Symptoms Of Scoliosis [Everything You Need to Know]

There are a number of factors that shape the type of symptoms a patient is experiencing from patient age to condition severity, type, and curvature location. The complex nature of scoliosis necessitates the customization of effective treatment plans, so let's explore the different types of effects scoliosis is associated with.

No two cases of scoliosis are the same, so symptoms can vary from patient to patient. In addition, scoliosis affects children and adults differently. The main symptoms of scoliosis in children involve postural changes, and the main symptom in adults is pain.

Part of diagnosing scoliosis involves further classifying conditions based on key patient/condition variables that also shape the type of symptoms a patient is likely to experience.

Diagnosing Scoliosis

When it comes to diagnosing scoliosis, this means an unnatural side to side curve of the spine has developed, and in order to be diagnosed as a true scoliosis, the unnatural spinal curvature also has to rotate, making scoliosis a 3-dimensional condition.

Being diagnosed with scoliosis means being diagnosed with a progressive condition; it has it in its nature to get worse over time.

Where a scoliosis is at the time of diagnosis doesn't mean that's where it will stay, especially if left untreated; only proactive treatment can work towards counteracting the condition's progressive nature.

Scoliosis progressing means the size of the unnatural spinal curvature is increasing, as are the condition's uneven forces, and their effects.

As mentioned, when it comes to the symptoms of scoliosis, each case is unique and shaped by the condition's classification-points, so let's explore each one and how it contributes to the types of symptoms a patient experiences.

Part of the diagnostic process involves further specifying conditions based on patient age, condition severity, type, and curvature location.

Patient Age

Scoliosis affects all ages. Babies can be born with the condition as congenital scoliosis, infants between the ages of 6 months and 3 years can be diagnosed with infantile scoliosis; early-onset juvenile scoliosis is diagnosed between the ages of 3 and 10, adolescent idiopathic scoliosis affects those between 10 and 18, and adult scoliosis diagnosed once skeletal maturity has been reached.

Patient age is an important factor for a number of reasons, and when it comes to scoliosis symptoms, it shapes a patient's progressive rate and whether or not the condition is likely to be painful.

While we don't know why most cases of scoliosis progress, we do know what causes it to get worse: growth.

So in young patients who are still growing, we know that they are the most at risk for continued progression and rapid-phase progression because of rapid and unpredictable growth spurts, especially with adolescent idiopathic scoliosis.

When it comes to pain, scoliosis doesn't become a compressive condition until skeletal maturity has been reached, and it's compression (uneven pressure) of the spine and its surrounding muscles and nerves that causes the majority of condition-related pain.

When a spine is still growing, the constant lengthening motion is counteracting the compressive force of the unnatural spinal curvature, and this is a barrier to early detection of childhood scoliosis; in most cases, as the child grows, scoliosis is noticed and diagnosed.

The main symptom of scoliosis in adults is pain; it's most often back pain and pain that radiates into the extremities that brings adults in to see me for a diagnosis and treatment.

While children and adolescents can experience varying degrees of muscle weakness and pain, back pain is more commonly a part of the adult experience of scoliosis.

So patient age tells me how likely scoliosis progressing rapidly is going to be, along with whether back pain is likely to be a symptom or not, requiring pain management as a focus of treatment.

Condition Severity

Condition severity is a very important factor when it comes to condition effects, and this is determined by a patient's Cobb angle measurement, and this is also needed to reach a diagnosis of scoliosis: a minimum Cobb angle of 10 degrees is necessary.

A patient's Cobb angle is determined during X-ray by drawing lines from the tops and bottoms of the curve's most-tilted vertebrae, and the resulting angle is expressed in degrees.

When the spine's natural curves are in place, its vertebrae (bones) are aligned in a straight and neutral position as they should be, but when one or more become unnaturally tilted, an unnatural spinal curve is developing, and this disrupts the biomechanics of the entire spine.

The health of each section is dependent on the health of the others, and the spine's natural curves make it stronger, more flexible, and better able to absorb and distribute mechanical stress incurred during movement.

The higher a patient's Cobb angle, the further out of alignment the spine is, the larger the scoliotic curve is, and the more severe the condition:

• Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
• Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
• Severe scoliosis: Cobb angle measurement of 40+ degrees
• Very-severe scoliosis: Cobb angle measurement of 80+ degrees

In general, the more severe and the more rotation there is, the more noticeable the condition's effects are likely to be.

In childhood scoliosis, the main effect is postural deviation, so the more severe a condition is, the more overt those changes are likely to be; in mild scoliosis, the lack of pain for children and the subtlety of postural changes, and the fact that when mild, scoliosis isn't known to cause functional deficits can be challenges to early detection.

In children, the earliest symptoms are often uneven shoulders and hips as the condition's uneven forces disrupt the body's overall symmetry.

Additional postural changes can include:

• The head appearing uncentered over the torso
• An uneven eye line
• Uneven shoulder blades
• The development of a rib cage arch
• Arms and legs that appear to hang at different lengths

So the more severe scoliosis is, the more likely it is to cause noticeable effects, and the more necessary treatment is to counteract the condition's progressive nature.

If scoliosis is particularly severe and/or is left untreated, it can cause complications such as lung impairment, digestive issues, and the need for invasive surgical scoliosis treatment.

Condition Type

When it comes to condition type, this is determined by causation.

In the majority of cases, approximately 80 percent, we don't know what causes their initial onset: idiopathic scoliosis.

The remaining 20 percent of known cases, however, are associated with known causes: neuromuscular scoliosis, congenital scoliosis, and degenerative scoliosis.

When it comes to the symptoms of scoliosis, these atypical types can also look different on an X-ray.

In typical cases of idiopathic scoliosis, curves bend to the right, away from the heart, but in atypical types, they can bend to the left, towards the heart, and when I see a left-bending curve, I know there's an underlying pathology that needs to be addressed with treatment.

With neuromuscular scoliosis, for example, the scoliosis is caused by the presence of a larger neuromuscular condition such as spina bifida, muscular dystrophy, and cerebral palsy, so this type tends be severe, with some patients becoming non-ambulatory (unable to stand and/or walk on their own).

Neuromuscular conditions cause a disconnect between the brain and the muscles and connective tissues that support the spine, and when it comes to my neuromuscular scoliosis patients, this complicates the treatment process.

Cases of congenital scoliosis are caused by spinal malformations that develop as the spine is forming in utero; sometimes, vertebrae can be more triangular in shape, than rectangular, as they should be, and this causes the spine to form out of alignment, and other times, vertebral bodies can fail to form into distinct and separate vertebrae, instead becoming fused together as one solid bone.

Many patients with congenital scoliosis often present with additional congenital abnormalities so need to be monitored comprehensively.

Degenerative scoliosis affects older adults and is caused by natural age-related spinal degeneration and the cumulative effect of certain lifestyle factors: carrying excess weight, leading a sedentary lifestyle, chronic poor posture, excessive consumption of alcohol and/or smoking, and repeatedly lifting heavy objects incorrectly.

While the progressive trigger of growth is removed, once natural age-related spinal degeneration comes into effect, adults can also progress faster; in fact, the actual rate of scoliosis increases with age, and this is due to older adults developing degenerative scoliosis.

So when I see an atypical condition type, I know it's likely that some of its effects will be atypical, and this can complicate the treatment process.

Curvature Location

There are three main sections of the spine: cervical spine (neck), the thoracic spine (middle/upper back), and the lumbar spine (lower back).

Scoliosis can develop in any of the spine's main sections, or in more than one as a combined scoliosis, and the health of each section depends on the health of the other sections, so if one section loses its healthy curve, it disrupts the biomechanics of the entire spine.

Each spinal section has unique roles to play in spinal function; for example, the cervical spine acts as the bridge between the brain and the rest of the body, has to support the weight of the head, and facilitate a wide range of motion for the neck.

Curvature location tells me what types of symptoms can be expected because in most cases, the area of the body located closest to the affected spinal section is the area that's going to feel the majority of the condition's direct effects.

For example, in cases of lumbar scoliosis that develop in the lumbar spine, a common complication is to develop sciatic nerve pain, and while many people think sciatica is a clinical condition, it more so refers to a set of symptoms that involve sciatic nerve pain and damage.

The sciatic nerve is the largest nerve in the body and has an extensive pathway that starts in the lumbar spine and extends down the backside of the hip, buttock, leg, and into the foot.\

Most sciatic nerve pain is felt down the left side of the body, but it can affect the right, and rarely, can affect both.

If the lumbar spine is unnaturally curved, it can compress the spinal nerves within, or where they exit the spine, and that uneven pressure can cause the sciatic nerve to become compressed, pinched, irritated, and/or impinged, and this can cause pain and discomfort felt anywhere along the nerve's pathway.

As a mixed nerve containing both sensory and motor fibers, symptoms of sciatic nerve compression can include numbness, weakness, zapping sensations, tingling and/or numbness.

If left untreated, sciatic nerve pain can also affect movement of the lower body.

The lumbar spine is vulnerable to a number of spinal issues because it has to support the weight of the torso, the spinal sections above, and feels the effects of bending, lifting, and twisting motions.

When scoliosis affects the cervical spine, symptoms can include shoulder pain, headaches, issues with the neck's range of motion and ability to support the weight of the head.

As the thoracic spine is the largest spinal section, it's vulnerable to a number of spinal conditions/issues, and is the spinal section most often affected by scoliosis.

As the thoracic spine connects to the rib cage, a noticeable rib cage hump can develop, and as the body's center of gravity shifts, movement and coordination can also be affected.

What's important for people to understand is that although scoliosis is a progressive and incurable condition, it can be highly treatable, and this means minimizing symptoms by preventing progression.

Minimizing Scoliosis Symptoms with Proactive Treatment

So who does scoliosis affect? Scoliosis affects all ages. How prevalent is scoliosis? Current estimates have close to seven million people living with scoliosis in the United States alone. Are there different severity levels and types of scoliosis? Yes, scoliosis ranges in severity from mild to moderate and severe to very severe, and the four main types of scoliosis include idiopathic scoliosis, neuromuscular scoliosis, congenital scoliosis, and degenerative scoliosis.

Symptoms of scoliosis will vary from person to person based on a number of fluctuating variables, and the best way to manage scoliosis and minimize its symptoms is to treat the underlying cause of the symptoms: the condition itself.

There are different approaches to treating scoliosis, and not all produce the same types of results, and there are never treatment guarantees, but in cases that are diagnosed early and responded to proactively, there are fewer limits to what can be achieved.

When scoliosis treatment is proactive, it's started as close to the time of diagnosis as possible because the milder a condition is, the simpler it is to treat; when it comes to symptom management, it's far more effective to proactively work towards preventing progression and increasing effects than it is to attempt to reverse symptoms once they've developed.

As scoliosis progresses, the spine gets increasingly rigid, making it less responsive to treatment, and as scoliosis gets more severe, its effects become more overt.

So how is scoliosis treated effectively?

Conservative Scoliosis Treatment

Here at the Scoliosis Reduction Center, patients benefit from accessing multiple scoliosis-specific treatment disciplines under one roof.

I want to impact conditions on every level, and chiropractic care can impact scoliosis on a structural level through a series of techniques and manual adjustments that work towards adjusting the position of the curve's most-tilted vertebrae back into a healthier alignment with the rest of the spine.

Physical therapy can help with increasing a patient's core strength; it's not just the spine that has to maintain its curves and alignment, it's also the responsibility of the spine's surrounding muscles to provide it with crucial support and stabilization.

Physical therapy and scoliosis-specific exercises can also help improve posture, address any related muscle imbalances, and activate specific areas of the brain for improved brain-body communication.

Corrective bracing is particularly effective on growing spines so is a regular facet of treatment in childhood scoliosis; the ultra-corrective ScoliBrace can help augment corrective treatment results by pushing the spine into a corrective position.

As a progressive and incurable condition, treatment is more about managing an ongoing condition than about reaching a fixed cure, so continued chiropractic care and rehabilitation is important and can involve a series of custom-prescribed home exercises to further heal and stabilize the spine for long-term sustainable treatment results.

I compare the need for continued chiropractic care to how when dental patients have their braces removed, most have to wear a retainer to hold the structural results the braces have achieved.

Conclusion

While symptoms of scoliosis can vary from one person to the next, some common symptoms include postural changes like uneven shoulders and hips, and for older patients who have reached skeletal maturity, pain is the main symptom.

Adults also experience postural changes, particularly a noticeable lean to one side, but the number-one reason adults come in to see me for a diagnosis and treatment is compression-related pain; this can involve localized back pain and/or pain that radiates into the extremities due to nerve compression.

When it comes to minimizing the symptoms of scoliosis, the best approach is proactive treatment that addresses the condition's underlying structural nature.

When scoliosis is treated proactively, it can be highly responsive, especially with early detection and intervention.

Here at the Center, I start treatment as close to the time of diagnosis as possible, in the hopes of working towards preventing progression, increasing condition effects, and the need for invasive surgical treatment in the future.

When scoliosis is severe and patients are on the path of traditional scoliosis treatment, spinal fusion surgery is commonly recommended, and while the procedure can straighten a bent spine, it can cost the spine in terms of its long-term spinal health and function.

Some common effects of spinal fusion that patients are disappointed with include a noticeable loss in spinal flexibility and range of motion, increased pain at the fusion site, and a spine that's weaker and more vulnerable to injury.

If scoliosis is treated effectively without surgical treatment, as much as possible of the spine's natural strength and function can be preserved, which is what I believe is best for long-term spinal health and for a patient's overall quality of life.

When it comes to scoliosis symptoms, as a progressive condition, symptoms a patient is experiencing at the time of their diagnosis don't indicate that's where they will stay; as scoliosis progresses, its symptoms are going to become more noticeable and difficult to reverse, hence the importance of proactive treatment.

Scoliosis treatment can minimize the symptoms of scoliosis by managing the condition effectively, and this includes working towards counteracting its progressive nature.

While having a single body asymmetry doesn't necessarily mean scoliosis has developed, if multiple postural changes that involve a disruption to the body's overall symmetry and/or issues with balance and coordination have developed, a screening and physical examination should be performed by a medical professional.

If a screening exam shows indicators of scoliosis, further testing is warranted and an X-ray is ordered to see what's happening in and around the spine; if a diagnosis of scoliosis is reached, patients have an important decision to make about treatment.

The decision to treat, not treat, and which treatment approach to commit to will shape the spine's long-term health, function, and the type of symptoms a patient is likely to experience.

When treated conservatively, a curvature reduction can impact the condition on a structural level, while physical therapy helps increase core strength for optimal spinal support/stabilization, and when bracing is necessary, the ultra-corrective ScoliBrace can push the spine into a healthier position, and with guidance, patients can continue to heal and stabilize their spines from home.