Scoliosis
Reviewed by:
, Lead GP at Livi
Scoliosis is where the spine curves to the side, a condition most often seen in children. We explain how scoliosis can be diagnosed and what treatment is available.
What is scoliosis?
Scoliosis is a condition where the spine curves to the side, varying in location and severity. Usually the spine is seen as a straight line from the back, but with scoliosis, you may see a visible sideways curve.
The curve can be in the lower back (lumbar), upper back (thoracic) or both (thoracolumbar). Scoliosis has no preventable cause, but there is treatment available.
What are the symptoms of scoliosis?
There are a range of symptoms depending on location and severity of the curved spine, which can change over time.
Scoliosis symptoms include:
A visibly curved spine
Uneven shoulders, ribcage or waist – your shoulder blade or hip may stick out
Constantly leaning to one side
Clothes not fitting properly
Mild discomfort or pain
In severe cases, lung and heart function may be affected because of the extra pressure
How common is scoliosis?
In the UK, 3 to 4 out of every 1,000 children require treatment for scoliosis. Scoliosis is more common in girls than boys, and girls are more likely to develop a greater curvature of the spine leading to severe scoliosis.
It can affect people of any age though most often starts in children aged 10 to 15 as they grow. More recently it’s been recognised as a condition that also affects older people.
What causes scoliosis?
In around 1 in 10 cases, the cause of scoliosis is not known. These cases are called idiopathic scoliosis.
In less common cases, scoliosis could be caused by:
Existing neuromuscular conditions where you cannot walk, for example cerebral palsy, spina bifida and muscular dystrophy
There is a link within families suggesting it could possibly be genetic
The spine ageing over time
In rare cases scoliosis can be caused by a spinal lesion or tumour
What are the types of scoliosis?
Idiopathic scoliosis – this is the most common form of scoliosis, which usually starts showing in adolescence but can be from younger
Degenerative scoliosis – this can either be a new onset condition or the worsening of a previously undiagnosed curvature, most likely diagnosed in older adults
Neuromuscular scoliosis – this is caused by existing conditions that affect your nerves or back muscles
Congenital sclerosis – this rarer type of sclerosis is caused by the bones of your spine not forming properly in the womb, causing a curvature that’s present from birth
How is scoliosis diagnosed?
When you see a GP, they will first discuss your symptoms with you. If you’re young and still growing, they may assess your development.
When the doctor examines your spine, they will ask you to remove your clothing where appropriate. If there’s any suspicion of scoliosis you’ll be referred for an x-ray of your spine.
You’ll be referred to a scoliosis specialist at a hospital if scoliosis is diagnosed from your x-ray. The scoliosis specialist will measure your Cobb angle – this is the degree of curvature in your spine – and they may carry out additional scans.
Scoliosis Association UK (SAUK) has a national support helpline that may be helpful in offering additional support for dealing with a diagnosis.
How to treat scoliosis
Not all forms of scoliosis need treatment, and even fewer require surgery. Treatment options include:
Observation – for most people, scoliosis may just be monitored with regular x-rays and appointments with specialists to check for any changes
Exercise – people with scoliosis should exercise regularly to keep fit and strengthen the back muscles, though if you plan to take on any new sports or hobbies, it’s important to let your specialist know
Brace – this is a rigid harness worn around your back, either all the time or just at night, to help prevent the curve getting worse while you’re still growing
Surgery – this may be the best option for you if you have severe scoliosis, that’s impacting your health or getting worse. This may happen in adolescence to control how your spine grows (using rods in the spine) or later in life to help straighten your spine by fusing some of the bones together. The rods will straighten your spine but can reduce bending and twisting movements.
Pain relief – adults may need painkillers or spinal injections
Mental health support – the impact of scoliosis and its treatments can affect your self-esteem and body image. Support is available to help manage your mental health.
When should I seek help?
If you have any concerns that you or your child have scoliosis please make a GP appointment. It’s likely not serious but may require further assessment.
Frequently asked questions
In children, pain might be a sign of an underlying condition so should be investigated further. Pain is more common in adults, but it’s important to contact a GP or your specialist directly to discuss pain relief options.
If you have a new severe back pain or new onset symptoms such as incontinence, numbness or leg weakness, it’s best to seek urgent medical advice.
There’s a quick test you can do to check for the possibility of scoliosis called the ‘Adam’s forward bend’. This requires someone like a doctor or guardian to observe you from behind with your back visible.
Bend forward at the waist with your arms straight and legs shoulder width apart. The observer should notice a curve in the spine or protruding shoulder blade or ribs.
The UK scoliosis clinic also has a free app called ScoliScreen that may help screen a friend or family member, but this is in no way a substitute for a medical opinion. If you think you have scoliosis, make an appointment to see a GP.
- Reviewed by:
- undefined, Lead GP at Livi