Scoliosis is a medical condition characterised by an abnormal curvature of the spine.

Typically, the natural alignment of our spines is straight and vertical. However, individuals with scoliosis experience a curvature in their spine, either mild or severe, resembling the shape of a "C" or an "S." These curvatures can lean towards either the right or left side.

However, it may also develop as a consequence of diseases like cerebral palsy or muscular dystrophy or due to spinal infections.

Recognising the Signs: Symptoms of Scoliosis

The symptoms of scoliosis can vary, ranging from mild to severe. Common signs include:

  • Uneven shoulders or shoulder blades
  • Asymmetrical waist or hips
  • Visible curvature of the spine

In severe cases, scoliosis can lead to a forward or backward bend of the spine, as well as a rotational twist.

Causes of Scoliosis

The cause of many cases of scoliosis is unknown, which is referred to as idiopathic scoliosis. If scoliosis is caused by genetics, it is further categorised based on the patient's symptoms, as described below:

  1. Idiopathic Scoliosis: The most common form, with no known cause. It's often categorised by the patient's age:
    • Infantile Idiopathic Scoliosis: Developing before age 3
    • Juvenile Idiopathic Scoliosis: Between ages 4-10
    • Adolescent Idiopathic Scoliosis: Scoliosis occurs without a known cause between the ages of 10-18. This type is the most frequently observed.
  2. Congenital Scoliosis: This type forms in the womb.
  3. Functional Scoliosis: Arises during childhood due to physical issues like uneven leg length or muscle imbalances.
  4. Neuromuscular Scoliosis: Caused by disorders affecting the brain or spinal cord.
  5. Degenerative Lumbar Scoliosis: Occurs in older adults due to prolonged spinal pressure.

Diagnosis of Scoliosis

Diagnosing scoliosis involves a comprehensive review of the patient's medical history and a physical examination. This examination may include:

  • Spinal inspection in various positions
  • Assessments for shoulder, hip, and waist alignment
  • X-ray or MRI scans for detailed spine analysis

Risk Factors

Scoliosis risk factors include:

  • Age: Commonly develops in childhood
  • Gender: Equal prevalence in boys and girls, but girls may experience more severe symptoms
  • Family History: Genetics can play a role, although many cases occur without a family history

Complications of Scoliosis

Scoliosis, even with mild symptoms, can lead to a range of complications, such as:

  • Reduced Heart and Lung Efficiency: In severe cases with pronounced spinal deformities, possibly accompanied by hip irregularities, the functionality of the heart and lungs can be compromised. This may result in heightened fatigue for the patient.
  • Chronic Back Issues: Those who experienced scoliosis during childhood are more likely to suffer from back pain as they age.
  • Visible Changes in Body Structure: The progression of scoliosis often makes its symptoms more apparent. This can include increasingly asymmetrical shoulders and hips or a protruding rib cage. These physical changes can also contribute to psychological distress.

Treatment of Scoliosis

Following a diagnosis, the doctor will formulate a personalised treatment strategy, which might include:

  • Use of a Back Brace: This is often prescribed to rectify spinal curvature. It's particularly effective for patients whose growth is complete. The primary purpose of the brace is to decelerate the curvature's progression. Typically, patients are advised to wear the brace continuously, except during physical activities or while bathing.

For some, wearing the brace is limited to sleeping hours. It's most effective for individuals with spinal curvatures ranging from 25 to 40 degrees. Those with curvatures between 40 to 50 degrees may use a back brace too, but surgery is often recommended in these cases.

  • Surgical Intervention: Surgery may be proposed when other treatments haven't yielded the desired results or in instances of extremely severe scoliosis. This option is considered when it's deemed to be the most viable solution for the patient.