Scoliosis

Scoliosis is a medical condition characterised by an abnormal sideways curvature of the spine, often developing during childhood or adolescence.

The curvature can take the shape of an “S” or “C” and may range from mild to severe, potentially leading to pain, posture issues, and, in extreme cases, breathing difficulties.

While the exact cause is often unknown (idiopathic scoliosis), some cases result from congenital spine abnormalities, neuromuscular conditions, or degenerative diseases. Treatment options vary based on severity and include physical therapy, bracing, or surgery in more severe cases to prevent progression and improve spinal alignment.

Types of Scoliosis

These are the different types.

Idiopathic Scoliosis

Idiopathic scoliosis is the most common type, with no clear underlying cause. It is categorized based on the age of onset: infantile (0–3 years), juvenile (4–10 years), adolescent (11–18 years), and adult. Adolescent idiopathic scoliosis is the most prevalent, often diagnosed during growth spurts.

Congenital Scoliosis

This type results from spinal malformations present at birth. Improperly formed vertebrae cause the spine to develop a curve as the child grows. The severity varies, and some cases require surgical intervention if the curvature worsens over time.

Neuromuscular Scoliosis

Neuromuscular conditions such as cerebral palsy, muscular dystrophy, and spinal cord injuries can lead to scoliosis. Weak or imbalanced muscles fail to support the spine properly, causing an abnormal curve. This type often progresses more rapidly than idiopathic scoliosis and may require bracing or surgery.

Degenerative Scoliosis

Typically affecting older adults, degenerative scoliosis develops due to age-related spinal changes, including arthritis, osteoporosis, and disc degeneration. The gradual weakening of spinal structures causes the spine to bend, often leading to pain and mobility issues.

Functional Scoliosis

Unlike structural scoliosis, functional scoliosis occurs due to an external factor, such as muscle imbalances, differences in leg length, or inflammation. The spine itself remains structurally normal, and addressing the underlying issue often corrects the curvature.

Symptoms of Scoliosis

Visible Spinal Curvature

One of the most noticeable signs of scoliosis is an abnormal curve in the spine. The spine may appear to have an “S” or “C” shape when viewed from behind, often causing an uneven posture.

Uneven Shoulders and Hips

Individuals with scoliosis may have one shoulder higher than the other or one hip appearing more prominent. This imbalance can affect the way clothes fit and may become more noticeable over time.

Rib Cage Asymmetry

In some cases, scoliosis can cause one side of the rib cage to protrude more than the other, especially when bending forward. This is known as rib hump and is often a key diagnostic indicator.

Back Pain and Stiffness

Mild scoliosis may not cause significant discomfort, but moderate to severe cases can lead to persistent back pain, muscle stiffness, and fatigue due to the uneven distribution of weight and pressure on the spine.

Difficulty with Breathing and Mobility

Severe scoliosis can impact lung function by reducing the space available for lung expansion, leading to shortness of breath. It may also affect mobility, making certain movements or prolonged standing and sitting uncomfortable.

Uneven Gait and Postural Changes

As the curvature progresses, it can affect walking patterns, causing an uneven gait. Postural changes may also result in a forward-leaning stance or difficulty maintaining balance.

Treatment for Scoliosis

Observation and Monitoring

For mild cases of scoliosis, doctors may recommend regular check-ups to monitor the progression of the spinal curve. X-rays and physical examinations help assess whether the condition is worsening or remains stable over time.

Bracing

Bracing is often used for children and adolescents with moderate scoliosis to prevent further curvature as they grow. The type of brace and duration of wear depend on the severity of the curve and the stage of skeletal development. While bracing does not correct scoliosis, it can help slow or stop its progression.

Physical Therapy and Exercise

Specific exercises and physical therapy techniques strengthen the muscles surrounding the spine, improve posture, and enhance flexibility. Core-strengthening exercises and stretching routines can help manage symptoms and provide better spinal support.

Pain Management

For individuals experiencing discomfort due to scoliosis, pain management strategies such as physical therapy, chiropractic care, anti-inflammatory medications, and heat therapy can provide relief. These treatments help alleviate muscle tension and improve mobility without directly addressing the spinal curve.

Surgery

In severe cases, surgery may be necessary to correct the spinal curvature and prevent further complications. Spinal fusion is the most common procedure, in which metal rods, screws, or bone grafts are used to stabilise and straighten the spine. Advanced techniques, such as vertebral body tethering, offer alternative surgical options with greater flexibility.

Lifestyle Adjustments and Alternative Therapies

Engaging in low-impact activities such as swimming, yoga, and pilates can help improve posture and spinal alignment.

Some individuals explore alternative therapies like acupuncture, massage therapy, and osteopathic treatment to complement traditional scoliosis care. While these approaches do not correct scoliosis, they may help reduce discomfort and improve overall well-being.