Scoliosis is a structural spinal problem defined by an abnormal curvature of the spine to the right or left when viewed from the front. Emerging during childhood and adolescence, scoliosis should not be evaluated solely as a postural disorder; it should be considered a condition that can affect the balanced structure of the spine and the body's general posture. While it may progress without symptoms in the early stages, scoliosis can be noticed through physical changes like asymmetry in the shoulders, waist, and hip alignment.
What is Scoliosis (Spinal Curvature)?
Scoliosis is a spinal deformity characterized by an abnormal lateral curvature when viewed from the front. While a healthy spine appears as a straight line from the back view, in scoliosis, it might exhibit a curvature similar to an S shape. The curvature is often accompanied by the vertebrae rotating around their axes.
Spinal curvature should not be evaluated as a mere postural disorder; it is crucial to remember that it can affect the structural integrity of the spine. The degree of curvature, the person’s age, and growth potential can be influential factors in determining the approach to be followed.
What Causes Scoliosis?
The exact cause of scoliosis may not always be identifiable. The most common type of scoliosis is known as idiopathic scoliosis, and a specific cause cannot be determined in this group. However, factors that can sometimes lead to scoliosis include:
-
Congenital causes: Structural abnormalities formed during the development of the spine in the womb
-
Neuromuscular diseases: Certain diseases affecting the muscle and nervous systems
-
Traumas: Serious injuries affecting the spine
-
Degenerative changes: Wear and tear seen in the spine in advanced ages
The idea that scoliosis directly results from postural disorders, carrying heavy bags, or improper sitting habits is prevalent, but these factors are usually not sole causes of scoliosis. However, they can delay the recognition of existing curvature or negatively affect posture.
What are the Symptoms of Scoliosis?
The symptoms of scoliosis can vary depending on the degree and rate of progression of the curvature.
Early Stage Scoliosis Symptoms
-
Uneven appearance of shoulder levels
-
A more pronounced appearance of the shoulder blade
-
Asymmetry in the waist or hip alignment
-
Clothing fitting unevenly on the body
Advanced Stage Scoliosis Symptoms
-
Back, waist, and shoulder pain
-
Noticeable postural disorder
-
Difficulty standing for long periods
-
Reduced breathing capacity in advanced cases
Symptoms may not appear the same in every patient. Therefore, regular observation is important, especially in children in their growth period.
What are the Types of Scoliosis?
Scoliosis is classified into different types based on its cause, the age of onset, and the characteristics of the spinal curvature. This classification is important for the progression of the disease and determining the approach to be followed.
- Idiopathic Scoliosis
Idiopathic scoliosis is the most common type of scoliosis and refers to cases where the exact cause is unknown. It can typically manifest during childhood and adolescence. It can be categorized into;
-
-
Infantile (0–3 years)
-
Juvenile (4–10 years)
-
Adolescent (10 years and older)
-
subgroups. Regular monitoring is crucial as it may carry the risk of progression, especially during growth periods.
- Congenital Scoliosis
Congenital scoliosis can occur due to structural abnormalities developed during fetal growth. There is incomplete or abnormal development of the vertebrae. This type of scoliosis is often noticed in early childhood and may require closer observation compared to other types.
- Neuromuscular Scoliosis
Neuromuscular scoliosis develops as a result of certain diseases affecting the nervous and muscular systems. Curvature may occur due to insufficient muscular support for the spine. In this type of scoliosis, evaluating the underlying neurological condition is an important part of the assessment process.
- Degenerative (Adult) Scoliosis
Degenerative scoliosis typically occurs due to wear and tear, disk, and joint changes in the spine in old age. It can develop during adulthood in people who did not have scoliosis before.
- Functional (Non-structural) Scoliosis
Functional scoliosis does not involve a permanent structural abnormality in the spine. Temporary curvature can develop due to postural disorders, leg length inequality, or muscle spasms. The curvature can resolve when the underlying cause is addressed.
How is Scoliosis Diagnosed?
Scoliosis diagnosis can be made using clinical evaluation and imaging methods together. In a physical examination, the alignment of the spine, and the levels of the shoulders and hips are evaluated. Simple examination methods such as the forward bending test can help identify asymmetry in the spine.
Radiological imaging methods are used to make an accurate diagnosis and determine the degree of curvature. The angle of spinal curvature is measured for monitoring and treatment planning.
How is Scoliosis Treatment Planned?
Scoliosis treatment can be individually planned for each patient. The degree of curvature, patient’s age, growth potential, and existing complaints are the fundamental elements that determine the treatment approach. The same treatment method does not apply to every scoliosis patient.
Monitoring and Observation
Regular monitoring may be sufficient in mild scoliosis cases. During this process, it is evaluated at intervals whether the curvature is progressing.
Scoliosis Exercises
Scoliosis exercises can help balance the muscles around the spine and increase posture awareness. However, exercises should not be considered a standalone method to eliminate scoliosis. They are generally planned as part of physiotherapy programs.
Brace Treatment
In some growing patients, brace treatment may be recommended to slow the progression of curvature. The duration and style of brace use are determined based on physician assessment.
Surgical Treatment
In advanced cases and those with a high risk of progression, surgical treatment may come into play. However, not every scoliosis patient requires surgery. The surgical decision is made by evaluating multiple criteria together.
What are the Lifestyle Recommendations for Scoliosis Patients?
Lifestyle adjustments for scoliosis patients do not replace treatment; however, they can provide a supportive approach to general well-being and reduce the load on the spine.
- Adopt Correct Posture Habits
Adopting correct posture in daily life can help reduce uneven loads on the spine. Avoid staying in the same position for long periods, and ensure back support when sitting. Pay attention to prevent the head and shoulders from falling forward when using computers, phones, and tablets.
- Ensure Ergonomic Work and Seating Arrangement
The height of the desk, chair, and screen should be adjusted according to the person’s height. It is recommended that the feet rest fully on the ground, the lumbar space is supported, and the screen is at eye level. Taking regular breaks during long periods of desk work can help relax the spine.
- Encourage Physical Activity and Mobility
A completely sedentary lifestyle is not recommended for people with scoliosis. On the contrary, regular physical activity, as deemed appropriate by the physician and physiotherapist, can help balance the muscles around the spine. Walking, swimming, and controlled exercise programs can increase general body awareness. The choice of sports and exercise must be made following individual assessment.
- Perform Scoliosis Exercises Consciously
Scoliosis exercises are generally planned as part of physical therapy and rehabilitation programs. These exercises aim to support muscle balance and increase postural awareness. It is not recommended to perform exercises unconsciously and uncontrolled; they must be planned under expert guidance.
- Be Careful with Daily Load-Carrying Habits
Carrying heavy bags on one shoulder can place uneven stress on the spine. If using a backpack, it is recommended to use both shoulder straps and reduce the bag’s weight as much as possible.
- Sleeping Position and Mattress Choice are Important
The goal is to maintain the spine’s natural alignment during sleep. Instead of very hard or very soft mattresses, suitable ones that support the spine can be chosen. As the sleeping position can vary by person, it is important to determine the most comfortable and supportive position.
- Do Not Miss Regular Check-ups
The progression of scoliosis can change over time. Therefore, regular medical check-ups are important for assessing whether the curvature is progressing.
Frequently Asked Questions
Does scoliosis cause pain?
Scoliosis may not cause pain in every patient. However, as the degree of curvature increases or in adult stages, complaints of back and waist pain may emerge.
Is bracing treatment necessary for every scoliosis patient?
Bracing treatment is typically considered in patients in their growth period with curvature within a certain degree range. It is not necessary for every scoliosis patient, and the decision is made based on physician assessment.
Is scoliosis a barrier to sports?
A diagnosis of scoliosis is not always a barrier to sports. However, the choice of sports and physical activity should be planned according to the patient’s condition and maintained under medical recommendations.
How is scoliosis recognized in children?
In children, scoliosis is often recognized through asymmetry in the shoulder, waist, or hip alignment. Therefore, it is important for families to pay attention to changes in posture and have evaluations done in suspicious situations.
