You won't usually have any symptoms of scoliosis but you may notice a change in how your back looks. For example, one of your shoulders may look higher than the other, or one of your shoulder blades may stick out. Your body may look wider on one side than the other when you stand with your arms at your side. Your hips may also look uneven. If your ribs stick out on one side when you bend forwards, it's known as a rib hump.
If you think you, or your child, may have scoliosis, see your GP for advice.
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.
Your GP may ask you to bend forwards from your waist, with the palms of your hands together. This will help show if one of your shoulders is higher than the other, or if your ribs are more prominent on one side. It may also cause a bulge in your back if you have scoliosis.
If your GP thinks you have scoliosis, they may refer you to see a specialist. This may be an orthopaedic specialist (a doctor who specialises in identifying and treating bone conditions.
Your GP may also refer you to have the following tests.
- An X-ray of your back to show the position and size of the curve in your spine. The curve is measured in degrees, which is called the Cobb angle. Your doctor may compare early X-rays with later ones to see if the curve has stayed the same or got worse.
- A CT scan or MRI scan to examine your spinal cord to check for any problems. A CT scan uses X-rays, while an MRI scan uses magnets and radio waves to produce images of the inside of your body.
There are a number of treatments for scoliosis. Your treatment will depend on how severe the curve in your spine is. It will also depend if the curve is likely to get worse and how much it affects your daily life.
If your scoliosis is mild and doesn't affect your normal function and everyday life, your doctor may recommend you have regular check-ups. This will allow your doctor to monitor the curve in your spine and it may get better without any treatment. Around nine in 10 children with adolescent idiopathic scoliosis don't need treatment and the curve corrects itself as they grow.
Your specialist doctor may recommend you wear a back brace for a short period of time. In adults this may give some pain relief.
If your child has scoliosis and the curve in his or her spine is more than around 20 degrees, your doctor may suggest a brace too. This will not correct scoliosis but may help to stop the curve getting worse. Your child will only be offered this treatment if he or she is still growing.
Different types of brace are available, which are usually made of a rigid or flexible plastic. The most common type covers roughly the same area as a waistcoat. If your child has a more severe curve, your doctor may suggest a brace that extends higher up their body and under their chin. Your child may need to wear the brace all the time for it to work, but this can vary depending on your child's condition. Ask your doctor for more information.
Doctors aren't sure how well braces work. They are more likely to work if treatment is started at a younger age, while your child's back is still growing. Your child may need to wear the brace until he or she stops growing. As your child grows, the brace will need to be replaced, usually every 12 to 18 months.
Depending on how curved your spine is, and if other treatments haven't worked, your specialist doctor may recommend you have an operation for scoliosis. Surgery aims to reduce the curve of your spine and prevent it from getting worse.
The most common type of surgery is called spinal fusion, where your affected spinal bones (vertebrae) are straightened and then fused (joined) together. Your surgeon will correct the curve in your spine using metal rods and screws that he or she will fit to your spine.
Children will need another operation about every six months to lengthen the metal rods as they grow. However, there is a new type of surgery for children over two that involves using special rods that can be lengthened using a remote control instead. Ask your doctor for more information.
Surgery to correct scoliosis can involve a long and complex operation and there’s a small risk of damage to your spinal cord. In order to make an informed decision on whether to have surgery, you need to be aware of the possible side-effects and the risk of complications. Your surgeon will discuss these with you to help you make a decision. See our Frequently asked questions for more information.
Other treatments, such as chiropractic medicine, physiotherapy exercises and electrical stimulation, may help ease any back pain you might have. However, they cannot correct the curve in your spine and treat scoliosis.
There are a number of causes of scoliosis. The cause of scoliosis also defines the different types of the condition.
Around eight in 10 people who have scoliosis don't ever find out what caused it. This is called idiopathic scoliosis. You can get idiopathic scoliosis at any age but it most commonly develops in children over 10 and is known as adolescent idiopathic scoliosis. The curve is almost always to the right and girls are up to eight times more likely to get it than boys.
Less commonly, scoliosis develops in younger children. If it develops in children aged three and under, it's known as infantile idiopathic scoliosis. The curvature is usually to the left and slightly more boys are affected than girls. If the condition develops in children between the ages of three and 10, it's called juvenile idiopathic scoliosis. Like adolescent idiopathic scoliosis, it's more common in girls and causes a curve to the right of the spine.
Adults can also get scoliosis. Idiopathic scoliosis often seems to run in families.
If your child is born with an abnormally curved spine, it's called congenital scoliosis. This happens when the spinal bones (vertebrae) don’t form properly – they may be wedged or fused together. The curve often becomes more obvious as your child grows. It’s not known why this happens and congenital scoliosis doesn't appear to run in families.
This type of scoliosis is caused by a condition that affects the nerves or muscles in your back, such as cerebral palsy or muscular dystrophy. Your spine is supported by these muscles, so if they are weak for any reason, your spine starts to tilt to one side. If you have neuromuscular scoliosis, your spine may be curved and twisted, which can make it difficult to walk.
Other causes of scoliosis can include damage to your spine or a problem with your spine caused by another health condition. For example, osteoporosis, arthritis, an injury, surgery, infection or rarely, cancer in the spine can cause scoliosis.
Not everyone who has scoliosis will develop complications. The chance of developing them depends on how curved your back is. Potential complications of scoliosis can include:
- back pain
- it may affect your body image and self-confidence leading to difficulties in breathing
- problems with your nervous system, such as a loss of feeling in your legs
There’s no way to prevent idiopathic scoliosis. If you get a diagnosis and have treatment early, it may help to prevent it from getting worse.
At present there’s no national screening programme for scoliosis. If you have a history of scoliosis in your family, look out for any signs of a curve in your own, or your child's, spine. If you notice anything or are unsure, contact your GP for advice.
How much scoliosis affects you will depend on how severe the curve of your spine is. For most people who develop idiopathic scoliosis as teenagers, it doesn't cause any life-threatening problems. It can make life difficult and affect your body image and confidence.
Family support is crucial and there are support groups you can get in touch with (see Further information). It may help to talk to other children, teenagers and parents who are going through the same thing.
Will my scoliosis stay the same or get worse?
If you’re diagnosed with scoliosis as a child, the curve may well get better but it's possible it could get worse.
Your age, and the size and type of curve you have are important factors for predicting how your scoliosis will progress. It's not possible to give concrete predictions for everyone. In very young children, scoliosis often improves without treatment. But for others it may not and you, or your child, will require treatment to stop it from getting worse.
If you have scoliosis, it’s important that you visit your GP who will refer you to a specialist for regular check-ups. This can help your doctor keep track of the curve and treat it before it causes any problems.
Will scoliosis stop my child playing sport?
Not necessarily. Many people who are diagnosed with scoliosis are able to play sport and do exercise.
Exercise is good for children – it improves bone health, self-confidence and helps keep their hearts healthy. What your child is able to do will depend on several factors. These will include their general health, how severe the curve of their spine is and the type of treatment your child has had. If your child has mild scoliosis, he or she should try to lead a normal life, which includes taking part in sporting activities. If your child has a back brace, your specialist doctor may advise him or her to take it off during contact sports.
Talk to your doctor for advice about any activities your child shouldn't do.
Does surgery for scoliosis carry any risks?
All types of surgery carry some risks. Your specialist doctor or surgeon will only recommend surgery for scoliosis if it's considered that the benefits outweigh the risks. The risks depend on the type of procedure you have and your personal circumstances.
Severe scoliosis is sometimes treated with a type of surgery called spinal fusion. Spinal fusion helps reduce the curve of your spine and stops it from getting worse. In spinal fusion, your surgeon will fuse (join together) several bones in your spine (vertebrae) and attach metal rods to keep it straight.
Like all surgery, there are some risks involved. Some problems specific to spinal fusion are listed below.
- There’s a small risk of spinal cord or nerve damage.
- There’s a chance of developing an infection – this can happen months or even years after surgery.
- Pseudoarthrosis. This is when your spine fails to properly fuse. It can happen years after surgery and you may need another operation
- Sometimes the rods attached to your spine may break or come loose. You might need to have another operation to correct this.
- Some people feel pain in their back following surgery. The cause isn't always known, but further surgery can sometimes help.
Ask your orthopaedic surgeon (a doctor who specialises in bone surgery) for advice about whether spinal fusion for scoliosis is the right choice for you.
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