Scoliosis – Understanding the Symptoms, Causes, and Risk Factors

A sideways curvature of the spine is medically termed as Scoliosis. The condition often occurs just before puberty, during the growth spurt. The cause of scoliosis remains unknown or uncertain in many cases. But, in some cases, conditions such as muscular dystrophy and cerebral palsy are known to be the causes of scoliosis.

In the majority of the cases, scoliosis is mild. Whereas, in some cases, children may develop spine deformities due to scoliosis that progresses and worsens as they grow. Severe scoliosis can be disabling. In extreme cases, scoliosis might cause severe spinal curves and compress the chest cavity, causing difficulty for the lungs to function efficiently.

It is essential to closely monitor children with mild scoliosis, with periodic X-rays, to see if the progression of the spine curve. In many cases, no treatment is necessary. Some children may be advised to wear a brace to prevent further worsening of the curve. Severe cases may require surgery to keep the scoliosis from worsening and to correct the curvature.

Symptoms of scoliosis:

•Uneven shoulders
•An unusual or abnormal prominence of one shoulder blade compared to the other
•Uneven waist
•One hip higher than the other

In cases where the scoliosis curve continues to progress, in addition to curving side to side the spine might rotate or twist. The twist results in sticking out ribs on one side of the body farther than on the other. Severe scoliosis can cause back pain and difficulty breathing.

When to see a doctor?

It is advised to consult your doctor if you notice any signs of scoliosis in your child. Mild curves, often go unnoticed by the child or the parent as the curve appears gradually and usually doesn’t cause any pain. Occasionally, teachers, friends, and sports teammates may first notice a child’s scoliosis.

Causes and Risk Factors

The exact cause of scoliosis remains undetermined. However, since scoliosis tends to run in families, hereditary factors are considered the cause of scoliosis in many cases. Other causes for less common types of scoliosis include:
•Neuromuscular conditions, such as cerebral palsy or muscular dystrophy
•Congenital defects (defects present by birth) interfering with the development of the bones of the spine
•Trauma to the spine
•Infections such as osteomyelitis or discitis, affecting the spine.

Risk factors –

•Adolescence or puberty (between 9-15 years of age) – the period at which a child is transitioning to adulthood and undergoes a significant growth spurt.
•Gender – Although mild scoliosis affects both genders at about the same rate, girls are at higher risk of the curve worsening and requiring treatment.

Complications

Mild scoliosis which is seen in the majority of the cases seldom causes any complications. However, severe scoliosis if left untreated may sometimes cause complications, including:
•Lung and heart damage. In severe scoliosis, the rib cage may press against the lungs and heart, making it more difficult to breathe and harder for the heart to pump
•Adults who had scoliosis as children often experience chronic pain
•As scoliosis worsens, it can cause more noticeable changes — including shoulder at different levels, prominent ribs, uneven hips, and a shift of the waist and trunk to the side. Individuals with scoliosis often develop negative or low self-esteem about their appearance.

This article is authored by Dr Ajay Kumar SP, Consultant- Spine Care, Manipal Hospital.