Scoliosis is a condition in which the spine has an abnormal curvature to either the right or left. In very severe cases, the spine can actually become shaped like a C or an S. The point where the spine bends can be anywhere along the spine itself, but it is usually found in the chest or in the lower back. Scoliosis affects both children and adults and it is important to understand the differences between the two. In this article, we will look at the causes, symptoms and treatment of scoliosis in both children and adults.
There are different scoliosis causes, particularly because there are different types of scoliosis. Let’s first look at causes in children.
• Idiopathic scoliosis generally has an unknown cause, but family history is believed to have an influence.
• Neuromuscular conditions are the most common other cause of scoliosis. These conditions include cerebral palsy and muscular dystrophy.
• Congenital scoliosis is a condition with which children are born. It is very rare and is caused by abnormal bone development in the womb.
In adults, the situation is somewhat different. Causes for scoliosis in adults include:
• Degenerative scoliosis, which is gradual spinal damage
• Osteoporosis, weakening of the bones
• Surgical spinal damage
• Multiple sclerosis, motor neuron disease and Parkinson’s disease
As with causes, scoliosis symptoms vary depending on the cause of scoliosis and the age of the sufferer. Again, let’s look at children first:
• Uneven shoulders
• One prominent hip
• Hanging clothes
• Leaning to one side
• Bulges on the back or chest (scoliosis signs in babies)
• Unusual, curved sleeping positions (scoliosis signs in babies)
In adults, the symptoms generally start with back pain. This pain tends to be worse in a standing or sitting position, with improvement when lying down. If scoliosis affects the nervous system, symptoms can include:
• Loss of bladder control
• Loss of bowel control
• Erectile dysfunction
• Numbness and/or weakness in the legs
Treatment of scoliosis again varies depending on the type of scoliosis and the age of the patient. In children, there are four main types of treatment, being:
• Observation – it can cure itself
• Casting – forcing the spine in the right position
• Bracing – as with casting, but bracing tends to be a longer term option
In adults, scoliosis treatment also varies and includes:
• Medication, particularly paracetamol and NSAIDs (like ibuprofen). Nerve blocks can also be prescribed, as well as supplements to strengthen your bones
• Scoliosis exercises, which have been found to improve posture. Exercise should take place for around two and a half hours per day and the scoliosis exercises should be designed by a physiotherapist
• Braces, which will not correct scoliosis, but will provide a great deal of relief. Shoe inserts can also help, as well as other orthotics.
• Surgery is a last option, but this is a very risky option. Therefore, it is generally not recommended if other options are also available
Let’s take a look at the surgical options.
Surgery is generally not recommended as a treatment for scoliosis. Spinal surgery has many risks associated with it, so it is avoided as much as possible. However, if the scoliosis pain is unmanageable and has not responded to treatment, it may be considered as an option. Also, if a patient’s scoliosis worsens and is believed to lead to heart or lung damage in the future, it may also be recommended. There are two main types of scoliosis surgery, being:
• Decompression, whereby a spinal disc that puts pressure on the nerve is removed.
• Spinal fusion surgery, which is designed to correct the position of the spine. Metal rods are inserted and these are then fused through bone and tissue grafts. If no biological materials are present for grafting, ceramics can also be used.