Scoliosis

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:

This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.