Scoliosis is an abnormal curvature of the spine. The human spine is made of bones called vertebrae that are stacked on top of one another. This flexible structure allows us to bend and twist our bodies in all directions.
A healthy spine curves from front to back at the neck, chest and lower back. However, in people with scoliosis, the spine also develops a side-to-side curvature. This usually happens during the growth spurt that begins just before puberty.
A scoliosis curve can be C- or S-shaped. In severe cases, the spine will rotate and twist, causing the ribs to stick out more on one side.
Most cases of scoliosis are mild and cause no health problems. In severe cases, the twisting of the spine and ribs reduces space within the chest cavity. This can interfere with breathing and put strain on the heart. Untreated scoliosis can also compress and damage the spinal nerves, leading to paralysis. However, these complications are very rare in the United States, because most cases are treated in their early stages.
Scoliosis affects about 3 in every 100 people, or about 6 million people in the United States. It can appear at any age, but usually starts between ages 9 and 15. While scoliosis is equally common in boys and girls, girls are eight times more likely to have severe curves that require treatment.
In 80-85 percent of scoliosis cases, the cause is unknown. This type of scoliosis is called “idiopathic,” meaning “of unknown origin.” Genetics may play a role in cases of idiopathic scoliosis; about 30 percent of children with this type of scoliosis have a close relative with the condition.
In a few cases, scoliosis is caused by another underlying medical condition such as cerebral palsy, muscular dystrophy, injury or infection. These conditions can cause muscle weakness and imbalance, which in turn can cause the spine to curve as it grows.
Scoliosis can also result if the bones of the spine do not form properly or separate before birth. Cases of this kind are called “congenital scoliosis.”
Mild scoliosis can be difficult to detect, because it usually doesn’t cause pain or discomfort. Early symptoms include:
In more severe cases, you might notice:
See your doctor if you or your child have symptoms of scoliosis. Early detection and treatment can help to prevent the curve from worsening.
About half of all schools routinely screen students for scoliosis. The test involves bending over and touching your toes so that a doctor or nurse can examine the position of your spine and ribs.
Diagnosis for scoliosis starts with a physical exam. Your doctor will have you assume different postures to check for evenness of the shoulders, hips and ribs. You also might receive a neurological exam to detect weakness, numbness or abnormal reflexes.
In most cases, a simple X-ray can confirm a diagnosis of scoliosis and show how far the curve has progressed. Children with scoliosis are usually referred to a specialist called an orthopedist or orthopedic surgeon for treatment.
Many cases of scoliosis do not require treatment. However, your doctor may recommend treatment if the condition is severe or progressing rapidly. Some factors to consider:
Treatment options for scoliosis include:
Fortunately, scoliosis is rarely life-threatening. While the condition has the potential for severe complications, these are extremely rare, thanks to the treatments now available.
Most people with scoliosis can lead normal, active lives with no restrictions on their activities. Some activity restriction may be necessary in severe cases or following surgery.
There is no known way to prevent scoliosis.