hip that’s higher than the other
• One leg that’s longer than the other
• Uneven shoulders
• Asymmetrical rib cage
• Leaning to one side
• Back pain
• Fatigue
• Breathing difficulties

It's important to understand that scoliosis can be present without causing any symptoms, especially in mild cases. Regular check-ups with your doctor, particularly during adolescence when scoliosis often develops, can help detect and monitor the condition.

Scoliosis diagnosis

Scoliosis is typically diagnosed through a combination of a physical exam, review of your medical history and imaging tests.

During a physical exam, your doctor will assess your posture, spinal alignment, shoulder height and waist symmetry, along with any noticeable curves or abnormalities. They may also observe your gait and mobility.

Your doctor will inquire about scoliosis symptoms you may have been experiencing, any family history of scoliosis or spinal conditions and any potential risk factors or underlying medical conditions that may contribute to scoliosis.

If scoliosis is suspected, imaging tests such as X-rays are typically ordered to confirm the diagnosis and evaluate the severity and characteristics of the curve in your spine. In some cases, additional imaging tests, such as MRI or CT scan, may be ordered to further evaluate the spine or to assess for any underlying causes or complications associated with scoliosis.

Other tests may include:

• Scoliometer screening: During this screening, your doctor places a card called an inclinometer on your back to measure the curve of your spine.
• Bone scan: Before a bone scan, you’ll receive a small injection of radioactive substance to help your doctor see the details of your spine better.

Once a diagnosis of scoliosis is confirmed, your provider may recommend a treatment plan based on the severity of the curvature, your age and overall health.

Scoliosis treatment

At Aurora Health Care, we connect you with a team of specialists who work together to give you a personalized treatment plan. Our spine experts work directly with chiropractors and physical therapy experts, offering noninvasive scoliosis treatment options whenever possible.

Treatment for scoliosis varies depending on factors such as the severity of the curve in your spine, your age and any associated symptoms or complications. In children with scoliosis, girls have a higher risk of the condition getting worse over time than boys.

If scoliosis is mild and not progressing, your provider may recommend regular monitoring without immediate intervention. This often involves periodic check-ups and X-rays to assess the progression of the curvature.

For adolescents with moderate scoliosis who are still growing, bracing may be recommended to prevent further progression of the curvature. Bracing involves wearing a specially designed brace for several hours each day to support the spine and prevent it from worsening as the body grows.

Other treatments for scoliosis may include:

• Schroth exercises: Using the Schroth Method, our physical therapists tailor stretching, strengthening and breathing techniques to the curvature of your spine. These special exercises, which help stop and reverse scoliosis, can be done at home, too.
• Physical therapy: Physical therapy can be beneficial for strengthening the muscles surrounding the spine, improving flexibility and helping to maintain good posture. It can also provide pain relief and improve overall function and quality of life.
• Spinal fusion surgery: This type of scoliosis surgery permanently fuses two or more vertebrae together using metal rods, screws and bone grafts. Your doctor may recommend surgery if your scoliosis is severe or to make sure the condition doesn’t affect the heart or lungs.