15837 Scoliosis

Overview

Scoliosis is a condition where the spine curves sideways, making the back look like an 'S' or 'C' instead of a straight line. It can range from very mild to severe, and often appears in children just before puberty but can also affect adults.

Yes, scoliosis is fairly common. Around 2 to 3 in every 100 people have some degree of scoliosis.

It most often affects children between the ages of 10 and 15, but adults can also develop it, usually as a result of wear and tear on the spine as they age.

Symptoms

Common symptoms

• One shoulder higher than the other
• One shoulder blade that sticks out more
• An uneven waist
• One hip higher than the other
• A visible curve in the spine
• Back pain (more common in adults with scoliosis)

Symptoms in children

• Often no pain at all
• Clothes not hanging straightly
• A visible curve when bending forward
• One side of the chest or back looking different from the other

Symptoms in older adults

• Back pain or stiffness
• A feeling that the spine is getting shorter or more bent
• Numbness or weakness in the legs due to nerve pressure
• Balance problems

Causes

Main causes

• Idiopathic: the most common type, where no clear cause is found
• Congenital: present at birth due to a spinal bone problem
• Neuromuscular: linked with conditions like cerebral palsy or muscular dystrophy
• Degenerative: can happen in older adults as the spine wears down
• Injury or infection in the spine (less common)

Risk factors

• Age: it often shows up during the growth spurt just before puberty
• Sex: girls are more likely to have a curve that worsens
• Family history: having a parent, brother, or sister with scoliosis increases the chance

When to see a doctor

See a doctor urgently if:

• If you or your child has sudden leg weakness, numbness, or loss of balance
• If there is a sudden change in bladder or bowel control
• If back pain is severe and does not go away

Book a routine appointment if:

• If you notice an uneven waist, shoulders, or hips
• If a school screening suggests a possible curve
• If back pain keeps coming back or limits daily activities

Diagnosis

A doctor will first ask about your symptoms and family history, then examine your back. They may ask you to bend forward to see if one side of your chest or back is higher. If a curve is found, an X-ray can confirm the diagnosis and measure how big the curve is.

Tests that may be done

• X-ray of the spine (the main test used to measure the curve)
• MRI scan (if the doctor needs a closer look at the spinal cord or nerves)
• CT scan (rarely needed, but can give more detail about the bones)

What to expect at your appointment

You may be referred to a specialist, such as an orthopaedic doctor or a physiotherapist, depending on your age and the size of the curve. For children, regular check-ups are important to see if the curve changes as they grow.

Treatment

Treatment depends on your age, the size of the curve, and whether it is likely to get worse. Many people with mild scoliosis only need regular check-ups and simple measures to stay comfortable. Growing children with moderate curves may be offered a back brace. Severe or quickly worsening curves may need surgery.

Self-care at home

• Stay active with low-impact exercises like swimming, walking, or cycling
• Do physiotherapy exercises to strengthen your core and back muscles
• Keep a healthy weight to reduce strain on your back
• Use heat or cold packs to ease mild back discomfort
• Practice good posture when sitting and standing

Medical treatments

For pain and discomfort, doctors may suggest over-the-counter pain relief, but always ask your pharmacist or healthcare provider first. Physical therapy is often recommended to help with posture and muscle strength. For growing children, a back brace may be used to stop the curve from getting worse. In some cases, a doctor may discuss surgery, but this is usually only for very large curves or curves that cause serious symptoms.

When is surgery considered?

Surgery may be considered if the curve is very large (usually more than 50 degrees), if it is getting worse quickly, or if it causes severe pain, breathing problems, or nerve symptoms. The most common operation is spinal fusion, where the curved part of the spine is straightened and joined together with bone and metal rods.

Living with this condition

Most people with scoliosis lead full and active lives. The key is to stay active, keep your back muscles strong, and talk to your healthcare team if you have any pain or worries.

Lifestyle tips

• Keep up with regular exercise and physiotherapy
• Avoid very heavy lifting that strains your back
• Take breaks from sitting for long periods
• Use a supportive chair and mattress

Diet and exercise

A balanced diet with enough calcium and vitamin D helps keep bones strong. Safe exercises include swimming, walking, yoga, and pilates, but it is a good idea to ask your physiotherapist what is right for you.

Mental health and emotional wellbeing

Scoliosis can sometimes affect how people feel about their body, especially for teenagers. It is normal to feel self-conscious or worried. Talking about these feelings with family, friends, or a counsellor can help. Your healthcare team can also suggest local support options.

Prevention

There is no known way to prevent most cases of scoliosis. However, early detection is important so that any curve that needs monitoring or treatment is found in time.

Complications

If left untreated

• A curve that gets larger over time
• Chronic back pain, especially in adults
• Breathing problems in very severe curves (rare)
• Nerve problems, such as leg weakness or numbness

Long-term outlook

The outlook for scoliosis is very good for most people. With the right care and follow-up, most individuals can do everything they want to do, including sports and exercise. Even when treatment is needed, it usually helps reduce symptoms and prevents the curve from getting worse.

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