What is Scoliosis?

May 10

Scoliosis is relatively commonly known, even though it’s not well understood. Here in the United States where I live, many states require screening for all school-aged children and teens. It’s also common for a doctor to check a child with something called the Adams Forward Bend Test during their annual well visits. Most people have heard of it, know someone who has it, or at least know it is a spinal condition.

But… what is it, exactly?

Let’s talk about it.

Scoliosis is defined as a complex, 3 dimensional condition of the spine and trunk in otherwise healthy individuals that can be progressive. The Scoliosis Research Society (SRS) states scoliosis is present when an x-ray shows a Cobb angle of at least 10° with rotation of the spinal segments. It’s commonly accepted that it affects 1-2% of the population here in the US, but recent research reports that up to 60% adults are diagnosed with it later in life. There’s some evidence that it can be passed on genetically. Recent studies in this show having a close relative with scoliosis could increase someone’s likelihood of developing it anywhere from 3 to 20%, higher if both parents have it.

As we speak, researchers and scientists across the world are conducting super exciting and innovative research into all things scoliosis. That said, there are many things we still don’t understand about scoliosis and how it develops.

One thing that can be tricky about scoliosis is, not only is it complex, but in many instances it’s not well explained to patients and families who get the diagnosis. It’s not only a shifting of the spine, it’s also a rotation of the spine. It impacts literally the entire body, from how the muscles work, to our breathing patterns, to our digestion, and so much more. It can change over time, sometimes getting worse as we age … but it can also get better if we work on it.

Is scoliosis dangerous?

Not all scoliosis curves are created equal, and every single person’s spine will curve at a different speed and magnitude. Most cases of scoliosis are called idiopathic, which is a fancy medical word that indicates that no one knows what causes it. It can be classified as mild, moderate or severe, usually based on what’s known as a Cobb angle, measured on an x-ray. Mild is usually classified between 10 degrees and 25 degrees, moderate between 25 and 45, and anything above 45 degrees would be considered severe. Sometimes a curve above 45 degrees may require surgery to correct it, but this is also a case by case basis.

There are so many different types of scoliosis, including:

Congenital scoliosis - present at birth
Early onset scoliosis - before age 10
Adolescent idiopathic scoliosis - most commonly known
Degenerative scoliosis - occurs often later in life, due to injury, bony or other structural spinal changes, et cetera
Neurogenic scoliosis, typically associated with another diagnosis. Think cerebral palsy, spinal cord injury, spina bifida and other neurologic conditions.

Generally scoliosis curves are not harmful. The younger someone’s scoliosis begins developing, the more risk there is of it impacting their health in a negative way. Larger curves can impact our organs and how they function, mainly the heart and lungs, when curves get larger and the spine gets more rotated. This is one reason why there are ranges in which they really consider surgical correction, particularly if it’s a kid or teen who has more growing to do. That acceptable range changes a lot from a growing spine to a fully grown one. For instance, 46 degrees is considered severe and is in surgical range for a growing child - whereas 60 degrees can be considered moderate for an adult. This is why early detection and treatment is key for kids with scoliosis. It’s also understood that curves greater than 30 degrees will tend to increase by a half a degree to a degree a year if left untreated, which makes a huge difference if someone is young and is expected to live a long and healthy life.

However… don’t let that scare you! Millions of people around the world have scoliosis - even severe curves (more than 60 degrees) - and don’t ever experience pain or issues with it. It’s important to know that the advances in scoliosis treatment in the past several decades have led to huge improvements for people across the world, in all ages and types of scoliosis.

Out of all the theories out there on how scoliosis starts and grows, one of the most well-accepted across the world is the Relative Anterior Spinal Overgrowth Theory, where some of the segments of the spine grow asymmetrically.

Why does asymmetrical growth happen?

If you look at an x-ray of someone with scoliosis, you may see some segments that look like a trapezoid, or a wedge. These segments are typically found at the biggest parts of the curve, or those furthest away from the middle.

Why this happens, we don’t exactly know. Current theories assert that there’s excessive tension, or force, on the front of the spine, which causes that side to grow taller than the back - leading to the wedged shape. Basically, the rest of the spinal column has to adapt to the differently shaped segment to preserve space for the disks and other structures that pass between the vertebrae. If you’re a really visual person, I have a graphic I’ve made on this you can view on my Instagram page.

Can you do anything to treat your scoliosis?

Absolutely! Talking about this is my biggest passion. There is a type of exercise known as scoliosis-specific exercise - a.k.a. PSSE (physiotherapy scoliosis-specific exercise) in the scientific research - a.k.a. the Schroth Method. I lived a whole life including spinal fusion at age 11, getting a Doctorate in Physical Therapy and practicing almost a decade and treating people with scoliosis (as a general PT) without knowing it was a thing I could do. A therapist trained in this method can assess your specific scoliosis curve and teach you how to strengthen the right muscles to stabilize your spine in 3 dimensions! Not only can these exercises balance your muscles and improve your endurance, they can also help improve the mobility of your spine and rib cage, keeping you more mobile and active even as you age.

It’s incredibly effective at reducing risk of a curve getting worse over time, actually decreasing someone’s curve, eliminating pain and improving someone’s posture and muscular balance or symmetry. It’s the number one recommendation I have for everyone with scoliosis to learn how to best support and stabilize their spine. (It’s also the only form of exercise or physical therapy scientifically proven to improve someone’s scoliosis. Now, if that’s not an endorsement, I don’t know what is…)

I hope you learned a bit more about scoliosis and got some of your questions answered in this post. It can be so helpful to understand what scoliosis is, and that you have options if you’re concerned about your back, if you’re experiencing pain, or if you just want to live your best, fittest life with scoliosis.

I have links to directories to find a local scoliosis specialist near you in the resources section of my website. You can also schedule a personalized virtual consult with me for insight on your specific spine!