June is National Scoliosis Awareness Month (NSAM) for 2021 and the years beyond. This month, we hope to help readers learn more about scoliosis – and understand why this condition requires more research, more funding, and more attention. Scoliosis is surprisingly prevalent. While it doesn’t affect most people, it is diagnosed in upwards of three million Americans every year. Unfortunately, most cases of scoliosis are identified and diagnosed as idiopathic scoliosis – which medically means that we don’t know what caused the curvature.
The majority of scoliosis cases are diagnosed in preadolescence, around the ages of 10 to 12. In all cases, early diagnosis and treatment is the key to preventing much greater complications over time – the earlier scoliosis is identified, the earlier it can be treated and potentially corrected. But one of the hardest things about diagnosing scoliosis is that it generally begins painlessly. As a result, back pain may not set in until the curvature has become much more significant.
Scoliosis & the Growing Need for Scoliosis Awareness
Scoliosis is the abnormal lateral curvature of the spine. This means that the spine is curving abnormally to the sides by at least 10 degrees on an x-ray machine. The spine curves naturally at the neck, the center of your upper back, lower back, and hip. These curvature points help the spine act as a shock absorber while positioning the head above the pelvis. When viewed from the side, the human spine has somewhat of an S shape. But when viewed from behind, the spine should be a straight column.
An easy way to test this is to measure and compare a person’s hips and shoulders when standing upright. Ideally, you would be able to draw a line between both shoulders and a line between both hips and have these lines both be parallel to one another, as well as perpendicular to the ground. If these lines are not parallel, then the spine may be abnormally curved. A slight curvature of the spine is nothing serious – but if diagnosed early, it may be more easily corrected (or may lead to an increased curvature with adulthood if left untreated). Scoliosis should not be diagnosed without a medical professional.
In many cases (especially with more subtle curvature), a doctor will require an imaging test to make sure. In other cases, scoliosis is much more obvious and may cause severe pain. Scoliosis is defined by its cause. The three types of scoliosis we diagnose today include idiopathic scoliosis (unknown cause), congenital scoliosis (identified at birth), and neuromuscular scoliosis (caused by muscular or neurological damage-related conditions). Scoliosis cases are also defined by age group (i.e., adolescent scoliosis and adult-onset scoliosis)
How Is Scoliosis Identified & Diagnosed?
The spine mechanics are a little complicated – and scoliosis is a much more three-dimensional problem than a simple x-ray might reveal. The exact way in which the spine is curving abnormally differs from case to case. When testing for spinal deformation, doctors make sure to check the spine from three planes: the coronal plane, the sagittal plane, and the axial plane. Each plane divides the body into two halves. If we assume an upright position, the coronal plane divides the body into a front-facing half and a back-facing half. The sagittal plane divides the body into a left half and a right half. Finally, the axial plane divides the body into an upper half and a lower half. Some ways to identify scoliosis, or reasons to visit a doctor, include:
- Uneven waist.
- Uneven shoulder blades.
- Constant lean to one side.
- Uneven rib cage (left and right are at different heights).
- One-sided scapular winging (shoulder blade sticking out).
Back pain may or may not be a symptom of scoliosis. One in ten patients with back pain also presented with a different spinal pain disorder (such as a herniated disc, a spinal tumor, or spondylolisthesis). Different imaging tests help doctors better look at the curvature of the spine and determine whether a patient needs treatment. These imaging tests include:
- MRI scan: Magnetic waves are used to get a detailed image of the bone and tissue passed through the machine.
- CT scan: Multiple x-rays are taken from different angles to create a computer-generated 3D picture of the spine.
- Bone scan: A harmless radioactive dye is injected into the bloodstream and scanned by a machine, highlighting spinal curvature via your circulation.
Once a doctor has gotten a good look at your spine and determined scoliosis, they may do further testing. They will consider your medical and family history to determine a potential cause.
Why Does Scoliosis Occur?
When no other cause is apparent, scoliosis is assumed to be at least partially caused by genetics. If a person is born with scoliosis, it is called congenital scoliosis. However, most cases of scoliosis are defined as idiopathic, meaning their cause is unknown. Certain injuries and diseases may increase the risk of preadolescent scoliosis. Most of these are neurological or involve the musculoskeletal system. Though uncommon, these conditions are called neuromuscular scoliosis. Posture or a sedentary lifestyle does not cause serious scoliosis. The fourth type of scoliosis, called functional scoliosis or nonstructural scoliosis, does not affect the spine’s structure and is reversible.
How Is Scoliosis Treated?
Treatment for scoliosis depends on the onset, the patient’s age, the severity of the deformation, pain, and its type. Common elements in a treatment plan include:
- Surgery (curvature above 40 degrees).
- A physical brace (curvature between 20 and 40 degrees).
- Pain management (through therapy, medication, and non-invasive interventions).
- Exercise (may not alleviate curvature but can greatly improve quality of life and reduce pain).
If you or someone you love shows signs of an abnormal curvature in their spine, get them to a specialist as soon as possible.
Educating & Advocating for Scoliosis Awareness Month
The Scoliosis Research Society is currently working on getting the month of June officially recognized as the National Scoliosis Awareness Month and is asking readers all over the country to help support them in bringing more awareness to the topics of scoliosis research, scoliosis treatments, and initiatives that try to help bring more information and resources to the public on how to lead a better life with scoliosis, in all its forms. So, if you are looking to share more information on scoliosis and its forms and treatments, consider having a look at the following resources:
You deserve to lead a better life. However, even mild scoliosis can affect the quality of life, lead to back pain, and require lifestyle adjustments and more serious interventions. Schedule an exam today and discuss your treatment options with a specialist.