Introduction & Overview: Scoliosis

Overview

Scoliosis is an abnormal curve in the spine from side-to-side.

  • Curves are described using the terms “convex” and “concave.”
  • A person with scoliosis will have a convex part of the curve – which is the longer side of the torso – and a concave part – the shorter side. (If you need a memory tip, try thinking of having to duck inside a cave to become shorter.

The potential effects of a scoliosis curvature include:

  • On the shorter side, the ribs will be compressed.
  • On the longer side, the ribs are spread apart.
  • In addition to the lateral curvature, the affected vertebrae rotate toward the concavity.
  • A potential symptom is chronic pain, which can result from even a mild case of scoliosis.

While your pain could be in your back, it might also be in your hip because scoliosis can make your hips uneven, or even your leg or knee because scoliosis can make one leg “virtually” shorter than the other because that hip is higher.” – Nina Zolotow

There are two major types of scoliosis: structural and functional.

  • Structural scoliosis is also called adolescent idiopathic (of no known cause) scoliosis. It is generally considered more permanent. Commonly, the onset of structural scoliosis will begin between the ages of 10 and 15, mostly in girls. (But there are other situations. See below for more.)
  • Functional (or nonstructural) scoliosis is also called degenerative scoliosis. It results from a soft tissue asymmetry. It is generally found in people over the age of 50 and may be connected to changes in vertebrae, discs and ligaments, osteoporosis and loss of bone density.
  • Leg Length Discrepancy (LLD) can be associated with both structural and functional scoliosis in the lumbar spine. (Doug Keller) LLD can be “real” (the leg bone itself is shorter) or “apparent” (misalignments make one leg appear to be shorter). For more on LLD, see this excellent article by Baxter Bell MD.

Prevalence

  • Both genders are affected by scoliosis, affecting 10.7 percent of women and 5.6 percent of men between the ages of 25 and 74.
  • In older adults, scoliosis may affect up to 68% of people.
  • According to The National Scoliosis Foundation, 600,000 doctor visits in the US are for scoliosis and 38,000 patients have spinal fusion surgery annually.

I think it’s important for us all—students and teachers alike—to realize what a common problem this is… [Jane Brody of the New York Times writes,] Although scoliosis is generally thought of as a problem of adolescents… the condition is actually far more prevalent in older adults. In a study… of 75 healthy volunteers older than age 60, fully 68 percent had spinal deformities that met the definition of scoliosis: a curvature deviating from the vertical by more than 10 degrees. – Nina Zolotow

Standard Western Medical Approach

  • Non-surgical treatments may include a focus on realigning the spine through such techniques as muscular relaxation or ligament stretching, physical therapy, chiropractor treatments and/or braces. (Loren Fishman)
  • In extreme cases the spine may be fused by implanting metal Harrington rods next to the spinal column to straighten the spine and prevent the curve from increasing. (Elise Browning Miller)