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What is scoliosis?

Scoliosis is a condition where the spine curves sideways.

Your spine has a natural S-shaped curve, tilting a little inwards in your lower back and a little outwards near your shoulders. In people with scoliosis, however, there’s an additional sideways curvature to the spine.

Is that a problem? Not always. Mild scoliosis may go unnoticed or cause few symptoms. Severe scoliosis, on the other hand, can cause breathing problems, chronic back problems and an unusual appearance.

Notable names with scoliosis include General Douglas MacArthur, actresses Isabella Rosselini, Sarah Michelle Gellar and Elizabeth Taylor, cellist Yo Yo Ma, and Olympians Usain Bolt and Jessica Ashwood.

Perhaps the most fascinating historical person found to have scoliosis is King Richard III. The last English king to die in battle (in 1485), his crown passed to his Tudor enemies whose most famous playright, Shakespeare, later depicted the fallen king as a hunchback with a withered arm. In reality, Richard III was a formidable warrior with mild scoliosis, confirmed by the discovery of his body under a carpark in Leicester in 2012.

What causes scoliosis?

Good question! We’re still working on the answer…

The most common type of scoliosis – idiopathic scoliosis which often appears in teenagers – may have some genetic component as it tends to run in families. Even if you’re not aware of any scoliosis in the family history it was perhaps there but went unnoticed if the symptoms were mild.

Other types of scoliosis may be caused by:

Cerebral palsy, muscular dystrophy or other neuromuscular conditions
Previous surgery on the chest wall as a baby
An injury to or infection on your spine
Spinal cord abnormalities or birth defects affecting the spine.

Who gets scoliosis?

Idiopathic scoliosis tends to become evident in adolescence when young people grow rapidly. Mild scoliosis is equally common in boys and girls but girls are much more likely to experience a worsening curve that requires treatment.

What are the symptoms of scoliosis?

A tween or teen who has developed scoliosis may have:

Uneven shoulders
One shoulder blade that sticks out more than the other
More prominent ribs on one side
An uneven waistline
Uneven hips.

Scoliosis involves a sideways curve in the spine. That has knock-on effects, causing the spine to twist, which makes some parts of the body stick out further than those on the other side.

How is scoliosis diagnosed?

It’s easy to miss signs of mild scoliosis. When your kids are little, you’re very aware of their bodies as you bathe them and dress them regularly. Scoliosis, however, tends to develop when kids are at an age where they shower and dress independently and value their privacy.

Scoliosis is often picked up during a routine check-up or when a scan is done for a different reason.

If your doctor or physiotherapist suspects scoliosis, they’ll take a detailed medical history and then do a physical examination. This may include the Adam’s forward bend test where your child bends forward from the waist with their hands hanging loosely in front of them. If one side of your child’s rib cage is more prominent than the other, it’s a sign of scoliosis. Your child’s doctor may also order an X-ray to see an image of their spine.

What are the treatment options for scoliosis?

The right treatment for scoliosis depends on things like:

Your child’s age
The severity of their spinal curve
Where the curve is on their spine
Whether the curve is worsening.

Treatment options include:

Watchful waiting: regular check-ups to ensure the curve is not worsening
Bracing: if your child’s spine has a 25° to 45° curve, your doctor may recommend a brace to prevent the curve worsening as they grow
Surgery: in very rare cases (less than 1%), a child may have such severe scoliosis that they need spinal surgery to correct the problem.

Physiotherapy for scoliosis

Physiotherapy is a recognised treatment for milder forms of scoliosis, helping to:

Correct side-shift
Improve coordination and control
Increase endurance and strength.

The Schroth method is the most studied and widely used technique for treating scoliosis through physiotherapy. The exercises are designed to:

Improve muscular symmetry
Improve postural awareness
Rotate the spine with breathing to help reshape the rib cage and surrounding soft tissue (known as rotational angular breathing).

Studies show the Schroth method:

Improves back muscle strength
Improves breathing function
Slows curve progression
Improves Cobb angles (the standard measurement used to track the progression of scoliosis)
Reduces the need for back surgery
Eases pain
Boosts self-image.