Overview

Scoliosis is a disorder in which there is a sideways curve of the spine. Curves are often S-shaped or C-shaped. In most people, there is no known cause for this curve. Curves frequently follow patterns that have been studied in previous patients (see "Curved patterns of the spine" diagram). 

People with milder curves may just need to visit their doctor for regular check-ups. Some people who have scoliosis require treatment.

Curved patterns of the spine
Curved patterns of the spine

 

Who Gets

People of all ages can have scoliosis. The most common type is caused by unknown factors, and typically occurs in children age 10 to 12 and in their early teens. Girls are more likely than boys to have this type of scoliosis. You are more likely to have scoliosis if your parent, brother or sister have it.

Symptoms

Scoliosis is a disorder in which there is a sideways curve of the spine. Signs of scoliosis can include:

  • Uneven shoulders.
  • Head that is not centered.
  • Sides of the body are not level with each other.
  • One side of the rib cage is higher than the other when bending forward.

Causes

In most cases, the cause of scoliosis is unknown. Causes of curves are classified as:

  • Nonstructural (functional) scoliosis. A structurally normal spine that temporarily appears curved. It is caused by a condition such as a difference in leg length, muscle spasms, or appendicitis. Doctors treat this type of scoliosis by correcting the underlying problem.
  • Structural scoliosis. A curve that can be caused by disease, birth defect, injury, infection, tumors, connective tissue disorders, or unknown factors.

Diagnosis

Your doctor may do the following to diagnosis you with scoliosis:

  • Medical history to look for medical problems that might be causing your spine to curve.
  • Physical examination to look at your back, chest, pelvis, legs, feet, and skin.
  • X-rays to measure the curve of the spine. This information is used to determine how to treat scoliosis.

Treatment

Your doctor may recommend the following treatments:

  • Observation. If the curve is mild and your skeleton is still growing, your doctor will re-examine you every few months.
  • Bracing. If the curve is moderate and you are still growing, your doctor may recommend a brace to keep the curve from getting any worse. Braces must be selected for the specific curve problem and fitted to each patient. Braces must be worn every day for the full number of hours prescribed by the doctor.
  • Surgery. If you are still growing and have a severe curve that is getting worse, your doctor may suggest surgery. This often involves fusing together two or more bones in the spine. The doctor may also put in a metal rod or other device to help keep the spine straight after surgery. You should seek the advice of at least two experts, and ask about the benefits and risks of the surgery.

The following treatments have not been shown to keep curves from getting worse in scoliosis:

  • Chiropractic treatment.
  • Electrical stimulation.
  • Nutritional supplements.

Living With

Exercise programs have not been shown to keep scoliosis from getting worse. But it is important for all people, including those with scoliosis, to exercise and remain physically fit. Weight-bearing exercise, such as walking, running, soccer, and gymnastics, helps keep bones strong. For both boys and girls, exercising and playing sports can improve their sense of well-being.

Research Progress

Research on scoliosis has focused on:

  • Factors that may cause scoliosis, in an effort to identify targets for prevention and new treatments.
  • Improved education for healthcare providers, to better guide decisions about treatment options.
  • How a variety of braces, surgical procedures, and surgical instruments can be used to straighten the spine or to prevent the curve from getting worse.
  • Long-term effects of scoliosis fusion and of untreated scoliosis.