Understanding Scoliosis: Causes, Symptoms, Diagnosis, and Treatment Options

Creator: Doctronic
Published: 2023-11-11

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on November 11th, 2023.

Key Takeaways

Spinal curves measuring 10-25 degrees require monitoring every 6 months during growth spurts, as adolescent curves can progress 1-5 degrees per month during peak growth periods.
The Cobb angle measurement on X-rays determines treatment: curves 25-40 degrees require full-time bracing (wearing 18-23 hours daily), while curves exceeding 45-50 degrees typically need surgical fusion.
Idiopathic scoliosis accounts for 80-85% of cases with no known cause, but genetic factors play a role—children have a 30% chance of developing it if a parent is affected.
Severe thoracic curves over 70 degrees can reduce lung capacity by 20-40%, potentially causing shortness of breath and limiting cardiovascular function in adulthood.
Girls are 8 times more likely to require treatment due to faster progression rates, with peak risk occurring during the adolescent growth spurt between ages 11-13.

Scoliosis is a condition where the spine curves sideways, forming a "C" or "S" shape. It affects about 2-3% of Americans, mostly between the ages of 10 and 15. While it can affect both genders, females are eight times more likely to need treatment. In this article, we'll explore the causes, symptoms, diagnosis, and treatment options for scoliosis.

What Causes Scoliosis?

In most cases, the exact cause of scoliosis is unknown. This is called idiopathic scoliosis. However, some types of scoliosis have clear causes, such as:

Congenital scoliosis: Caused by spinal defects present at birth
Neuromuscular scoliosis: Caused by disorders like cerebral palsy or spina bifida
Degenerative scoliosis: Develops in adults over 65 due to wear and tear on the spine

Scoliosis also tends to run in families, suggesting a genetic component. Researchers believe that a combination of genes, hormones, and environmental factors may play a role in the development of scoliosis.

Symptoms of Scoliosis

Common symptoms of scoliosis include:

A visible curve in the spine
Uneven shoulders, waist, or hips
One shoulder blade or rib cage appearing more prominent
Leaning to one side when standing

In severe cases, scoliosis may cause back pain, stiffness, and even breathing difficulties. However, most teenagers with scoliosis do not experience pain.

Understanding Scoliosis: Causes, Symptoms, Diagnosis, and Treatment Options

Diagnosing Scoliosis

Scoliosis is diagnosed through a combination of physical exams and imaging tests. The Adam's forward bend test is often used in school screenings, where the person bends forward at the waist to reveal any spinal curvature. If scoliosis is suspected, an X-ray will be taken to confirm the diagnosis and measure the degree of the curve.

In some cases, additional imaging tests like CT scans or MRIs may be ordered to determine the cause of the scoliosis or to assess any related complications.

Treatment Options for Scoliosis

Treatment for scoliosis depends on the severity of the curve and the person's age. Options include:

Observation

For mild curves (less than 25 degrees), the doctor may recommend regular checkups to monitor the curve's progression.

Bracing

In growing children with moderate curves (25-40 degrees), wearing a brace can prevent the curve from worsening. Braces are worn for 16-23 hours a day until the child stops growing.

Surgery

Surgery is typically recommended for:

Curves greater than 45-50 degrees in growing children
Curves greater than 50 degrees in adults
Curves that continue to progress despite bracing
Curves causing significant pain or breathing problems

Surgical options include spinal fusion, expandable rods, and vertebral body tethering.

Living with Scoliosis

Most people with scoliosis can lead normal, active lives. Low-impact exercises like swimming and walking can help strengthen back muscles and improve posture. Maintaining a healthy weight and practicing good posture can also alleviate strain on the spine.

Regular checkups with a doctor are essential to monitor the progression of the curve and address any complications. With proper management and treatment, people with scoliosis can enjoy a high quality of life.

The Bottom Line

Early detection during routine physical exams is crucial since most curves progress silently without pain during the critical growth years. Regular monitoring and appropriate intervention can prevent severe deformity and preserve normal lung function throughout life. If you notice uneven shoulders or waist asymmetry in yourself or your child, Doctronic can help you understand next steps quickly.