The spine plays an important role in your body structure, keeping you upright and connecting different parts of your skeleton. But your spine is something you probably think of rarely — unless you have scoliosis.
Scoliosis is defined as sideways curvature of the spine that results in an “s” or “c” shape. Mild cases of scoliosis may be hardly noticeable, while the most severe cases may require corrective surgery. The good news is, there are many treatment options (both surgical and non-surgical) to help you thrive with scoliosis.
What causes scoliosis?
There are four types of scoliosis:
- Congenital: The type you are born with if your spine does not develop fully in the womb.
- Neuromuscular: Caused by a neurological or muscular condition such as muscular dystrophy.
- Degenerative: Usually diagnosed in older adults, this is a result of wear and tear as you age.
- Idiopathic: Typically develops during late childhood or adolescence with no known cause.
Idiopathic scoliosis is the most common type of scoliosis and is present in about 3 percent of adolescents. There are varying severities, with pain and progression of curve as the most frequent presenting symptoms.
If you have a child or teen, their doctor may perform regular forward bend tests to monitor the curve of their shoulders and back. If they notice signs of scoliosis, they may refer you to a specialist who can diagnose scoliosis based on a standing X-ray.
How does scoliosis develop in adults?
Although scoliosis is most commonly diagnosed during childhood or adolescence, it is possible to develop scoliosis as an adult or experience worsening of an already existing curve.
Scoliosis seen in adults is typically either an undiagnosed or untreated adolescent (idiopathic) form, or degenerative in nature. The thoracic spine is most commonly involved as an adolescent while the lumbar spine is more often the site in degenerative scoliosis.
The degree of your curve, measured using a Cobb angle, is the best predictor of how your scoliosis will progress over time. This is especially important for teenagers and children to be able to project whether their scoliosis will worsen as they age. Those with measurements in the upper 30 degrees or higher are more likely to progress with age. Likewise, degenerative scoliosis can also worsen with age.
In severe cases, people can have difficulties with breathing due to decreased space within the chest cavity.
What are the treatment options for scoliosis?
There’s good news — most people with scoliosis do not require any specialized treatment or surgery. Observation is often the first line “treatment” for most people to monitor and track your curvature over time and make sure it does not interfere with your day-to-day life.
Other non-surgical options consist of physical therapy and exercise, medications (NSAIDs), interventional procedures or injections, and bracing (often reserved for adolescents).
A spine expert can walk you through your options to help figure out what treatment is best for you based on your history, overall balance, bone quality and other factors.
If you experience severe pain, significant progression of your curve, or neurologic/respiratory dysfunction, surgery becomes an option. A spine expert can walk you through your options to help figure out what treatment is best for you based on your history, overall balance, bone quality and other factors.
The primary goals of surgery are to decompress the neural elements, and correct and stabilize the curve. Depending on the flexibility of the curve, the amount of correction varies from person to person. In most cases, instrumentation is used to help stabilize the spine after correction. Of course, the specific surgical procedure is tailored to each person’s needs.
Can you exercise with scoliosis?
You may have heard the common misconception that people who have scoliosis should avoid certain activities and might not be able to live an active lifestyle. However, scoliosis should not keep you from being active or participating in sports, as long as you take the proper safety measures (as should we all). Core strengthening should be a primary focus for people with or without scoliosis, as a strong core helps you stay healthy as you age.
Scoliosis should not keep you from being active or participating in sports, as long as you take the proper safety measures (as should we all).
No different from most ailments of the spine, factors like weight loss, smoking cessation and frequent exercise can help decrease pain. These factors are also important during the recovery process after a corrective scoliosis surgery.
Bottom line: If you’re worried about your scoliosis or your child’s, take a deep breath and talk to your doctor. Most of my office visits aren’t about surgery — they’re focused on educating my patients and their families on how to thrive with scoliosis.
About the author
Jason S. Taub, MD, is a neurological surgeon and Medical Director of Spinal Deformity and Spinal Oncology at Baylor Scott & White Medical Center – Plano. He received his education at Duke University and Emory University School of Medicine, and he completed a combined orthopedic and neurosurgery fellowship at the Cleveland Clinic. He enjoys exercising, traveling and spending time with his family. He sees patients at multiple locations across North Texas.