It is natural for the spine to curve forward and backward to a certain degree. This is what gives the side-view of the spine its “S”-like shape. But sometimes the spine twists and develops curves in the wrong direction – sideways. When the spine twists and develops an “S”-shaped curve that goes from side to side, the condition is known as scoliosis (sko-lee-oh-sis).
Scoliosis is divided into categories based on the age when it is diagnosed:
Scoliosis is most commonly seen in adolescents and adults. Adults can also develop scoliosis as a result of bone degeneration.
Adolescent Idiopathic Scoliosis
The word “idiopathic” (id-e-oh-path-ic) means that the cause of this form of scoliosis is unknown. Adolescent idiopathic scoliosis can affect a child who is healthy and not having nerve, muscle, or other spine problems. It is the most common form of spinal deformity doctors see, affecting about three percent of the general population.
Adolescent idiopathic scoliosis affects children between 10 and 18 years old, and affects girls more often than boys. In fact, girls are treated 10 times more often than boys. There are many theories as to why this type of scoliosis develops, but the root of the condition has yet to be discovered. Some of the theories include:
A concern when scoliosis is diagnosed in children is that the curves will continue to grow bigger. There is no absolute way to tell, but this much is known:
Scoliosis that occurs (or is discovered) after puberty is called adult scoliosis. Adult scoliosis can be the result of untreated or unrecognized childhood scoliosis, or it can arise during adulthood. The causes of adult scoliosis are usually different from the childhood types.
Most cases of adult scoliosis are idiopathic because the cause is not known. Sometimes adult scoliosis is the result of changes in the spine due to aging and degeneration. The causes of adult scoliosis are further categorized into several types:
Degenerative adult scoliosis occurs because of a combination of age and deterioration of the spine. It usually starts after age 40. In older patients, particularly women, it is also often related to osteoporosis. Osteoporosis weakens the bone, making it more likely to deteriorate. The combination of these changes causes the spine to lose its ability to maintain a normal shape. The spine begins to “sag” and as the condition progresses, a scoliotic curve can gradually develop.
Scoliosis is often painless. People with scoliosis commonly see a spine specialist because they notice a problem with the way their back looks. If you have scoliosis, you may notice some of the following things about your body.
Back pain can eventually develop as the condition progresses. The deformity may cause pressure on your nerves and possibly even on your spinal cord. This can lead to weakness, numbness, and pain in your lower extremities. In severe cases, pressure on the spinal cord may cause loss of coordination in the muscles of your legs, making it difficult to walk normally. If your chest is deformed due to the scoliosis, your lungs and heart may be affected. This can cause breathing problems, fatigue, and even heart failure. Fortunately these severe symptoms are rare.
Degenerative adult scoliosis usually begins as low back pain. While there may also be a deformity that causes the back to look abnormal, usually pain is what motivates people to see their doctor. The pain is probably not coming from the curve, but rather from the degeneration occurring in the spine.
A combination of the degeneration of the spine and scoliosis deformity may cause pressure on nerves and possibly even the spinal cord. This can lead to weakness, numbness, tingling and pain in the lower extremities. In severe cases, pressure on the spinal cord may cause loss of coordination in the muscles of the legs, making it difficult to walk normally. The degeneration and the scoliosis may lead to a condition called spinal stenosis (sten-oh-sis), which is a narrowing of the spinal canal.