Brief Overview: According to Cleveland Clinic, “Scoliosis is an abnormal side-to-side curvature of your spine. Your spine (backbone) naturally has a slight forward and backward curve. With scoliosis, your spine curves to the left and right into a C or S shape.”
Prevalence: According to Cleveland Clinic, “Scoliosis affects an estimated 2% of people around the world. In the United States, this equals over 6 million people.”
Etiology:
- Idiopathic scoliosis (unknown cause)
- Congenital scoliosis results from vertebral malformation present at birth.
- Neuromuscular scoliosis stems from nerve or muscle disorders (e.g., cerebral palsy).
- Degenerative scoliosis develops in older adults due to wear-and-tear of spinal discs and joints.
- Other secondary causes include injury, spinal tumors, or systemic illnesses.
Risk Factors:
- Age of onset (more common during puberty)
- Female
- Family history/genetic predisposition
- Degenerative changes in older age
Commonly Associated Conditions:
- Degenerative disc disease
- Spinal arthritis or spondylolisthesis
- Postural imbalance and chronic back discomfort
Common Medications:
- NSAIDs
- Tylenol
- Muscle relaxers
- Turmeric supplement
- Calcium and vitamin D supplements
Common Labs, Imaging, and Tests:
- X-rays
- MRI of the spine
- CT of the spine
Common Symptoms:
- Back pain
- Postural imbalance with difficulties standing and walking
- Radiculopathy – Pain, numbness, tingling, or weakness that radiates into the legs and/or feet
- Neurogenic claudication – Unilateral or bilateral thigh and/or leg pain (often asymmetric), sensory loss, and/or weakness affecting the legs; exacerbated by walking, standing, or certain postures
Common Treatments:
- Observation, or “watch and wait”
- Brace
- Physical therapy
- Weight management
- Epidural glucocorticoid injections
- Surgery
Physical Findings:
- Spine deviation noticeable in a forward bend (rib hump or asymmetry)
- Uneven shoulders, hips, or waist height
- Tenderness or stiffness in spine
- No neurological deficits unless advanced or severe
Potential Complications and Contraindications:
- Respiratory compromise with severe thoracic curves
- Pain and reduced mobility
- Psychological distress due to cosmetic appearance
- Surgical risks: infection, nerve injury, non-union, implant issues
General Health and Lifestyle Guidance:
- Maintain healthy weight and posture
- Avoid activities that strain the spine
- Engage in regular, scoliosis-friendly exercise (e.g., gentle stretching, core work, swimming). Ask your healthcare provider what types of exercise are recommended for you
- Use ergonomically supportive seating and mattresses for spinal alignment
- Work with a physical therapist experienced in scoliosis care
Suggested Questions to Ask Patients:
- When did you first notice an uneven shoulder or rib hump?
- Does your posture or breathing feel impacted?
- Have you tried bracing or physical therapy before?
- Have you experienced any chest tightness, fatigue, or pain?
Suggested Talking Points:
- If needed, there are multiple options, like bracing, pain management, or surgery—but many patients do well with conservative care
- Staying active, strong, and mindful of your body alignment can make a big difference in your comfort and mobility
- Make sure to report any new, worsening, or persistent symptoms to your healthcare provider
Sources:
- UpToDate: https://www.uptodate.com/contents/scoliosis-in-the-adult?search=scoliosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H231588133
- Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/15837-scoliosis
This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.