Scoliosis is a sideways (lateral) curvature of the spine, or backbone. The curvature of the spine may occur in the lower or upper spine. The bones that make up the spine are called vertebrae. The vertebrae can rotate at any level of the spine and cause the curve in the spine. When the curve in the spine is more than 40-45 degrees, it generally requires some type of treatment. The curve in the spine also causes a deformity at the shoulders, waist and chest level. Simply correcting the posture does not correct the scoliosis. When the scoliosis progresses, patients will complain of back pain and some may even complain of difficulty in breathing.

People of all ages can have scoliosis, but it is most commonly seen in children and adolescents. Moderate to Severe scoliosis is seen in about 3 out of every 1000 children. Many cases of mild scoliosis exist but never come to medical attention. Adolescent idiopathic scoliosis (scoliosis of unknown cause) is the most common type and occurs after the age of 10. Girls are more likely than boys to develop of scoliosis.

Occasionally, degenerative disease and osteoporosis of the spine can cause scoliosis. The softening of the bones can cause the vertebrae to bend/break and alter the shape of the spine.

Scoliosis can run in families. Occasionally, a few children in the same family develop scoliosis. This type is called an idiopathic disease because the cause of it is unknown. Some nonidiopathic cases of scoliosis may be linked to neurological disorders, such as polio, spinal cord injuries, cerebral palsy, and muscular dystrophy.

In the majority of individuals, the cause of scoliosis is unknown (also called idiopathic). Before concluding that a person has idiopathic scoliosis, the physician will make all attempts to look for all possible causes such as neuromuscular, metabolic, infection or injury. Causes of curves are classified as either nonstructural or structural. It still is not well understood why scoliosis progresses in some and remains stable in others.

Occasionally scoliosis is temporary and may occur in a normal spine. This may be due to muscles spasms, leg discrepancy, Cholecystitits, appendicitis and kidney stones. In non structural scoliosis, the underlying condition should be treated.

It is important that scoliosis be identified as early as possible, since prompt treatment of progressing curves provides the best chance of slowing or halting an increasing curvature. A medical history, physical exam and x rays are essential to evaluate scoliosis. The degree of scoliosis is measured and its progression is followed. Curves that are greater than 30 degrees require some type of treatment. The larger the curve is, the more likely it will progress.

Many children have a diagnosis of a back problem in school and referred to a doctor. The majority of these children have mild scoliosis and do not require treatment. However, it is best to have a child follow up with a doctor to ensure that the scoliosis is not progressing. The doctor will recommend treatment based on the child’s age, the degree of scoliosis and the type of scoliosis.

For those who have very mild scoliosis or who are still growing (children), observation is the mainstay of treatment.

For those adults with moderate degree of Scoliosis, the classic method of therapy involves wearing a spinal prosthesis. These are custom made and easily concealed by loose fitting clothes. Basically these prosthesis are worn for most of the day and then weaned as skeletal maturity has occurred. Wearing these braces has been shown to slow the progression of the spinal curve. An orthopedic brace can be used to prevent the curve from worsening and does not limit physical activity.

A variety of treatments are available including spinal manipulation, physiotherapy, and electric stimulation. However, none of these treatments can reverse or prevent the progression of scoliosis have not shown to be effective treatments. Moist heat will help alleviate some pain.

In extreme cases surgery may be required but only after the continuous observation has shown that a brace is not helping. Spinal fusion and instrumentation is a surgery specialized for people with scoliosis whereas rods and hooks are inserted to help align your spine and prevent further curving.

Generally surgery for scoliosis is undertaken when the curve is greater than 40 degrees. Curves greater than 45 degrees have a high likelihood of progression. As the curve size increases, more chest and trunk deformity develop, which reduce surgery’s ability to completely correct the cosmetic appearance. Breathing problems can occur in scoliosis, but usually occur when curves are greater than 90 degrees.

Chiropractic care can help improve symptomatic scoliosis. The chiropractor looks at your overall health, examines your spine as well as evaluating your lifestyle. The chiropractor will carefully assess the scoliosis and order relevant X rays which will help him follow up the progression of the scoliosis. Your chiropractor will measure the length of the legs to determine unevenness, perform a range of motion test that measures the degree to which there is mobility of the spine and determine which is the best treatment.

All patients with a diagnosis of Scoliosis need regular follow up. The follow up visits are important to ensure that the scoliosis is not progressing. Scoliosis can be relatively easily treated in the early stages and allows for normal life activities. Irrespective of treatment, physiotherapy is the mainstay of managing Scoliosis. This modality helps to increase muscle strength and mobility.