Scoliosis

What is scoliosis?

Scoliosis is the term for the sideways curvature of your spine. Scoliosis is a descriptive term, like headache, and not a diagnosis.

It can occur at any age but tends to start in older children and teenagers.

What are the symptoms of scoliosis?

The symptoms and signs of scoliosis include:

• your head not being centred over your body
• one shoulder being higher than the other
• one shoulder blade being higher than the other and may stick out more
• unusual gaps between one arm and the trunk
• one hip being higher than the other

You can find out more about self-detecting scoliosis in this factsheet from Scoliosis Australia.

What causes scoliosis?

Most of the time, the cause of scoliosis is unknown. Most cases of scoliosis develop in otherwise healthy children.

Scoliosis can be congenital, meaning it is present at birth. It can also be caused by problems with the nerves and muscles, such as:

• cerebral palsy
• muscular dystrophy
• spina bifida

We do know that scoliosis is not caused by:

• a heavy school bag
• poor posture
• a soft mattress

Scoliosis is much more common in girls (90%) than boys. It usually appears between:

• 10 and 12 years in girls
• 12 to 14 years in boys

Scoliosis tends to run in families.

When should I see my doctor?

If you are concerned that your child may have scoliosis, see your doctor. Early diagnosis and treatment is important.

If your doctor thinks you have scoliosis, they may arrange for you to have tests such as:

• an x-ray
• a CT scan
• an MRI scan

Your doctor may also refer you to an orthopaedic specialist who will discuss treatment options with you.

How is scoliosis diagnosed?

Your doctor can diagnose scoliosis simply with a physical examination of your:

• spine
• ribs
• hips
• shoulders

How is scoliosis treated?

Your treatment options depend on the severity of your scoliosis and how old you are.

The main treatment options for children are:

• observation — your doctor will monitor you
• casting — an external brace that is worn constantly and cannot be removed
• bracing — can stop the curve from getting worse
• surgery — only needed by 1 in 3 people

In younger children surgery might involve the insertion of metal rods to straighten your spine. You will need to return to the specialist every few months to have the rods lengthened. When your child stops growing, the rods can be removed and a spinal fusion will be carried out.

If you have scoliosis you may need to see your doctor regularly to monitor the curve of your spine.

There are several different types of rods:

• Traditional locked growing rods — the rods are lengthened during an operation every 6 to 9 months to allow for growth.
• Magnetic rods — these are lengthened by placing a rotating magnet on the skin.

In teenagers and young adults whose spine has stopped growing, a spinal fusion may be carried out.

Exercise and physiotherapy can help ease muscle pain.

If you don’t get treatment for your scoliosis, the curve of your spine may increase.

Can scoliosis be prevented?

Scoliosis can’t be prevented because the cause is often unknown.

Complications of scoliosis

Physical complications of scoliosis are rare.

In bad cases of scoliosis your ribcage can be pushed against your heart and lungs. This may cause breathing problems and can increase the chances of lung infections, such as pneumonia. It can also lead to problems such as heart failure.

Sometimes the bones in your spine can push on your nerves. This can cause problems such as:

• pain in your back
• pain, numbness or weakness in your legs
• incontinence — loss of bladder or bowel control
• erectile dysfunction — an inability to get or maintain an erection

Emotional complications

Having a curved spine and needing to wear a back brace may cause problems with body image and self-esteem. This is especially true for children and teenagers with scoliosis.

Encouraging your child to talk with other teenagers who have scoliosis can help improve their confidence.