When we hear about scoliosis, it often refers to the most common type: adolescent idiopathic scoliosis. There are however other types of scoliosis, such as neuromuscular and congenital which I will not touch on in this blog post.
What is it?
Scoliosis is characterised by a lateral curvature of the spine. Contrary to common belief, it is a complex three-dimensional (3D) deformity involving lateral deviation as well as rotation.
It is most often diagnosed in early adolescence (about 3% of the population), with females being more frequently affected. The curvature can range from mild to severe and can cause pain, discomfort, and more rarely breathing difficulties. Some cases may be asymptomatic and only diagnosed when parents bring their child for an examination as they have noticed an unusual structure in their child’s spine.
How it is diagnosed?
1. Physical examination
The most common and non-invasive way for diagnosis is through physical examination. A doctor or manual therapist will look for signs of abnormal curvature in the spine.
The common signs and symptoms of scoliosis are:
Uneven shoulders
One shoulder blade that is more prominent than the other
Waist creases that are uneven
Uneven gaps between arms and trunk
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
Picture by: https://www.columbiachiropractors.com/blog/209774-scoliosis-facts
2. X-rays
An X-ray would then be the next step. They are useful to measure the curvature’s degree and location, also known as the Cobb angle. This will help guide the treatment selection.
How is it treated?
The treatment for scoliosis depends on two major factors:
the severity of the curvature
the age of the patient at the time of diagnosis
1. Severity of the curvature
If the curve is mild, it may not require treatment, but regular monitoring will be needed to ensure it doesn't worsen.
In more severe cases, treatment options may be:
i. Physical therapy: used to help improve posture and reduce pain associated with scoliosis.
ii. Bracing: wearing a brace won't reverse the curve, but usually prevents its progression.
iii. Surgery: may be indicated for severe cases of scoliosis where the curvature is >40 degrees, causing breathing difficulties or significant pain. Surgery involves realigning the spine and fusing the affected vertebrae together.
2. Age at the time of diagnosis
The age at the time of diagnosis determines the likelihood of progression. This can be divided into 3 periods:
i. Infantile (<3 years)
ii. Juvenile (3 – 10 years) iii. Adolescent types (>10 years) - most common
These periods are associated with different growth velocities, therefore, they behave differently (the prognosis will be different). In general, the younger the age at onset, the greater the likelihood of progression.
Conclusion
Scoliosis is a medical condition that causes a lateral and rotational curvature of the spine with adolescent idiopathic scoliosis being the most common type. It can be diagnosed through physical examination and imaging tests such as X-rays. Treatment options depend on the severity of the curvature and the age of the patient, ranging from physical therapy and bracing to surgery in severe cases.
If you suspect you have scoliosis or are experiencing back pain or discomfort, it's important to speak with a healthcare professional for an accurate diagnosis and treatment plan.
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