Scoliosis is a condition in which the spine is curved in an unusual manner. It can be caused by a birth defect in the spinal column or a neuromuscular disorder such as cerebral palsy or muscular dystrophy. In many cases, however, the cause of an abnormal spine cannot be identified. Doctors refer to such cases as idiopathic scoliosis, and it is most common in young children and adolescents under the age of 18. A person with idiopathic scoliosis does not usually suffer from painful symptoms, though his or her ability to engage in physical activity can be limited because of an awkward stance or gait.
Idiopathic scoliosis usually appears in children and teenagers, whose bodies are still growing and developing. For reasons not understood by doctors, some adults with no history of muscle or bone problems develop scoliosis later in life. The condition causes one side of the spine to grow more quickly or protrude more prominently than the other side. It is usually easy to recognize the signs of idiopathic scoliosis: the shoulder blades or hips are be uneven, the spine noticeably sticks outward, and the individual appears to be leaning or hunched over when standing. Most people do not experience pain, though severe scoliosis can put excessive pressure on the ribs and lungs, leading to discomfort and difficulty breathing.
Doctors typically try to determine the seriousness of scoliosis before recommending treatment. The physician can conduct a physical exam in which he or she feels the patient's back to determine the location of the deformity. X-rays and magnetic resonance imaging scans produce clear images of the spine, which allow the doctor to measure the severity of a curvature.
Depending on the patient's age and the severity of idiopathic scoliosis, the physician might fit the patient with a corrective back brace, suggest physical therapy, or recommend surgery to fully correct the problem. A brace can help to keep the back straight during activity and put light pressure on the spine to encourage proper growth. Licensed physical therapists can help patients build muscular strength and learn how to move around comfortably while wearing braces.
Surgery is usually held off until an adolescent's spine has finished growing. A surgeon can physically fuse bones in the spine together using metal screws to straighten out the curve. Depending on the severity of the condition, skilled surgeons can usually bring the spine very close to normal. Most patients undergo several months or years of physical therapy following surgical procedures to build strength and overcome lingering back pain. They may still be required to wear back braces until their spines fully heal.
