Scoliosis

Scoliosis

• About scoliosis
• Causes of scoliosis
• Diagnosing scoliosis
• Treating scoliosis in children
• Treating scoliosis in adults
• Possible complications of scoliosis

About scoliosis

Scoliosis is the abnormal twisting and curvature of the spine.

It is usually first noticed by a change in appearance of the back.

Typical signs include:

• a visibly curved spine
• one shoulder being higher than the other
• one shoulder or hip being more prominent than the other
• clothes not hanging properly
• a prominent ribcage
• a difference in leg lengths

Back pain is common in adults with scoliosis. Young people with scoliosis may also experience some discomfort but it’s less likely to be severe.

When to get professional help

If you or your child have signs of scoliosis, make an appointment to see your GP. They can examine your back and can refer you for an X-ray for confirmation.

If you or your child are diagnosed with scoliosis, it’s important to see a scoliosis specialist to talk about treatment options.

Read more about diagnosing scoliosis.

Rarely scoliosis can cause a condition called cauda equina syndrome to develop. Cauda equina syndrome is a rare but serious back condition which can lead to permanent damage or disability. If you develop this condition you’ll need to be seen by an emergency specialist spinal team.

Phone 111 if:

• there has been a new, significant trauma within the last 7 days, for example a fall from height or direct blow to the back

Or you have experienced a new onset of the following symptoms:

• loss of feeling/pins and needles between your inner thighs or genitals
• numbness in or around your back passage or buttocks
• altered feeling when using toilet paper to wipe yourself
• increasing difficulty when you try to urinate
• increasing difficulty when you try to stop or control your flow of urine
• loss of sensation when you pass urine
• leaking urine or recent need to use pads
• not knowing when your bladder is either full or empty
• inability to stop a bowel movement or leaking
• loss of sensation when you pass a bowel motion
• change in ability to achieve an erection or ejaculate
• loss of sensation in genitals during sexual intercourse

What causes scoliosis?

In around eight out of every 10 cases, a cause for scoliosis is not found. This is known as idiopathic scoliosis.

A small number of cases are caused by other medical conditions, including:

• cerebral palsy – a condition  associated with brain damage
• muscular dystrophy – a genetic condition that causes muscle weakness 
• Marfan syndrome – a disorder of the connective tissues

Rarely, babies can be born with scoliosis, as a result of a problem with the development of the spine in the womb.

In adults, age related changes in the discs and joints of the spine and a reduction in bone density may cause scoliosis. Adults can also experience worsening over time of previously undiagnosed or untreated scoliosis.

Read more about the causes of scoliosis.

Who is affected

It used to be thought that scoliosis was only a childhood condition, but it’s now increasingly recognised as a condition that affects older adults as well.

It can develop at any age, but is most common in children aged 10-15. In the UK, around three or four in every 1,000 children need treatment for scoliosis.

It’s more common in females than males.

How scoliosis is treated

Treatment for scoliosis depends on your age, how severe it is, and whether it’s thought it will worsen with time.

In very young children, treatment is not always necessary because the curvature of the spine may improve naturally as they get older. If treatment is necessary, bracing or casting may be used to attempt to halt the curve’s progression.

If the infant or younger child’s curve continues to progress despite bracing or casting, an operation may be necessary. This will usually involve inserting metal rods into the back to stabilise the spine, which are lengthened at regular intervals as your child grows.

In older children and adults, it is unlikely that scoliosis will improve with time, and in some it may progressively worsen.

The main treatments for older children are:

• a back brace worn until they stop growing, to prevent the spine from curving further
• surgery to correct the curvature – where the spine is straightened using rods attached to the spine by screws, hooks and/or wires

In adults, treatment primarily aims to relieve any pain. Non-surgical options, such as painkillers and exercises are often tried first, with correctional surgery seen as a last resort.

Read more about treating scoliosis in children and treating scoliosis in adults.

Further problems

Scoliosis can sometimes lead to further emotional and physical problems.

Having a visibly curved spine or wearing a back brace can cause problems related to body image, self-esteem and overall quality of life. This is particularly the case for children and teenagers with scoliosis.

If this is a problem for you or your child, you may find it useful to contact a scoliosis support group, such as Scoliosis Association UK. These groups are a good source of information and support for people with scoliosis.

In rare cases, scoliosis can lead to physical problems if it’s severe. For example, significant curvature of the spine can sometimes put increased pressure on the heart and lungs.