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Scoliosis is an abnormal side-to-side curvature of your spine. Your spine (backbone) naturally has a slight forward and backward curve. With scoliosis, your spine curves to the left and right into a C or S shape. Most cases of scoliosis are mild, don’t cause symptoms, and don’t need treatment. Severe cases can cause uneven posture and pain. Treatment may include wearing a brace or surgery.
How Common is Scoliosis?
While scoliosis can affect people at any age, it most commonly begins in children between ages 10 and 15. According to the National Scoliosis Foundation, it is estimated to affect 7 million people in the United States—around 2% to 3% of the population.
Is Scoliosis Genetic?
About 30% of people with scoliosis also have a family member with it. However, no one gene has been found for idiopathic scoliosis. A variety of genes might affect whether you get it and how severe it is. There might be hormones or things in the environment at work, too (for instance, the amount of sunlight exposure a teen gets). Since girls are much more likely to have a severe curve than boys, scientists think the female hormone estrogen plays some kind of role. If you or one of your children has scoliosis, check your other kids regularly.
Are You Born with Scoliosis?
Approximately 20% of scoliosis cases have known causes, including birth defects, bone damage, and neuromuscular conditions like spina bifida, cerebral palsy, and spinal cord injuries, which can affect spinal development. However, the majority—over 80%—are idiopathic, meaning their causes remain unknown. Those with specific conditions, such as spina bifida, have a higher risk of developing scoliosis.
Research into adolescent idiopathic scoliosis has uncovered some insights, but there’s still no clear reason why some children’s spinal curves progress rapidly while others remain stable. The National Institutes of Health suggests that a combination of genetic and environmental factors may play a role. Factors potentially linked to scoliosis include hormonal imbalances, abnormal growth in bones or muscles, nervous system irregularities, and certain genetic patterns.
Is Walking Good for Scoliosis?
Walking is a low-impact exercise that can help strengthen the muscles in the legs, hips, and back. This can be particularly helpful for people with scoliosis, as weak muscles in these areas can contribute to poor posture and spinal curvature. Walking also helps improve balance, coordination, and flexibility, which are important for maintaining good spinal health.
In addition to physical benefits, walking can also have mental health benefits. Exercise has been shown to reduce stress and anxiety, improve mood, and increase overall feelings of well-being. For people with scoliosis, who may experience pain and discomfort as a result of their condition, walking can provide a natural way to manage symptoms and improve their quality of life.
Can You Get Disability for Scoliosis?
In the U.S., the Social Security Administration uses a medical guide called the Blue Book to find out if you're eligible for disability benefits. Scoliosis is not considered a disability by the Blue Book, but some spinal disorders are considered to be disabilities. If your scoliosis means that you have trouble walking or are in so much pain you have to reposition yourself more than once in 2 hours, you might qualify for disability benefits. For more information, visit the Social Security Administration website.
What Happens If Scoliosis is Left Untreated in Adults?
Untreated scoliosis, particularly in moderate to severe cases, can lead to various physical and mental health issues.
1. Spinal Deformity: Progression of scoliosis causes visible spinal deformities, often resulting in uneven shoulders, hips, and rib cage. This leads to muscle imbalances, chronic back pain, and limited mobility.
2. Respiratory Problems: Severe curvature can compress the chest cavity, restricting lung expansion and leading to shortness of breath, fatigue, and a higher risk of respiratory infections.
3. Cardiovascular Issues: As the spine compresses the chest, it can place pressure on the heart and blood vessels, which may cause chest pain, heart palpitations, and, in severe cases, increase the risk of heart failure.
4. Psychological Effects: Physical deformities and limitations may lead to low self-esteem, social isolation, and increased anxiety or depression, impacting daily activities and quality of life.
Can Scoliosis Cause Pain?
Back pain is common, particularly among people with scoliosis, though the severity varies widely. Scoliosis pain can significantly affect the quality of life, impacting both the individual and their family. The pain's intensity and location depend on the scoliosis type, as spinal curvature can irritate and strain nerves, muscles, tendons, and even organs. This irritation often disrupts posture and triggers muscle spasms, leading to a gradual decline in well-being. In severe cases, pain may radiate down the legs, causing sciatica and instability when walking. Much of the pain in adult scoliosis stems from stress on the spinal discs, which normally act as cushions between vertebrae to absorb impact and reduce friction during movement.
Can Backpacks Cause Scoliosis?
Scoliosis is not a condition caused by carrying a heavy load (not even a very heavy one). Scoliosis is also not caused by childhood sports injuries, heavy backpacks full of books, or hiking gear. Heavy loads may cause back, neck, and shoulder pain, but scoliosis develops in different ways. There is a fine line between degenerative conditions due to prolonged heavy load bearing, and the potential cause and diagnosis of scoliosis. It often helps to have a better understanding of certain conditions, as being informed can often be good medicine by itself.
Can Scoliosis Get Worse as You Age?
Childhood scoliosis often progresses with age, especially during adolescence, due to rapid bone growth. Scoliosis is typically diagnosed between ages 10 and 15, and doctors monitor it closely using regular X-rays and curvature assessments. Physical therapy may be recommended, while severe cases might require bracing or corrective surgery.
In adults, scoliosis can either arise without a clear cause or due to age-related spinal degeneration. Studies indicate that around 40% of adults with scoliosis experience worsening curvature over time, though for most, progression remains mild.
Can Scoliosis Cause Back and Leg Pain?
Adult scoliosis is different from idiopathic scoliosis, which typically affects children and teens. Idiopathic scoliosis can develop without an apparent cause and accounts for approximately 80% of scoliosis cases in the U.S. Adult degenerative scoliosis is a wear-and-tear breakdown of the spinal discs and joints that results in shifting and twisting of the vertebrae. As the degeneration progresses, the spine can become more out of balance, resulting in back and leg pain. As adults live longer, more active lives, we’re seeing an increase in cases of adult scoliosis.
1. Idiopathic scoliosis: This is the most common type. “Idiopathic” means the cause is unknown. Research does indicate that it runs in families and has a genetic (hereditary) link.
2. Congenital scoliosis: This is a rare spine abnormality that a healthcare provider may detect at birth. It occurs when vertebrae (the bones that make up your spine) don’t form as they should during embryonic development.
3. Neuromuscular scoliosis: Abnormalities in the muscles and nerves that support your spine cause this type. It usually happens alongside neurological (nerve) or muscular conditions like an injury, cerebral palsy, spina bifida, or muscular dystrophy.
Signs and Symptoms of Scoliosis
Scoliosis usually doesn’t cause symptoms, but they may include:
- Back pain.
- Difficulty standing upright.
- Core muscle weakness.
- Leg pain, numbness, or weakness.
Signs of scoliosis may include:
- Uneven shoulders.
- Shoulder blades that stick out.
- Head that doesn’t center above your pelvis.
- Uneven waist.
- Elevated hips.
- Constant leaning to one side.
- Uneven leg length.
- Changes in skin appearance or texture (dimples, hair patches, skin discoloration). These occur on your back along your spine.
What Causes Scoliosis?
A person with scoliosis will have a sideways C- or S-shaped curve in their spine. For a doctor to diagnose scoliosis, the Cobb angle — a measure of the curvature — must be at least 10 degrees. Scoliosis can appear at any age, but it often occurs between the ages of 10 and 12 years or during a person’s teens. While scoliosis is rare in infants, infantile scoliosis can affect people before the age of 3 years. In most cases, there is no known cause of scoliosis. Below are some of the possible causes of scoliosis:
1. Neuromuscular conditions: These conditions affect the nerves and muscles. They include cerebral palsy, poliomyelitis, and muscular dystrophy.
2. Congenital scoliosis: Congenital means that the condition was present at birth. Scoliosis is rare at birth, but it can occur if the bones in the spine develop abnormally when the fetus is growing.
3. Specific genes: Researchers believe that at least one gene plays a role in the development of scoliosis.
4. Leg length: If one leg is longer than the other, an individual may develop scoliosis.
5. Syndromic scoliosis: Scoliosis can develop as part of a medical condition, including neurofibromatosis or Marfan’s syndrome.
6. Osteoporosis: Osteoporosis can cause secondary scoliosis due to bone degeneration.
7. Other causes: Poor posture, carrying backpacks or satchels, connective tissue disorders, and some injuries that can cause spinal curvature.
Common Risk Factors for Scoliosis
Because early intervention can help prevent spinal curvature from progressing, you need to know the common risk factors for scoliosis to ensure that your child receives the appropriate screenings for scoliosis during childhood.
A. Three common risk factors for idiopathic scoliosis
Risk factors for developing idiopathic adolescent scoliosis (the most common type of scoliosis that accounts for 80% of all cases) include:
1. Age
Symptoms of scoliosis often begin during puberty, often between the ages of 10 and 18. You might notice your child’s hips are uneven or his/her backpack straps slide off one shoulder easily. You might also notice your child’s ribs are uneven.
2. Sex
Both boys and girls can develop signs of scoliosis during puberty, but the condition affects more girls than boys. Girls are also more likely to require treatment, according to the American Academy of Orthopaedic Surgeons.
3. Family history of scoliosis
Scoliosis can run in families, but most children with scoliosis don't have a relative with the condition. That being said, having a parent or sibling with scoliosis increases a person’s chances of having scoliosis too.
B. Common risk factors for congenital scoliosis
Congenital scoliosis is a spinal curvature present from birth. Maternal environmental factors experienced or encountered during pregnancy contribute to the risk. Study findings that 19% of mothers with children born with congenital scoliosis reported at least one of the following:
1. Hyperthermia during pregnancy
2. Twin gestation
3. Insulin-dependent diabetes
4. Alcohol use and smoking were also identified as significant risk factors.
C. Common risk factors for neuromuscular scoliosis
Neuromuscular scoliosis is a type of scoliosis that develops as a result of neurological or muscular disease. It makes sense, then, that having a neurological or muscular disease is a risk factor for neuromuscular scoliosis. Examples of neurological or muscular diseases that can lead to secondary scoliosis include:
1. Spina bifida
2. Cerebral palsy
3. Muscular dystrophy
4. Spinal muscular atrophy
Spinal cord trauma is also a risk factor for neuromuscular scoliosis. Unlike the first two types of scoliosis, neuromuscular scoliosis tends to progress more rapidly and more often requires surgical intervention.
How is Scoliosis Diagnosed?
Scoliosis is usually confirmed through a physical examination, an X-ray, spinal radiograph, CT scan, or MRI. The curve is measured by the Cobb Method and is diagnosed in terms of severity by the number of degrees. A positive diagnosis of scoliosis is made based on a coronal curvature measured on a posterior-anterior radiograph of greater than 10 degrees. In general, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment.
A standard exam that is sometimes used by pediatricians and in grade school screenings is called the Adam’s Forward Bend Test. During this test, the patient leans forward with his or her feet together and bends 90 degrees at the waist. From this angle, any asymmetry of the trunk or any abnormal spinal curvatures can easily be detected by the examiner. This is a simple initial screening test that can detect potential problems but cannot determine accurately the exact type or severity of the deformity. Radiographic tests are required for an accurate and positive diagnosis.
1. X-ray: The application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are obtained to search for other potential causes of pain, i.e. infections, fractures, deformities, etc.
2. Computed tomography scan (CT or CAT scan): A diagnostic image created after a computer reads X-rays; can show the shape and size of the spinal canal, its contents, and the structures around it. Very good at visualizing bony structures.
3. Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology; can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and deformities.
How to Fix Scoliosis
Treatment for scoliosis varies based on several factors, including the patient’s age, type and severity of scoliosis, and risk for progression. In general, the goals of treatment are to prevent the progression of the spinal curve, relieve any symptoms, and reduce the degree of spinal curvature. Treatments for scoliosis include:
1. Observation. Doctors may recommend monitoring the spine for people with mild scoliosis. Observation may involve seeing a health care provider regularly for a physical exam and X-rays of the spine. If the curve worsens, other treatments may be necessary.
2. Braces. A brace may prevent or slow the progression of the spinal curve in growing children and adolescents with moderate scoliosis. There are several types of braces, including a rigid, plastic one known as the Boston brace (it was developed at Boston Children’s Hospital) and a nonrigid, flexible one. Some braces, including the Boston brace, can be worn under clothing and during many sporting activities.
3. Casts. Infants and toddlers with scoliosis may wear a plaster cast as part of their treatment. Casts can help correct spinal curves. Every two to four months, a new cast is fitted to accommodate the child’s growth.
4. Physical therapy. Scoliosis-specific physical exercises to improve range of motion and strength may help prevent the progression of the condition.
5. Steroid injections. Epidural spinal injections of steroids and/or local anesthetics may be used to temporarily relieve pain caused by scoliosis in adults.
6. Halo-gravity traction (HGT). HGT may treat children and adults with severe spinal curvature caused by scoliosis (and other conditions). In HGT, pins attach a “halo”—a ring made of metal, carbon, or other materials—to the patient’s skull. The halo is then attached to a weighted pulley system that pulls upward on the patient’s head, straightening the spine. Usually, the halo remains in place for two to 12 weeks.
7. Surgery. Doctors may recommend surgery for children or adolescents with significant and/or progressing spinal curves. Surgery may also be used to treat adults with scoliosis. Surgical procedures include:
- Spinal fusion is a surgical procedure that joins two or more vertebrae into a single, solid bone to stabilize the spine. During the surgery, bone grafts—sourced from the patient, a donor, or synthetic materials—are placed around the vertebrae, and metal rods are attached to hold the spine in position as it fuses. These rods are typically left in place after fusion. This procedure is often done to correct spinal curvature and prevent further growth in the fused section.
- Growing rods are used to correct spinal curvature in children with scoliosis while allowing spine and lung development. Surgeons attach these extendable rods above and below the curve using screws or hooks. The rods are lengthened every six months during surgery to accommodate growth. Magnetic growing rods offer a non-surgical lengthening option, which can be adjusted in a doctor’s office with a remote control, avoiding anesthesia. Once growth is complete, the rods are removed, and spinal fusion surgery is performed.
- Vertebral body tethering (VBT) is a minimally invasive surgical treatment for scoliosis that corrects spinal curvature while allowing for natural growth. During VBT, a surgeon attaches a tether device to the spine with screws and applies tension to reduce the curve. As the child’s spine grows, the tether continues to guide the spine toward a straighter alignment. Removal of the tether is only necessary if complications, like tether damage or overcorrection, arise.
- Spinal decompression, a surgical procedure that relieves pressure on nerves in the spine, may be used to treat adults with scoliosis.
What to Avoid When You Have Scoliosis
There are some activities that scoliosis sufferers are better off avoiding (usually because they put unnecessary pressure on the spine, which can cause the curvature to get worse). Here are 5 things we recommend steering clear of – please remember that all cases of scoliosis are different and that you should consult a medical professional before engaging in any activities you’re unsure about.
1. Looking down at your phone
When you bend your neck forward to stare down at your smartphone (adopting a posture sometimes known as ‘text neck’), the effect on your spine is as though your head were significantly heavier than it is. Of course, we’re all glued to our smartphones these days, but we’re not saying that you have to put your device down for good – just be aware of your posture when you’re using your phone, and try to avoid bending your neck forward if possible.
2. Lifting heavy objects
Lifting large weights puts pressure on your spine, and if it’s already curving to one side, the extra pressure can make that curvature even more pronounced. Scoliosis sufferers should endeavor to avoid lifting heavy objects alone. If you find yourself tasked with carrying a large weight, ask someone else to help you with it.
3. Certain exercises
Exercise is an important ally in the fight against scoliosis. However, certain exercises and stretches can do more harm than good when you’re coping with a curved spine.
4. One-sided / impact sports
Some sports are more problematic than others for scoliosis patients. To assess whether or not you should get involved in a particular sporting activity, ask yourself:
- Will I be colliding with other players? Sports like rugby, hockey, and lacrosse are best avoided for this reason.
- Will I be putting more stress on one side of my body than on the other? Examples of one-sided sports include golf and racket games like tennis and badminton.
5. High heels, flip-flops, and other shoes that don’t provide much support
When you’re purchasing footwear, it’s important to look for shoes that will give your body the support it needs. High-heeled shoes can put your spine under a lot of stress, but so can overly flat footwear such as flip-flops. Try to wear shoes with good arch support.
When to See a Doctor for Scoliosis
Generally speaking, you should see a scoliosis doctor if your spinal curvature is causing any degree of pain or discomfort. After all, back pain of any kind should not be left untreated, as pain is a symptom that your body creates to warn you that something is wrong. What’s more, mild pain can often become debilitating pain, if left untreated.
You should also see a scoliosis doctor if you experience shortness of breath, difficulty standing or sitting, or experience ongoing fatigue or tiredness. Scoliosis can affect your spine—and your health—in many ways, so it’s always best to see a specialist even if you have the slightest concern.
How to Choose the Right Scoliosis Doctor Near You
When selecting a specialist for scoliosis treatment, it’s critical to consider several crucial criteria to ensure the most effective care and support. Scoliosis doctors must have the following qualities that all scoliosis and spine doctors should possess:
1. Proven Success: Choose a practitioner who has demonstrated positive outcomes in treating scoliosis and spine patients. Their track record should showcase a history of effective treatment results.
2. Realistic Goals: Ensure that the specialist sets achievable and clear treatment objectives. Also, they must provide a straightforward and honest outlook on what to expect from the treatment process.
3. Patient Empowerment: A top-tier scoliosis doctor should not only treat the condition but also empower their patients. In addition, look for someone who actively teaches patients how to manage their condition independently, providing them with the necessary tools and knowledge.
4. Experience and Qualifications: The specialist’s qualifications, expertise, and experience are extremely important. Check their credentials, training background, and how long they have been practicing.
5. Teaching Ability: Since managing scoliosis and spine conditions is an ongoing process, the ability of a doctor to educate and instruct effectively is essential. Assess their aptitude for teaching and ensure you understand your treatment plan.
6. Passion and Dedication: Choose a specialist who is genuinely passionate about helping scoliosis and spine patients. Their commitment can be a significant determinant in the success of your treatment.
How to Find the Best Scoliosis Doctor Near Me
Finding the right scoliosis doctor for your child is crucial for ensuring they receive the best care possible. Here are some steps to help you gather reliable recommendations:
1. Ask Other Parents: Talk to other parents within your community or support groups who have children with scoliosis. Their firsthand experiences can provide valuable insights and suggestions.
2. Consult Local Professionals: Reach out to local chiropractors, orthopedic clinics, and pediatricians. They often have networks and can recommend specialists who focus on scoliosis treatment.
3. Check Online Reviews: Utilize websites to read reviews and ratings of doctors in your area. These platforms often include patient testimonials that can help you make an informed decision.
4. Join Support Groups: Online forums and social media groups dedicated to scoliosis can be excellent resources. Members frequently share their experiences and can recommend reputable doctors.
5. Verify Credentials: Ensure that any recommended doctor has the proper certifications and expertise in treating scoliosis. This information can often be found on the doctor’s or clinic’s website.
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