What is scoliosis?

Scoliosis is a condition characterized by an abnormal curvature of the spine, often forming an "S" or "C" shape. This lateral curve can occur in any part of the spine but is most commonly found in the thoracic (mid-back) and lumbar (lower back) regions.

Scoliosis can affect people of all ages, but it is most commonly diagnosed during adolescence, when rapid body growth can make the spinal curve more noticeable.

Symptoms

Common signs and symptoms of scoliosis include:

poor posture: the curvature of the spine can lead to a visible misalignment of the back
uneven shoulder height: one shoulder may appear higher than the other when the patient is standing or bending forward
spinal rotation: in more advanced cases, the spine may rotate, leading to asymmetry in the rib cage (mid-back area)

Causes

Scoliosis can have different causes, and they can be classified into several types depending on the origin of the spinal curvature. The main causes include:

idiopathic scoliosis: this is the most common form and accounts for the majority of cases. In this type, the exact cause of the curve is unknown
congenital scoliosis: present at birth and caused by problems in the spinal bones while the baby is developing in the womb
neuromuscular scoliosis: associated with neuromuscular conditions (problems that affect both the nerves and muscles of the body) that impact muscle strength and control, such as cerebral palsy
degenerative scoliosis: arises due to the natural wear and tear of the spine with aging. It generally affects older adults
functional scoliosis: caused by muscular, postural imbalances, or leg length discrepancies. The curvature is often temporary and can be corrected with physical therapy

Diagnosis

The diagnosis of scoliosis is made by an orthopedic specialist in the following way:

medical history: the specialist may begin by asking questions about the patient’s medical background, including any family history of scoliosis, development during childhood and adolescence, and the presence of symptoms such as back pain or changes in posture
physical examination: the patient’s spine will be examined while standing, bending forward, and in other positions. The doctor will look for any asymmetries, lateral curves, misalignments, or spinal rotations
curve measurement: the specialist may use a tool called a scoliometer to measure the curvature of the spine. This is typically done by observing the patient’s back from behind while they are standing

Treatment

The treatment of scoliosis can vary depending on the curvature, the patient’s age, and other individual factors. The goal of treatment is to stabilize the scoliosis and relieve symptoms when present. The most common options include:

observation: In mild cases of scoliosis, especially when there are no obvious symptoms, the doctor may choose to simply monitor the condition over time without taking immediate action. This is particularly applicable in cases of adolescent idiopathic scoliosis
physical therapy: may be recommended to strengthen the muscles around the spine, improve posture, and provide relief from symptoms such as back pain
use of orthopedic braces: In moderate cases of scoliosis, especially during periods of rapid growth in children and adolescents, braces may be recommended to help control the progression of the curvature
surgery: in more severe cases of scoliosis, surgery is recommended when the curvature reaches a significant degree and there is a risk of future complications

Prevention

Scoliosis, especially the adolescent idiopathic form, often cannot be fully prevented, as its exact cause is still unknown. However, there are measures that can be taken to help with prevention or management:

screening and early diagnosis: especially during adolescence, this can help identify scoliosis in its early stages
physical activity and muscle strengthening: swimming or strength training exercises can help promote spinal health and maintain back muscle strength
good posture: encouraging proper posture from childhood can be beneficial. This includes habits like sitting and standing correctly to avoid overloading the spine
proper use of school backpacks: it’s important to choose a backpack that is ergonomically designed—meaning it’s made with comfort, efficiency, and safety in mind—and to wear it properly, with even weight distribution across the back

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