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Scoliosis

This factsheet is for people who have scoliosis, or who would like information about it.

Scoliosis is a sideways curve of your spine, which may also be rotated (twisted), and has several different causes.

About scoliosis

It's normal to have a slight sideways curvature in your spine. Scoliosis is defined as a curve of more than 10 degrees. This curvature of your spine can be C-shape or S-shape, and the spine may also be rotated.

When you’re lifting or standing with a poor posture, it’s normal for your spine to curve. However, scoliosis is a permanent curvature of your spine.

Symptoms of scoliosis

You will usually have no symptoms of scoliosis. However, most people notice a change in the appearance of their back.

You may notice one shoulder being higher than the other or one shoulder blade sticking out. The space between your body and your arms may look different on each side when you stand with your arms at your side. Your hips may also look uneven. If the curve is in your upper back, your ribs may stick out on one side. This is known as a rib hump.

If you think you or your child may have scoliosis, see your GP for advice.

Complications of scoliosis

Not everyone who has scoliosis will develop complications and the time it takes for complications to develop will depend on the individual and degree of the curve. Potential complications can include back pain (usually in adults), anxiety and depression because of your change in appearance and breathing difficulties.

Causes of scoliosis

There are a number of causes of scoliosis.

Idiopathic

Around eight in 10 people with scoliosis have the type that has no known cause. This is called idiopathic scoliosis. Ididopathic scoliosis can occur at any age, but it most commonly develops from the age of 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 be affected than boys.

Less commonly, scoliosis develops in younger children, known as infantile idiopathic scoliosis. The curvature is usually to the left and slightly more boys are affected than girls.

Idiopathic scoliosis often seems to run in families. About three in 10 people with scoliosis have one or more close family members with the same condition.

Congenital

If you're born with an abnormally curved spine, it's called congenital scoliosis. This happens when your spinal bones (vertebrae) don’t form properly. Your spinal bones may be wedged or fused together. It’s not known why this happens and congenital scoliosis doesn’t run in families. The curve often becomes more obvious as a child grows.

Neuromuscular

This is due to a condition that affects the nerves or muscles in your back, such as cerebral palsy or muscular dystrophy. The spine is often curved and twisted, making it difficult to walk.

Other causes

Other causes of scoliosis, especially in adults, can include damage or uneven growth of your spine caused by osteoporosis, injury, surgery, infection or rarely, tumour of the spine.

Diagnosis of scoliosis

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. You may be asked to bend forward from the waist, with the palms of your hands together. One of your shoulders may be higher than the other, your ribs may be more prominent on one side and cause a bulge in your back if you have scoliosis.

Illustration showing the effects of scoliosis

If your GP thinks you have scoliosis, he or she will usually refer you to a specialist. This is often an orthopaedic specialist (a doctor who specialises in identifying and treating bone conditions).

Your GP may also refer you to have the following tests.

  • X-rays of your back to show the position and size of the curvature. The curve is given a measurement in degrees, called the Cobb angle. Early X-rays can be compared with later ones to tell whether the curvature is stable or getting more pronounced.
  • CT scan or MRI scan to look at the spinal cord for abnormalities.

Treatment of scoliosis

Treatment of scoliosis depends on how severe your curve is, whether it‘s likely to get worse and how much it affects your normal function. There are a number of treatment options.

Observation

If your scoliosis is mild and not affecting your normal function, your doctor will recommend regular check-ups to monitor the curvature.

Bracing

Your doctor may recommend a back brace for children if the curvature is more than around 20 degrees. A brace only works for children who have not finished growing. It will not correct scoliosis, but can help to stop the curvature getting worse. Different types of braces are available, usually made out of a rigid plastic or fibreglass. The most common type covers roughly the same area as a waistcoat. For more marked curvature, a brace that extends higher up the body and under the chin may be required. To be effective, a brace needs to be worn for up to 23 hours a day.

The medical evidence for how well braces work is mixed, but they're likely to be more effective when treatment is started at a younger age, while the back is still growing. Braces are usually worn until the child stops growing. As your child grows, the brace will need to be replaced, usually every 12 to 18 months.

Children may feel embarrassed and might find wearing a brace difficult and uncomfortable, it can also make going to the toilet difficult.

Surgery

Depending on the degree of curvature, your specialist may recommend surgery. Surgery aims to reduce the amount of curvature of your spine and prevent it from getting worse.

The most common technique is spinal fusion, where your affected vertebrae are straightened and then fused (joined) together. The curvature is largely corrected by metal rods and screws fitted to your spine.

Surgery to correct scoliosis can involve a long and complex operation, with a small risk of damage to your spinal cord. In order to make a well-informed decision, you or your child need to be aware of the possible side-effects and the risk of complications. Your surgeon will discuss these with you.

Other treatments

Other treatments, such as chiropractic medicine, physiotherapy, yoga and electrical stimulation, may help ease any back pain you might have. However, they cannot correct the curvature in your spine and treat scoliosis.

Prevention of scoliosis

There is no way to prevent idiopathic scoliosis. Early detection and treatment, if necessary, helps to prevent it from getting worse.

At present there is no national screening programme for scoliosis. If you have a history of scoliosis in your family, speak to your GP for more information.

Living with scoliosis

How much scoliosis affects you will depend on how severe the curvature of your spine is. For most people who develop idiopathic scoliosis as adolescents, it doesn't cause any life-threatening problems, but 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). Talking to other children, teenagers and parents who are going through the same thing may help.

 

Published by Stephanie Hughes, Bupa Health Information Team, May 2012 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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