Scoliosis is not a disease, but rather it is a deformity in the spine that causes an abnormal C-shaped (one curve) or S-shaped curvature (two curves). Depending on when it develops, there are 3 types of scoliosis:
- Infantile– Birth-3 years of age
- Juvenile- 4-9 years of age
- Adolescent– 10 years-when growth is complete
Adults can have residuals of childhood scoliosis.
A specific cause of scoliosis is unknown or idiopathic. This Scoliosis most typically occurs in individuals 10 to 18 years old (Adolescent). It tends to run in families & is more common in girls than boys. Often it develops in middle or late childhood during a rapid growth spurt.
Scoliosis can also be present at birth or may develop as a result of another neurological condition such as cerebral palsy, spina bifida, or spinal muscular atrophy.
Any part of the spine can be affected-cervical, thoracic, or lumbar vertebrae. Most often the thoracic & lumbar spines are affected. At first, a C-shaped curve may develop causing the shoulders and hips to tilt down on one side. In an effort to keep the head in the middle, the spine may compensate by curving the lower part of the spine in the other direction, hence forming an S-curve.
This article focuses on the most common form of scoliosis-idiopathic scoliosis.
What does Scoliosis feel like?
Scoliosis is a painless condition. You may not feel any change in the spine but instead notice that your clothes don’t fit quite right. The shoulders & hips may be uneven, causing one shirtsleeve or pant leg to seem shorter than the other. Often there is rotation of the vertebrae causing an uneven waist so that a pair of pants or skirt twists to one side.
The most common signs of scoliosis are-
- Visible curvature of the spine to one side/ Leaning to one side
- Uneven shoulders
- Prominent or winging shoulder blades
- Uneven breasts (girls) or nipples (boys)
- Uneven hips
- Leg-length difference
- Abnormal gait
- Bump or rib hump on one side of the spine, most noticeable when bending forward at the waist.
- Hemlines or trouser lengths uneven
- Clothing does not fit correctly
The presence of one or more of these signs suggests a need for a medical exam by your medical professional.
It is important to note that idiopathic scoliosis results in spinal deformity, but is not a cause of back pain.
The optimal treatment depends on the degree or severity of the scoliosis.
There are several ways to treat scoliosis in children:
Examination & x-rays taken over a period of time will help show if the scoliosis is staying the same or progressing (getting worse).
Selecting treatment options for the child with scoliosis involves several factors-
- Age of the child
- Degree of the spinal curve
- Skeletal maturity of the spine
- Preferences of the patient & family
Treatment may be nothing more than observation especially if the curve is 30-degrees or less in a child who is no longer growing. If the curve is progressing & the child is growing rapidly, the child is referred for exercise and/or bracing.
Preventing severe curvature is important for the physical appearance & health of the patient. The deformity can cause marked psychological distress & physical disability, especially among adolescent patients. A high degree of curvature may also put the patient at risk for cardiopulmonary compromise as the curve in the spine rotates the chest & can cause pressure on the heart, lungs (i.e. shortness of breath), liver, & other internal organs.
Early diagnosis & treatment are important to help prevent curve progression & stabilize the spine while the child grows & also prevent problems with breathing & cardiovascular function.
Important Note: That idiopathic scoliosis is not caused by activity such as exercise, sports or carrying heavy object; nor does it come from sleeping position, posture or minor differences in leg length.