Scoliosis is a lateral curvature of the spine that most often occurs during the growth spurt just before puberty. While the spine normally has natural curves from front to back, a person with scoliosis has a spine that curves from side to side, often in an S or C shape. In many cases, the cause is unknown, which is referred to as idiopathic scoliosis.
Symptoms can vary depending on the severity of the curve. Because scoliosis often develops gradually, it may first be noticed by a parent or during a school screening.
Uneven Shoulders: One shoulder blade may appear more prominent or higher than the other.
Uneven Waist: The waistline may look flat on one side and curved on the other.
Hip Discrepancy: One hip may sit higher or appear more prominent.
Rib Hump: When bending forward, the ribs on one side may stick out further due to the rotation of the vertebrae.
Back Pain: While not always present in adolescents, adults with scoliosis frequently experience chronic back pain or muscle fatigue.
Early detection is important to monitor the curve during peak growth years.
Physical Examination
X rays: These are used to confirm the diagnosis and calculate the angle of the curve.
The choice of treatment depends on the age of the patient, how much they are likely to grow, and the degree of the spinal curve.
Observation: For small curves under 25 degrees, doctors often suggest checkups every 6-12 months to ensure the curve is not progressing.
Bracing: If the curve is between 25 and 40 degrees and the patient is still growing, a brace is worn to prevent the curve from getting worse.
Physical Therapy: The mainstay of treatment for the majority of symptomatic scoliosis. Focus on breathing, posture, and muscle symmetry to help stabilize the spine.
Pain Management: For adults or symptomatic patients, NSAIDs can be used to help manage discomfort.
Surgery: Reserved for severe curves, usually over 45 to 50 degrees, where surgeons use metal rods and screws to straighten the spine and fuse the vertebrae together.