Scoliosis is a lateral — sideways — curvature of the spine. Most scoliosis cases are idiopathic, meaning medical experts don't know the cause. Depending on the severity, the physician will suggest surgical or non-surgical options to treat the curvature and its symptoms. Certain physical activities that promote spinal symmetry alignment may also provide some relief from discomfort.
People with scoliosis may change their posture to alleviate discomfort and to correct the sense of imbalance. Leaning to the side is one way that an individual may compensate for these changes. Physicians opt for nonsurgical relief whenever possible. In many cases, scoliosis is mild and no treatment is necessary. Some individuals improve after participating in a type of physical therapy called the Schroth Method. This method focuses on restoring muscular symmetry and posture alignment.
Shooting pain in the legs, along with numbness and cramping, sometimes occurs in cases of adult scoliosis. These issues are usually due to pinched nerves in the spine and may eventually lead to a loss of function. Physical therapy and exercises such as yoga can strengthen core muscles, improve flexibility in the back, and alleviate the pain. Nonsteroidal anti-inflammatory drugs may also be effective.
Muscle strain in the lower back or legs is also a symptom due to the postural changes occurring with scoliosis. The individual may lean forward in an attempt to relieve discomfort and correct their posture. While physical activity usually helps symptoms, high-impact exercises or competitive sports can worsen them. Some people find relief by applying moist heat or cold packs to the lower back. Low-impact exercise such as swimming relieves discomfort and maintains strength.
Scoliosis symptoms may lead to mild discomfort, but it does not usually cause severe pain. Those who do experience severe pain usually have an additional underlying factor, such as a herniated disc. Adults who have pain and have degenerative scoliosis find that activity makes it worse. Physicians recommend surgery only when other methods — activity avoidance, bracing, over-the-counter pain medications, massage, physical therapy — are not effective. Research shows that smoking speeds up the degenerative process.
People with scoliosis, especially children, may have one hip that is higher than the other. For mild curves, treatment is not usually necessary and may even correct itself. However, because children’s bones are growing, about 30% of those with scoliosis require bracing. Once the child stops growing, the brace is discontinued. About 10% of children need surgery.
Scoloisis also often presents with a difference in leg length. Some orthopedists recommend adding a heel lift to improve posture and ease discomfort.
Physicians usually perform Adam’s forward-bending test to determine the presence of or progression of scoliosis. Sometimes scoliosis causes the chest to twist, which leads to a hump on the back. The ribs on one side of the body also stick out further. Treatment depends on the severity of the hump. Non-jarring exercises such as swimming, yoga, and elliptical machines may help. In addition to custom prescribed home exercises, specialized corrective bracing can be useful. In certain cases, the physician may recommend rib thoracoplasty surgery. This surgical procedure is less common nowadays; it involves rib resection to reduce the size of the rib hump and the severity of symptoms.
Most of the discomfort from scoliosis is due to changes in posture. One of the most common signs is that the head is not centered over the pelvis, throwing the body out of alignment. Medical recommendations include physical activities that strengthen the back and abdominal muscles, improve posture, and encourage proper breathing. Exercise techniques such as pelvic tilts, planks, cat-camels, single-leg balances, and double leg abdominal presses may help.
Uneven shoulder blades are a common sign of scoliosis that can also cause the arms to hang unevenly at the sides. Physical therapy, low-impact exercises, bracing, and over-the-counter medications usually help ease the problem. However, if they do not slow the curvature’s progression or soothe the discomfort, or if the condition becomes disabling, the physician may recommend surgical treatment, such as microdecompression, surgical stabilization, fusion, osteotomy, or vertebral column resection procedures.
Additional symptoms of scoliosis are dimples, hairy patches, or color abnormalities that develop on the skin along the spine. Present at birth, these skin changes may indicate underlying condition, such as spinal cord abnormalities. Neurofibromatosis type 1 causes dark brown spot, called cafe au lait spots.
Although rare, people with scoliosis may experience decreased lung-size, which can impair pulmonary function and lead to shortness of breath. Research shows that both exercise and biofeedback can help improve posture, also making breathing easier. Severe cases of scoliosis that occur with neuromuscular diseases may require the use of airway clearance devices.
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