Understanding Scoliosis: Causes, Types, and Symptoms

Your spine’s natural curve provides essential support and flexibility, but when that curve exceeds 10 degrees, it may lead to a condition known as scoliosis. Far from just a cosmetic concern, scoliosis may impact posture, mobility, lung function, and overall quality of life. With an estimated six to nine million people in the United States living with scoliosis, understanding the different types, causes, and symptoms of this condition is important for early detection and effective management.

What is Scoliosis?

Scoliosis is a sideways curve of the spine that is typically detected in adolescents. While everyone may have natural curves in the spine, those with scoliosis have an abnormal S-shaped or C-shaped curve that may impact the natural asymmetry of the body. The severity of the symptoms varies from case to case.

• Mild scoliosis is defined as a curvature between 10 and 20 degrees

• Moderate scoliosis is classified as a curvature greater than 20 degrees and up to 40 degrees

• Severe scoliosis involves a curvature over 40 degrees

Mild scoliosis may cause little to no symptoms. If there is any pain or discomfort, it can usually be managed with physical therapy and exercises that strengthen the core and back muscles. However, severe cases may result in mobility issues, along with lung and heart problems. In such cases, surgical treatments may be necessary.

What are the Types of Scoliosis?

There are different types of scoliosis, each varying in severity. While factors such as genetics, injuries, birth defects, or spinal infections may contribute to the development of scoliosis, the exact cause of most cases is still unclear.

Idiopathic scoliosis

Idiopathic scoliosis is the most common type of scoliosis, yet it’s the least understood. Experts believe that it may be influenced by a combination of genetics and environmental factors, but the exact reason is typically unknown. While it’s known as a pediatric condition and commonly detected in childhood or adolescence, people at any age can be diagnosed with idiopathic scoliosis. However, missed signs of the condition during childhood and adolescence may lead to more severe forms of scoliosis in adulthood, resulting in curvatures over 40 degrees or more.

Neuromuscular scoliosis

While neuromuscular scoliosis is less common than idiopathic scoliosis, it's not any less serious. It makes up about 10% of all scoliosis cases. This type of scoliosis typically occurs in people with neuromuscular conditions like cerebral palsy or muscular dystrophy. These disorders lead to uneven muscle and nerve growth — which disrupts normal spinal development and causes the spine to become uneven — resulting in scoliosis.

Congenital scoliosis

Congenital scoliosis is a rare condition that develops in the womb. It affects about one in 10,000 newborns. It can result from spinal bones not forming correctly, partial formation of the spinal bones, or the absence of one or more spinal bones. Although the condition begins before birth, it may not be diagnosed until the child is older. In many cases, scoliosis surgery may be necessary to prevent the condition from worsening. 

Degenerative scoliosis

Degenerative scoliosis — also known as adult-onset scoliosis — is a type of adult scoliosis that occurs when the spine’s discs and joints wear down. This usually happens after age 40. It most commonly occurs in the lumbar spine (lower back). In some cases, degenerative scoliosis can also lead to nerve compression, resulting in symptoms like numbness, tingling, or weakness in the legs. A combination of treatments – including physical therapy, pain management, and in severe cases, surgery – can help manage the symptoms and improve quality of life.

What are the Physical Symptoms and Signs of Scoliosis?

The physical symptoms and signs of scoliosis can vary widely and often reflect the severity of the condition. Understanding these symptoms can help in managing it.

Visible asymmetries in skeletal structure

Scoliosis is often visible because it creates noticeable asymmetries in the skeletal system. The visibility of symptoms can vary depending on the severity and type of the curve. Common signs include:

• Uneven shoulders: One shoulder may appear higher than the other

• Uneven hips: One hip may be more prominent or higher than the other

• Asymmetrical waist: The waist may look uneven when viewed from behind

• Uneven rib cage: One side of the rib cage may stick out more than the other

• Leg length discrepancy: One leg may appear shorter than the other

Chronic pain and discomfort

The abnormal spinal curvature may cause imbalances and strain in the back. Over time, this strain can contribute to muscle fatigue and stiffness, resulting in back pain. Effective pain management often includes physical therapy, exercises, and, in some cases, surgical intervention to address the underlying spinal curvature and relieve discomfort.

Postural muscle imbalances

Individuals with idiopathic scoliosis may overcompensate for postural imbalances. This leads to improper muscle use. This can worsen posture and contribute to chronic pain. Strengthening exercises can help manage these muscle imbalances and improve overall posture.

Reduced respiratory capacity 

In severe cases of scoliosis, the abnormal curvature may compress the chest cavity, reducing lung capacity. This compression can make it harder to breathe deeply and efficiently, leading to shortness of breath.

What are the Neurological Symptoms of Scoliosis?

Scoliosis may have a broader impact beyond physical symptoms, affecting the nervous system and leading to various neurological issues.

Impacts on the digestive system

Your digestive system has its own nervous system. It’s called the enteric nervous system, and it’s directly linked to your spine. Scoliosis may disrupt the electrical signals sent through and lead to problems with digestion, including abdominal pain, IBS, constipation, and other issues. Scoliosis can affect the nervous system, resulting in various neurological symptoms.

Effects on nerve function

The abnormal curvature of the spine may put pressure on the nerve roots. This may disrupt the communication between the brain and the rest of the body. This often leads to symptoms like numbness, tingling, and weakness in the limbs.

Is Scoliosis Treatable?

While surgery is the only definitive cure for severe scoliosis, various other treatment options can help manage symptoms and prevent progression. For mild to moderate cases, non-surgical treatments such as bracing, physical therapy, or exercises can be effective. In cases where the curve is progressing or causing significant pain and functional impairment, surgical intervention may be necessary.

What Can I Do If I Have Scoliosis?

Scoliosis can progress over time and lead to more significant issues. If you suspect you may have scoliosis, consult an orthopedist or spinal specialist who can assess the severity of your scoliosis and find suitable treatment options.

While LifeMD can’t treat scoliosis, a team of board-certified healthcare professionals may be able to assist with your other health needs as supplementary support to your scoliosis treatment, including pain management and overall wellness.

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