Scoliosis: Causes, Symptoms and Treatment

Scoliosis is a disorder in which the spine curves away from the middle (C-shaped) or sideways (S-shaped). Unfortunately, it is difficult for an untrained eye to grasp this type of curving. An indication of scoliosis is if one shoulder of a person appears to be higher than the other, or their pelvis appears to be tilted.

Causes

There are a few reasons for the development of this disorder. In fewer cases, it is present at birth (congenital), and develops while in the womb. While the fetus is growing in the womb, the spine bones may not form properly, or the ribs may fuse together, leading to a curved spine. Another type of scoliosis is neuromuscular, which means that it is caused by poor muscle control or muscle weakness, or paralysis due to diseases such as cerebral palsy, muscular dystrophy, spina bifida, and polio. When scoliosis develops in a previously straight spine without an identifiable cause, it is known as Idiopathic scoliosis. It is the most common type of scoliosis and affects more girls than boys. It usually takes place in adolescents, and gets worse as they grow. Though the reason is unknown, it seems that some people may be prone to curving of the spine.

Among the measures taken to deal with the disease, are routine scoliosis screening, which are done in middle and junior high schools. This is very useful in early detection and consequent treatment of cases, that may previously have gone undetected until the condition became more advanced.

Symptoms

Though hard to detect visually, one may notice both shoulders or hips not being at the same level. However, this and the tilt of the stomach can be attributed to bad posture. A person with scoliosis is likely to experience backache or low-back pain. After a long period of sitting or standing, they are also likely to feel fatigue in the spine. The pain usually gets worse, if irritation results. Severe scoliosis, where the curve in the spine is greater than 100 degrees, can cause breathing problems.

Diagnosis

In order to diagnose scoliosis, a medical practitioner will first carry out a physical examination. Part of it is a forward bending test, that will enable the doctor to define the curve. However, this is not sufficient for the degree of the curve to be clearly defined, so an x-ray, taken from the front and side, of the spine is usually asked for. The doctor will also perform a neurologic exam to look for any changes in strength, sensation, or reflexes. Additionally, scoliometer measurements (a device for measuring the curvature of the spine) are usually taken, and if required, an MRI may be asked for.

Treatment

The course of treatment for scoliosis depends on a number of factors: the cause of the disorder, the size and location of the curve, and whether the patient is still growing. Usually, if the curve of the spine is less than 20 degrees, in adolescent idiopathic scoliosis, it does not require treatment. However, as the patient may still be growing, he needs to be checked every 6 months.

If idiopathic scoliosis is present to a degree above 25 to 30, in a growing child, a brace to slow the progression of the curve is recommended. Braces used are of several different kinds, such as the Boston Brace, Wilmington Brace, Milwaukee Brace, and Charleston Brace. Each kind is used differently and there are slight differences in appearance. It is for a doctor to decide, which one will benefit the patient most. The manner in which the brace functions, is by using pressure to straighten the spine. It is adjusted as the person grows. However, it cannot be utilized for cases of congenital or neuromuscular scoliosis.

In patients where the curve of the spine is 40 degrees or greater, surgery is required. This is to avoid worsening of the condition, which is likely to take place even if bone growth has stopped. During surgery, metal rods are usually used to hold the bones in place while they heal. Post operative care may include the wearing of a brace to stabilize the spine.

Adolescents who develop this condition, struggle with issues of self confidence and self image which emanate from having to wear a brace. Emotional support and understanding is what teenagers need during this time.