Scoliosis is an abnormal curvature of the spine. The normal shape of a person’s spine includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis.
According to the American Association of Neurological Surgeons (AANS), about 80 percent of scoliosis cases have no identifiable cause.
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Everything You Need to Know About Scoliosis
Medically reviewed by Arefa Cassoobhoy, MD, MPH — Written by Shannon Johnson — Updated on January 6, 2021
Types
Symptoms
Causes
Diagnosis
Treatment
Pain management
Outlook
Scoliosis is an abnormal curvature of the spine. The normal shape of a person’s spine includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis.
According to the American Association of Neurological Surgeons (AANS), about 80 percent of scoliosis cases have no identifiable cause.
The condition is often diagnosed during the first 7 years of a child’s life. Common causes, when they can be pinpointed, are:
congenital disabilities
neurological abnormalities
genetic conditions
What are the common types of scoliosis?
The largest category of scoliosis is idiopathic scoliosis, which refers to cases that have no definite cause. Idiopathic scoliosis is broken down by age group:
Infant: 0 to 3 years
Juvenile: 4 to 10 years
Adolescent: 11 to 18 years
Adult: 18+ years
Of these, adolescent idiopathic scoliosis is the most common, according to the AANS.
When researchers know the cause of different types of scoliosis, they include:
congenital, in which spinal deformities are apparent at birth
neurological, when nerve abnormalities affect muscles in the spine.
Incidence and Prevalence
Scoliosis affects 2-3 percent of the population or an estimated six to nine million people in the United States. Scoliosis can develop in infancy or early childhood. However, the primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females are eight times more likely to progress to a curve magnitude that requires treatment. Every year, scoliosis patients make more than 600,000 visits to private physician offices, an estimated 30,000 children are fitted with a brace, and 38,000 patients undergo spinal fusion surgery.
Source: National Scoliosis Foundation, June 2007
Symptoms:
Symptoms associated with scoliosis can include:
Pain in the back, shoulders, neck, ribs, and buttock pain nearest the bottom of the back
Respiratory or cardiac problems in severe cases
Constipation due to curvature causing "tightening" of the stomach, intestines, etc.
Limited mobility is secondary to pain or functional limitation in adults, mostly when twisting the torso.
The signs of scoliosis can include:
Uneven musculature on one side of the spine
Rib prominence or a prominent shoulder blade, caused by rotation of the rib cage in thoracic scoliosis
Uneven hips, arms, or leg lengths
Slow nerve action
Uneven posture
Heart and lung problems in severe cases
Calcium deposits in the cartilage endplate and sometimes in the disc itself.
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More information
Everything You Need to Know About Scoliosis
Medically reviewed by Arefa Cassoobhoy, MD, MPH — Written by Shannon Johnson — Updated on January 6, 2021
Types
Symptoms
Causes
Diagnosis
Treatment
Pain management
Outlook
Scoliosis is an abnormal curvature of the spine. The normal shape of a person’s spine includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis.
According to the American Association of Neurological Surgeons (AANS), about 80 percent of scoliosis cases have no identifiable cause.
The condition is often diagnosed during the first 7 years of a child’s life. Common causes, when they can be pinpointed, are:
congenital disabilities
neurological abnormalities
genetic conditions
What are the common types of scoliosis?
The largest category of scoliosis is idiopathic scoliosis, which refers to cases that have no definite cause. Idiopathic scoliosis is broken down by age group:
Infant: 0 to 3 years
Juvenile: 4 to 10 years
Adolescent: 11 to 18 years
Adult: 18+ years
Of these, adolescent idiopathic scoliosis is the most common, according to the AANS.
When researchers know the cause of different types of scoliosis, they include:
congenital, in which spinal deformities are apparent at birth
neurological when nerve abnormalities affect muscles in the spine
Scoliosis can also be categorized as either structural or nonstructural. In structural scoliosis, the spine’s curve is caused by a disease, injury, or congenital disability and is permanent.
Nonstructural scoliosis describes temporary curves that can be fixed.
Scoliosis symptoms
Symptoms vary depending on the degree of scoliosis. Common symptoms associated with scoliosis include:
one shoulder blade that’s higher than the other
one shoulder blade that sticks out more than the other
uneven hips
a rotating spine
problems breathing because of the reduced area in the chest for lungs to expand
back pain.
What causes scoliosis?
The cause of scoliosis often can’t be determined. Common causes that doctors may identify:
cerebral palsy, a group of nervous system disorders that affect movement, learning, hearing, seeing, and thinking
muscular dystrophy, a group of genetic disorders that result in muscle weakness
congenital disabilities that affect an infant’s spinal bones, such as spina bifida
spinal injuries or infections
People with a family history of scoliosis are more likely to develop the condition. People with a vagina are more likely to have more severe scoliosis than those with a penis.
How is adult scoliosis treated?
Conservative treatment
The majority of cases of adult scoliosis can be managed non-operatively through regular observation by a doctor, over-the-counter pain medications, and core-strengthening exercises to strengthen your abdomen and back and improve flexibility. If you smoke, it’s important that you quit. Smoking has been shown to speed up the degenerative process.
In most cases, your doctor will recommend some forms of physical therapy to both maintain strength and relieve pain. These may include:
Working to improve posture
Doing low-impact exercises, such as swimming
Daily stretching
Staying active
If pain is not relieved by oral medications or physical therapy, your doctor may recommend epidural (given around the spinal cord) or nerve block injections for more effective relief.
Surgical treatment
Surgery is necessary in some cases of adult scoliosis. This treatment is the last option because of the risks of complications from spinal surgery. Surgery may be suggested for the following reasons:
Pain. Surgery may be needed if back and leg pain from scoliosis becomes severe and ongoing and doesn’t respond to conservative treatment.
Spinal imbalance. Whether the spine remains balanced is important in assessing scoliosis progression and the need for surgery. When we stand, the head should be balanced over the center of the pelvis when looking from the front and over the hip joints when looking from the side. If the curve progresses to the point that this is no longer possible, patients will progress over time and have more pain and disability.
Surgery is needed to improve quality of life. Although surgery is not recommended solely to improve appearance, some people find the symptoms of their spinal deformity unbearable. Their spinal imbalance, too, affects basic function and overall quality of life. Surgery is the only option in these cases. In younger adults, cosmetic deformity may be a major factor in deciding to have surgery, but this is not usually the case in older adults. There are a variety of spinal surgical options, depending on each case. Generally, surgical procedures are designed to stabilize the spine, restore balance, and relieve pressure on nerves. Spine stabilization surgery fuses the spine's bones using bone grafts and then metallic implants to hold the spine in place.
Advances in surgical techniques and computer-assisted navigation systems make less invasive approaches possible and recovery time quicker.
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