Scoliosis

What is scoliosis?

Scoliosis is a condition where the spine curves to the side, varying in location and severity. Usually the spine is seen as a straight line from the back, but with scoliosis, you may see a visible sideways curve.

The curve can be in the lower back (lumbar), upper back (thoracic) or both (thoracolumbar). Scoliosis has no preventable cause, but there is treatment available.

What are the symptoms of scoliosis?

There are a range of symptoms depending on location and severity of the curved spine, which can change over time. 

Scoliosis symptoms include:

• A visibly curved spine 

• Uneven shoulders, ribcage or waist – your shoulder blade or hip may stick out

• Constantly leaning to one side

• Clothes not fitting properly

• Mild discomfort or pain

• In severe cases, lung and heart function may be affected because of the extra pressure

How common is scoliosis?

In the UK, 3 to 4 out of every 1,000 children require treatment for scoliosis. Scoliosis is more common in girls than boys, and girls are more likely to develop a greater curvature of the spine leading to severe scoliosis. 

It can affect people of any age though most often starts in children aged 10 to 15 as they grow. More recently it’s been recognised as a condition that also affects older people. 

What causes scoliosis?

In around 1 in 10 cases, the cause of scoliosis is not known. These cases are called idiopathic scoliosis.

In less common cases, scoliosis could be caused by:

• Existing neuromuscular conditions where you cannot walk, for example cerebral palsy, spina bifida and muscular dystrophy

• There is a link within families suggesting it could possibly be genetic

• The spine ageing over time

• In rare cases scoliosis can be caused by a spinal lesion or tumour

What are the types of scoliosis?

• Idiopathic scoliosis – this is the most common form of scoliosis, which usually starts showing in adolescence but can be from younger

• Degenerative scoliosis – this can either be a new onset condition or the worsening of a previously undiagnosed curvature, most likely diagnosed in older adults

• Neuromuscular scoliosis – this is caused by existing conditions that affect your nerves or back muscles

• Congenital sclerosis – this rarer type of sclerosis is caused by the bones of your spine not forming properly in the womb, causing a curvature that’s present from birth

How is scoliosis diagnosed?

When you see a GP, they will first discuss your symptoms with you. If you’re young and still growing, they may assess your development.

When the doctor examines your spine, they will ask you to remove your clothing where appropriate. If there’s any suspicion of scoliosis you’ll be referred for an x-ray of your spine.

You’ll be referred to a scoliosis specialist at a hospital if scoliosis is diagnosed from your x-ray. The scoliosis specialist will measure your Cobb angle – this is the degree of curvature in your spine – and they may carry out additional scans. 

Scoliosis Association UK (SAUK) has a national support helpline that may be helpful in offering additional support for dealing with a diagnosis.

How to treat scoliosis

Not all forms of scoliosis need treatment, and even fewer require surgery. Treatment options include:

• Observation – for most people, scoliosis may just be monitored with regular x-rays and appointments with specialists to check for any changes

• Exercise – people with scoliosis should exercise regularly to keep fit and strengthen the back muscles, though if you plan to take on any new sports or hobbies, it’s important to let your specialist know

• Brace – this is a rigid harness worn around your back, either all the time or just at night, to help prevent the curve getting worse while you’re still growing

• Surgery – this may be the best option for you if you have severe scoliosis, that’s impacting your health or getting worse. This may happen in adolescence to control how your spine grows (using rods in the spine) or later in life to help straighten your spine by fusing some of the bones together. The rods will straighten your spine but can reduce bending and twisting movements.

• Pain relief – adults may need painkillers or spinal injections

• Mental health support – the impact of scoliosis and its treatments can affect your self-esteem and body image. Support is available to help manage your mental health.

When should I seek help?

If you have any concerns that you or your child have scoliosis please make a GP appointment. It’s likely not serious but may require further assessment.