Health Topics


The Top 5 Things You Should Know
By Eric J. Belin, MD

Scoliosis is a fairly common spinal condition that affects approximately three percent of the U.S. population. For most it’s not cause for concern, but for a small number of people the curve does get worse and requires medical intervention. This article outlines the top five things you should know about scoliosis.

  1. What is scoliosis?

Types of ScoliosisPut simply, scoliosis is an abnormal curve of the spine. Typically, it’s a condition diagnosed in childhood or early adolescence: eighty percent of scoliosis cases are idiopathic, or stemming from an unknown cause, and it’s especially common in adolescent girls. There are also congenital (born with spine deformity) and neuromuscular (result of neurologic disorder like cerebral palsy or muscular dystrophy) causes as well.

It’s not a condition limited to childhood, as there are adult causes of scoliosis – Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis. The former is when childhood idiopathic scoliosis progresses into adulthood; the latter is a result of degeneration of spinal structures.

It is also important to note that not all curvatures are the same, with three classifications defining this disorder:

  • Scoliosis – sideways curve to the spine that is often S-shaped or C-shaped
  • Kyphosis – abnormally rounded upper back, with more than 50 degrees of curvature
  • Lordosis – significant inward curve of the lower back, also called swayback

It’s important to point out that scoliosis is caused by your genes. It’s not a result of outside, situational factors such as playing sports, carrying heavy bags or lying on your side.

  1. What are signs and symptoms of scoliosis?

Scoliosis may be difficult to spot, but if you see the following common signs and symptoms, you should schedule an appointment with your physician:

  • Uneven shoulders
  • One shoulder blade more prominent than the other
  • Uneven waist/leaning toward one side
  • One hip higher than the other
  • Clothing fits awkwardly or hangs unevenly
  • Changes in walking as hips move out of alignment
  • Reduced range of motion as spinal twisting causes rigidity
  • Trouble breathing and cardiovascular problems as the rib cage twists, limiting space for the lungs and heart to function
  • Pain as back muscles become prone to spasms and inflammation occurs locally around strained muscles

In cases of kyphosis and lordosis, other signs include:

Kyphosis Lordosis
  • Bending forward of the head compared to rest of body
  • Hump or curve to upper back
  • Fatigue in back or legs
  • Appearing swayback
  • Back pain and discomfort
  • Large gap between lower back and floor when lying on hard surface


  1. How is scoliosis diagnosed?

Along with taking a medical and family history, a physical exam is the first step in diagnosing this condition. This exam will include an observation of your back and spinal curve from the front, sides and back. You’ll also be asked to stand with your arms at your side to check for spine curvature and whether your shoulders and waist are symmetrical. Next, you’ll be asked to bend forward for additional observation of your spine to look for curvature in your upper and lower back (you may recall this exam from yearly pediatrician visits). You may also be checked for range of motion, muscle strength and reflexes.

If your physician sees signs of scoliosis, you may be referred for additional imaging tests to confirm the diagnosis. The type of imaging test you may receive will depend on the suspected underlying cause for the condition:

  • X-rays can confirm the diagnosis by revealing the severity of the spinal curvature
  • MRIs, CT scans and bone scans provide more detailed pictures of the curve condition, highlighting any additional issues surrounding the bone and muscle tissue

Early detection of scoliosis is important, so that your physician can monitor the curvature and halt it from progressing over time. If you suspect an abnormal curve to your or a loved one’s spine, see your doctor for an evaluation.

  1. What is the treatment for scoliosis?

Treatment plans for scoliosis are determined by the severity of the spinal curve and the potential for that curve to worsen. Cause of scoliosis also plays a part in treatment as degenerative conditions or structural abnormalities may necessitate different treatment options than idiopathic scoliosis (which in some cases don’t need treatment). Other factors for treatment include age, anticipated future growth and type of scoliosis. When treatment is needed, the primary options are bracing and surgery.

Braces are typically used in children whose bones are still growing and present with moderate scoliosis.

While they can’t cure scoliosis, they do usually prevent further curvature of the spine. Braces are made of plastic and fitted to the body, virtually invisible when worn under clothing. These are most effective when worn day and night, and can be worn during most activities. Braces are discontinued once a child’s bones stop growing.

Some cases may require surgery to halt the progression of the spine curvature, as severe scoliosis typically progresses over time. The most common type of scoliosis surgery is spinal fusion, where a spinal surgeon fuses two or more of the bones in the vertebrae together.

Typically your primary care physician or pediatrician will first take notice of the condition. If the curvature is mild, they may choose to schedule a follow-up appointment to monitor the condition. However, if your physician feels the condition is severe or a result of an underlying condition, you may be referred to an orthopaedic spine specialist.

  1. What is the prognosis for scoliosis?

Prognosis for this condition can vary, especially in children who are still growing. It also depends on the type and severity of the condition. In those cases in children and adolescents where the curvature is mild and idiopathic, scoliosis often resolves on its own without treatment. Moderate or severe cases in both children and adults are usually treated successfully with bracing or surgery. It usually does not cause serious complications or reduce life expectancy, except in those instances involving severe, untreatable conditions.

To schedule an appointment with one of our spinal experts, call 630-967-2225 or click here for more information.


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Topics and Subtopics: Spine & Back Problems

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