Scoliosis

What is scoliosis?

Scoliosis means that the spine curves from side to side rather than being straight down the back. The spine is made of bones called vertebrae that normally stack one on top of the other in a straight line. The bones in the upper back are called thoracic vertebrae. This is the most common site for scoliosis. The bones in the lower back are called lumbar vertebrae. Scoliosis occurs less often in the lumbar vertebrae.

Scoliosis develops gradually. Scoliosis is usually noticed just before or during puberty when a child goes through a growth spurt. Females get scoliosis more often than males. Often parents do not notice the gradual changes caused by scoliosis. The curvature is usually discovered by a healthcare provider. Occasionally, scoliosis is diagnosed during infancy and is treated sooner.

What is the cause?

There are many causes of scoliosis. Sometimes vertebrae are incompletely formed or misshapen. Sometimes people who have legs of different lengths develop a curvature of the spine. Other times, diseases cause scoliosis.

When a cause for scoliosis cannot be found, it is called idiopathic scoliosis. In idiopathic scoliosis some of the vertebrae are rotated because the muscles attaching the vertebrae to the ribs may not be pulling with equal force. One set of rib muscles pulls harder causing the vertebrae to twist and move out of a straight line down the back. This may also cause the ribs on one side of the back to stick out more, causing a hump.

What are the symptoms?

At first, the symptoms are painless and not always easy to recognize. If you have scoliosis, you may:

• Have uneven shoulders, hips, or waist.
• Have a hump on one side of the back.
• Have one or both shoulder blades sticking out.
• Lean slightly to one side.
• Have back pain.

How is it diagnosed?

The healthcare provider will take a medical history to see if there may be a cause for the scoliosis. The provider will do a physical exam, checking the back, chest, shoulders, pelvis, legs, feet, and skin. The curve of the spine may be measured during the exam. X-rays can be taken to measure the curvature more precisely.

How is it treated?

Your healthcare provider will suggest treatment based on your age, how much you are likely to grow, the degree and pattern of the curve, and the type of scoliosis. You may be referred to a back specialist.

Treatment may include:

• Observation: You will be reexamined every 4 to 6 months if you are still growing and if you have a curvature of less than 20 to 25 degrees.
• Bracing: Your provider may advise you to wear a brace if you are still growing and have a curvature of 25 to 40 degrees. The brace will help stop the curve from getting worse.
• Surgery: Healthcare providers usually advise surgery if the curvature is greater than 40 degrees.

Symptoms from scoliosis may be treated with physical therapy. You may need to work on proper posture and avoid overusing your back (such as carrying a heavy backpack).

How long will the effects last?

The curvature in the back will never go away. However, many people have no symptoms or problems from their scoliosis. When problems do occur, they will last until the symptoms are treated. How well the treatment works depends on the type of treatment and the severity of the problem.

How do I take care of myself?

• Use good posture.
• Exercises that keep your back strong and flexible are usually recommended. They are not proven to be effective, but are believed to be helpful.
• Avoid carrying backpacks that are too heavy. Be sure to carry a backpack evenly over both shoulders, instead of slung over one shoulder.
• Take frequent stretching breaks if you work at a desk or computer for long periods of time.
• Stay fit and avoid becoming overweight.