Living with Scoliosis: Causes, Symptoms, and Diagnosis

Dec 17, 2024

7 min read

In simple terms, A condition marked by a side-to-side curve of the backbone. The curve is usually shaped like an S or a C. Everyone has normal curves in the spine, and when looked at from behind, the spine appears straight. For people with scoliosis, there tends to be visible curves in the spine, but not every case. Read the following blog to learn more about scoliosis, a medical condition that impacts over 9 million people in the United States.

What is Scoliosis?

Scoliosis is a sideways curvature of the spine that most often is diagnosed in adolescents. Scoliosis is more common in people with conditions such as cerebral palsy and muscular dystrophy. Most cases of scoliosis are mild, but some curves worsen as children grow. Scoliosis is more than just a curved spine; severe cases of scoliosis can be disabling. An especially serious spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. Thankfully with modern medicine, the pros are outweighing the cons of helping scoliosis.

Causes of Scoliosis

In more than 80 percent of cases, the cause of scoliosis is unknown. In other cases, scoliosis may develop because of degeneration of the spinal discs, as seen with arthritis, osteoporosis or as a hereditary condition that tends to run in families. Congenital factors, which happen during the development of the spine when the baby is in the womb, leading to a curve in the spine. Genetic diseases, which happen when changes occur in one or more genes. Injury to the spine, usually from trauma to the spine or back. Neuromuscular diseases, which affect the nerves that send messages to muscles, leading to muscle weakness and loss. Tumor, which can cause physical changes to the spine.

Symptoms of Scoliosis

There are many physical and mental symptoms of having scoliosis. Symptoms of scoliosis may include:

· Uneven shoulders.

· One shoulder blade that appears more prominent than the other.

· Uneven waist.

· One hip higher than the other.

· One side of the rib cage jutting forward.

· A prominence on one side of the back when bending forward.

With most scoliosis cases, the spine will rotate or twist in addition to curving side to side. This causes the ribs or muscles on one side of the body to stick out farther than those on the other side. Imbalances in serotonin and norepinephrine levels are often seen in people with idiopathic scoliosis. These imbalances can cause mood disorders. Mood disorders include several issues, such as depression, anxiety, and bipolar disorder.

Kinds/Severity of Scoliosis

There are three main kinds of scoliosis people suffer from, idiopathic scoliosis, congenital scoliosis, and neuromuscular scoliosis.

· Idiopathic Scoliosis- The most common kind of scoliosis with an unknown cause, but research does indicate that it runs in families and has a genetic (hereditary) link.

· Congenital Scoliosis- A rare spine abnormality that a healthcare provider may detect at birth. It occurs when vertebrae (the bones that make up your spine) don’t form as they should during embryonic development.

· Neuromuscular Scoliosis- Abnormalities in the muscles and nerves that support your spine cause this type. It usually happens alongside neurological (nerve) or muscular conditions.

There are three forms of scoliosis: mild, moderate, and severe. They each have different levels of risk progression and are treated differently.

Mild Scoliosis is easiest to overcome because the curve is small, some people don’t even realize they have scoliosis.

Curve is less than 25 degrees
Risk of progression can be up to 22%. Once the curve passes 20 degrees, the risk of progression skyrockets up to 68%
The patient may have uneven shoulders or hips and a tilted head, the patient may also appear as if they are permanently slouching (forward head posture)
The patient may have uneven leg lengths
This form of the condition often goes unnoticed
The patient may or may not experience pain
This form of the condition commonly occurs in young, premenstrual girls (although it can also occur in adults or boys)

Moderate Scoliosis is easiest to treat before the curve becomes severe. It is important to stop progression before the curve gets worse. Often, treatment allows more room for the organs as well as increased lung capacity.

Spinal curve is 26-40 degrees
(MoS) has a 68% chance to progress
The patient may have uneven shoulders or hips and a tilted head
The patient may appear as if they are permanently slouching
Clothing may appear to hang unevenly when worn
Patient’s with (MoS) often have rib humps
The patient may or may not experience pain
Physical activity easily leads to fatigue
The patient often appears clumsy
The patient may feel pain at the base of the rib cage and at the shoulders
Headaches are common in patients with (MoS)
Braces are often used to treat (MoS)

Severe Scoliosis is the worst form of scoliosis and is very serious. Treatment can alleviate chronic pain, headaches, digestive orders, and loss of balance. Many patients with (SS) often struggle with depression, social anxiety, and poor body image.

Spinal curve is above 40 degrees
(SS) has a 90% chance to progress
May have uneven shoulder or hips and a tilted head
Spine may appear to have a “S” or “C” shape underneath the skin
The patient’s belly button may appear off center
The patient’s clothing may appear to hang unevenly when worn
The patient with (SS) has prominent rib humps
Easily fatigued by physical activity, as well as long periods of standing or sitting
The patient often appears clumsy or accident-prone
Patients with (SS) are more likely to experience pain at the base of the rib and between the shoulder blades
Headaches are common in patients with (SS)
Doctors often suggest surgery for (SS) patients

How Common is Scoliosis?

While scoliosis can affect people at any age, it most commonly begins in children between ages 10 and 15. According to the National Scoliosis Foundation, scoliosis is estimated to affect 7 million people in the United States—around 2% to 3% of the population. Only a small percentage of people who suffer from scoliosis need a severe treatment method, like surgery. About 30 percent of people require bracing, and an even smaller percent, about 10 percent, of patients require surgery.

Impacts of Scoliosis on Daily Life

Scoliosis can significantly impact daily life, often in ways that are both physical and emotional. For those with scoliosis, chronic back pain is one of the most common issues, making simple tasks like sitting, standing, or walking for long periods uncomfortable or even unbearable. This pain can vary depending on the severity of the curvature and often worsens after long hours of activity. Physical limitations may also arise, making it difficult to perform basic chores, like lifting heavy objects, bending down, or carrying groceries. Scoliosis can affect posture, causing individuals to appear uneven or asymmetrical, which may impact self-esteem and confidence, especially for adolescents and young adults. Additionally, the misalignment of the spine can lead to muscle fatigue, as muscles have to work harder to compensate for the curvature. In severe cases, breathing difficulties can arise if the rib cage is affected, leading to a reduced lung capacity. This can make physical activities like running, climbing stairs, or even walking long distances more challenging and exhausting. The mental toll of scoliosis can be just as significant, as living with chronic pain and physical limitations can lead to feelings of frustration, isolation, and even depression. Financially, the cost of medical treatments and ongoing care can add a significant burden to families.

Treatments for Scoliosis

Scoliosis treatments vary, depending on the size of the curve. Some cases are so minor, no treatment is needed. Bracing or surgery may be needed if the spinal curve is moderate or large. The most common type of treatment is the brace, and it is made of plastic and is contoured to conform to the body. Most braces are worn between 13 and 16 hours a day. A brace's effectiveness increases with the number of hours a day it's worn. Braces are discontinued when there are no further changes in height. For more severe scoliosis, surgery can be used. There is a variety of surgical options.

· Spinal fusion- In this procedure, surgeons connect two or more of the bones in the spine, called vertebrae, together so they can't move independently. Pieces of bone or a bonelike material is placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together.

· Expanding rod- If the scoliosis is progressing rapidly at a young age, surgeons can attach one or two expandable rods along the spine that can adjust in length as the child grows. The rods are lengthened every 3 to 6 months either with surgery or in the clinic using a remote control.

· Vertebral body tethering- This procedure can be performed through small incisions. Screws are placed along the outside edge of the spinal curve, and a strong, flexible cord is threaded through the screws. When the cord is tightened, the spine straightens. As the child grows, the spine may straighten even more.

“What Is Scoliosis?” Cleveland Clinic, 12 Aug. 2024, https://my.clevelandclinic.org/health/diseases/15837-scoliosis

Lowenstein, Jason. “Symptoms of Scoliosis: Mild, Moderate, & Severe: Jason Lowenstein.” Dr. Jason Lowenstein | Scoliosis & Spinal Deformities Surgeon, https://jasonlowensteinmd.com/symptoms-of-mild-moderate-severe-scoliosis/

“Scoliosis.” Johns Hopkins Medicine,

https://www.hopkinsmedicine.org/health/conditions-and-diseases/scoliosis

“Niams Health Information on Scoliosis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, U.S. Department of Health and Human Services, 7 Oct. 2024, https://www.niams.nih.gov/health-topics/scoliosis

“Scoliosis.” Yale Medicine, Yale Medicine, 14 July 2024, https://www.yalemedicine.org/conditions/scoliosis#:~:text=According%20to%20the%20National%20Scoliosis,special%20treatment%20beyond%20regular%20monitoring