Scoliosis is a lateral, or sideways, curving of the spine. The degree of curving is measured by angles. The larger the angle, the greater is the chance that the disorder will get worse. Curves less than 30 degrees at the end of childhood growth rarely get worse and don’t usually need close watching. Curves larger than 50 to 75 degrees may need aggressive therapy.
Scoliosis usually begins in childhood or adolescence and may slowly worsen into adulthood. The younger the age when scoliosis starts, the worse it’s likely to become. More girls than boys have the severe disorder.
The cause is usually unknown. Some cases are due to uneven leg length, congenital (present at birth) spine disorders, or rare neurological disorders. The risk increases with a family history of scoliosis. It’s not caused by backpacks, poor diet, exercise, or bad posture.
Pain is the most common reason that adults go to doctors for treatment. The true source of pain isn’t clear.
Some people may have a loss of height, increase in prominence of a rib, or changes in waistline, which can mean progression of the curve.
The emotional aspects of scoliosis may be severe, especially for teenagers. Breathing problems may develop with large curves, but usually pain and fatigue are felt before the breathing trouble.
The health care provider makes a diagnosis from a physical examination and x-ray of the spine. Deformities can range from mild to painful and severe. X-rays taken for several years is the best way to watch the curving.
A slowly progressive curve may not be painful and not need treatment. A curve that causes pain and deformity may need aggressive treatment.
Analgesics and anti-inflammatory drugs may reduce pain. No medicines, injections, diets, or exercises can fix the curve itself.
The health care provider will take routine x-rays at regular times to watch for progression of the curve. Braces can help prevent a curve from getting worse but don’t correct an already developed curve. Exercises and electrical stimulation of muscles don’t help people with scoliosis.
When the curve progresses or causes severe pain, surgery may be used. If the curve is not getting worse, people must decide whether the pain is bad enough that a complex operation should be done. The operation involves fusing, or joining, the bones (vertebrae) of the back. The surgeon must be sure that something else unrelated to scoliosis is causing the back pain.
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