Scoliosis is a musculoskeletal disorder in which there is a sideways curvature of the spine, or backbone. Some people who have this condition require treatment. Other people, who have milder curves, may only need to visit their doctor for periodic observation.
For most people (80-85 percent of cases), the cause of scoliosis is not known. This is called idiopathic scoliosis.
Doctors classify the other cases of scoliosis into one of two types: nonstructural (functional) and structural scoliosis.
Nonstructural scoliosis is when the spine is structurally normal and the curve is temporary. In these cases, your doctor will try to find and correct the cause.
Structural scoliosis is when the spine has a fixed curve. In these cases, the cause could be a disease, injury, infection, or birth defect.
(Click Causes of Scoliosis for more information.)
People of all ages can have scoliosis. Out of every 1,000 children, three to five of them will develop spinal curves that are considered large enough to need treatment.
Idiopathic scoliosis falls into three different age ranges, which include:
- Infantile or early onset (children less than three years of age)
- Juvenile (children between the ages of 3 and 10)
- Adolescent (children older than 10 years of age).
Adolescent idiopathic scoliosis (where the cause is unknown) is the most common type of scoliosis, and girls are more likely than boys to have this type. Scoliosis can run in families, which means that a child who has a parent, brother, or sister with idiopathic scoliosis should be checked regularly for scoliosis by the family physician.
Although idiopathic scoliosis can occur in children younger than 10 years of age, it is very rare and it is more common in Europe than in the United States.
In order to make a scoliosis diagnosis, your doctor will:
- Ask you for a medical and family history
- Perform a physical exam
- Order tests.
An x-ray of the spine can also help your doctor determine whether you have scoliosis. The x-ray will allow your doctor to measure the curve of your spine in degrees (such as 25 degrees) and see its location, shape, and pattern.
(Click Curvature of the Spine for more information about spine curvature. Click Scoliosis Diagnosis for more information on how the condition is diagnosed.)
Treatment for scoliosis is based on:
- The person's age
- How much more he or she is likely to grow
- The degree and pattern of the curve
- The type of scoliosis.
Your doctor may recommend one of the following treatments:
- Observation
- Bracing
- Surgery.
Observation
Observation is used for people who have a curve of less than 25 degrees and who are still growing.
Your doctor will check the curve every four to six months to see if it is getting better or worse.
Bracing
Doctors may advise bracing in order to stop a curve from getting worse. Bracing may be used when:
- The person is still growing and has a curve of more than 25 to 30 degrees
- The person is still growing and has a curve between 20 and 29 degrees that is getting worse
- The person has at least two years of growth remaining and has a curve that is between 20 and 29 degrees.
However, females who have started their monthly period should not use bracing.
(Click Back Brace for Scoliosis for more information about bracing.)
Surgery
Doctors use
scoliosis surgery to correct a curve or stop it from getting worse when the person is still growing and:
- The curve is more than 45 degrees
- The curve is getting worse.
Surgery often involves fusing together two or more bones in the spine. During scoliosis surgery, your doctor may also put in a metal rod or other device, which is called an implant. The implants stay in the body and help keep the spine straight after surgery.
(Click Surgery for Scoliosis for more information about surgical treatment options.)
Exercise programs have not been shown to prevent scoliosis from getting worse. However, it is important for all people, including those with scoliosis, to exercise and remain physically fit. Weight-bearing exercises such as walking, running, soccer, and gymnastics help keep bones strong, and exercising and playing sports may improve a person's sense of well-being.
(Click Scoliosis Exercises for more information about scoliosis and exercise.)
So far, the following treatments have not been shown to prevent spinal curves from getting worse:
- Chiropractic treatment
- Electrical stimulation
- Nutritional supplements
- Exercise.
Researchers continue to look for the cause of idiopathic scoliosis. They have studied genetics, growth, structural and biochemical alterations in the discs and muscles, and central nervous system changes. The changes in the discs and muscles seem to be a result of scoliosis and not the cause of scoliosis. However, scientists are still hopeful that studying changes in the central nervous system (in people with idiopathic scoliosis) may reveal a cause of this disorder.
Researchers continue to examine how a variety of braces, surgical procedures, and surgical instruments can be used to straighten the spine or to prevent further curvature. They are also studying the long-term effects of a scoliosis fusion and the long-term effects of untreated scoliosis.
