Scoliosis

Symptoms of scoliosis may include:

• A visible curving of your spine
• Uneven shoulders and waist
• One shoulder blade sticking out more than the other
• One hip higher than the other
• Leaning to one side
• Ribs jutting out on one side
• Clothes not fitting properly
• Changes over the affected areas of your spine like dimples, hairy patches, or a change in skin colour
• Back or leg pain

Idiopathic scoliosis

Around 80% of people with scoliosis have idiopathic scoliosis meaning there is no known cause. Idiopathic scoliosis may be genetic and sometimes runs in families.

Congenital scoliosis

Congenital scoliosis is present from birth and occurs when the bones of the spine don't form properly in the womb. It may be diagnosed soon after birth but sometimes isn't picked up until childhood or adolescence.

Neuromuscular scoliosis

This type of scoliosis occurs due to an underlying condition that affects the nerves or muscles such as cerebral palsy, spina bifida, spinal cord injury, or muscular dystrophy.

Degenerative scoliosis

This affects older adults and is caused by wear and tear on the discs and joints of the spine over time.

Some things that increase your risk of developing scoliosis include:

• Age - most people develop symptoms between ten to fifteen years of age
• Family history - idiopathic scoliosis can sometimes run in families
• Sex - scoliosis affects boys and girls equally, but girls are much more likely to develop severe scoliosis that needs treatment

See a doctor as soon as possible if you or your child show any signs of scoliosis. Signs of scoliosis often develop gradually, and you may not notice them right away.

Your GP will examine you or your child and refer you to a specialist for further examinations and tests if they suspect scoliosis.

At your first consultation with Circle Health Group, you will be introduced to your consultant. For scoliosis treatment, this will be a consultant orthopaedic surgeon, a doctor specialising in conditions affecting the bones, joints, and muscles.

During your consultation, your consultant will ask you about your symptoms, perform a physical examination, and order any necessary tests or scans. These may include:

• X-ray - to check the bones and joints in your back and look for other problems like fractures, deformities, or infection
• Computerised tomography (CT) scan - to examine the bones of the spine in more detail and check the spinal canal
• Magnetic resonance imaging (MRI) scan - to examine the spinal cord, nerves, and surrounding tissues

Scoliosis is diagnosed using a method called the Cobb method where your consultant will examine your X-ray to determine the degree of curvature in your spine.

A diagnosis of scoliosis is made when your curve is greater than ten degrees.

A curve between ten and twenty-four degrees is mild scoliosis that needs to be monitored to make sure it doesn't get worse.

A curve between twenty-five and thirty degrees is considered significant and may need treatment.

Curves between forty-five and fifty degrees indicate severe scoliosis and need immediate treatment.

At your first consultation, you will meet your consultant and talk about your symptoms and concerns. Your consultant will make a diagnosis based on your physical examination, and the results of any tests and scans.

Your consultant will discuss your diagnosis with you, answer any questions you may have, and recommend a suitable treatment based on your diagnosis.

Your first consultation is important because it's where we get to know you, discuss any concerns you may have and your expectations for treatment. At Circle Health Group it's important to us that you are as well-informed and comfortable as possible before, during, and after your treatment. Please feel free to ask your consultant any questions or discuss any concerns you may have at any time.

Treatment for scoliosis depends on several factors including your age, how severe your scoliosis is, and whether it is likely to get worse.

Scoliosis in children may be treated in the following ways:

Observation

Scoliosis in babies and children often corrects itself as they grow and may not need treatment. Your child will be monitored regularly as they grow to check that their condition is not getting worse or impacting their health.

If your child's scoliosis gets worse it can reduce the space needed for their internal organs to grow. If this occurs, treatment will be necessary. Treatment for scoliosis in children includes:

Casting

In children under two years of age, a cast may be applied to guide the growth of the spine and correct the curve. The cast is worn all the time and cannot be removed. It is changed under anaesthetic every two to three months.

Bracing

If your child's scoliosis is getting worse, a removable back brace may be used. The back brace doesn't correct the curve in the spine but aims to stop it from getting worse. The brace is normally worn for 23 hours a day until your child stops growing.

Surgery

If your child's scoliosis is severe and other treatments haven't worked, surgery may be recommended.

In children under ten, growing rods may be inserted to control the growth of the spine and correct the scoliosis. The rods are lengthened every four to six weeks as your child grows. Your child will normally need to wear a back brace to support and protect the rods. Once your child has finished growing, they will have another operation called a spinal fusion to straighten and fuse the bones in the spine.

Older children and young adults who have stopped growing may have spinal fusion surgery.

During the operation metal rods attached to screws, wires, and bone grafts are used to straighten the spine and hold it in place.

Risks of surgery

Spinal fusion surgery is a major operation and as with any surgery, there is a risk of possible complications. Your consultant will discuss these with you allowing you to make an informed decision. 
Some possible complications of spinal fusion surgery include:

• Bleeding
• Infection
• The implants may move, or the bone grafts may not fuse properly which may lead to additional surgery
• Rarely, nerve damage which can cause permanent numbness and paralysis of the legs and lower half of the body

Scoliosis treatment for adults

One of the main complications of scoliosis in adults is back pain. This may be treated in several ways including:

Medication

The first choice of medications for back pain includes over-the-counter painkillers such as paracetamol and ibuprofen. If they don't work your doctor may prescribe stronger, prescription painkillers or other treatments like corticosteroids or local anaesthetic injections.

Exercise

Taking regular exercise can help back pain by controlling your weight, strengthening your muscles, increasing flexibility, and improving posture. In some cases, physiotherapy can help by recommending some exercises to reduce back pain.

Bracing

Braces can help with back pain in some cases but are not usually recommended for adults. Back braces may be used if you are not well enough to have surgery.

Surgery

In adults, surgery aims to relieve pain or prevent your scoliosis from getting significantly worse. There are two types of surgery for adults with scoliosis.

• Decompression surgery is where a disc or bone is removed to stop it from pressing on a nerve and causing pain
• Spinal fusion surgery is a major operation to insert metal rods, plates, and screws to correct the spine's position and fuse it into place using bone grafts

Risks of surgery

These operations all comprise major surgery, and it can take around a year to fully recover. As with any surgery, there is a risk of complications including:

• Infection
• Blood clots
• The operation may not work to reduce pain
• Implants may dislodge or break
• Rarely, nerve damage can occur causing permanent numbness and paralysis in the lower body

Your consultant will discuss all the possible risks and complications of surgery with you, allowing you to make an informed decision.

Scoliosis is normally a mild condition that has minimal impact on your day-to-day life, but if your scoliosis is severe or worsening, and is left untreated it can lead to complications such as:

• Breathing difficulties — in severe scoliosis the ribcage may restrict your lung's ability to move properly making breathing difficult
• Back and leg pain — a severe curvature of the spine can cause one leg to be shorter than the other causing problems with posture and resulting in back and leg pain
• Heart problems — rarely, severe scoliosis can restrict the ribcage causing heart problems
• Lumbar stenosis — is the narrowing of the spinal canal which can cause nerve problems, weakness, and leg pain
• Problems with body image and low self-esteem — if scoliosis causes a noticeable change in your appearance it can make you self-conscious and affect your self-esteem

The majority of people with scoliosis live normal lives and are able to take part in most activities and sports. Once you have stopped growing, the condition is unlikely to get worse.

If you feel that your scoliosis is getting worse, causing you pain, or making it difficult to participate in some activities, see a doctor for advice.

If you are self-conscious about your appearance due to scoliosis, a support group like Scoliosis Association UK is a great source of information and support.

Is scoliosis hereditary?

There is increasing evidence that idiopathic scoliosis runs in families. Nearly a third of people with idiopathic scoliosis have a family history of the condition and first-degree relatives of someone with scoliosis have an 11% chance of developing it. The likelihood is higher in girls and 29% of daughters compared to 9% of sons of a parent with scoliosis develop the condition.

Does scoliosis get worse with age?

Scoliosis often gets worse with age, though to what extent varies from person to person. If your scoliosis was diagnosed and treated in childhood or adolescence, it is unlikely to get significantly worse after you stop growing. Scoliosis is an unpredictable condition that can stay almost the same or get worse quickly. Regular medical check-ups are important to monitor your scoliosis.

Can scoliosis be cured?

There's no cure for scoliosis, but effective treatments are available, especially when the condition is diagnosed early. Many people with scoliosis live normal, active lives.

Is scoliosis a disability?

Scoliosis may or may not be classed as a disability depending on how it impacts your life, your ability to work and carry out day-to-day tasks. Each case of scoliosis is assessed on an individual basis.

What does scoliosis pain feel like?

Scoliosis pain varies between patients and depends on factors such as age, severity, and the location of the curvature. Some people experience lower back pain, stiffness, and tightness on one side of the body. Scoliosis can also cause pain, numbness, cramping, and shooting pain in the legs.

How common is scoliosis?

In the UK around three or four out of every 1000 children need treatment for scoliosis.

Can you have scoliosis and not know it?

Yes. If your curve is mild and not causing you any problems it is possible to have scoliosis and not know it. Sometimes scoliosis may be diagnosed later in life in people who have had the condition since childhood or adolescence.

Can scoliosis be corrected in adults?

Scoliosis is harder to correct as an adult as your skeleton has finished growing. Treatment for adults normally consists of managing symptoms like pain with medication and exercise. In some cases, surgery may be performed as an adult to partially correct the spinal curvature and prevent the condition from getting worse.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant best suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about scoliosis treatment, book your appointment today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in December 2022. Next review due December 2025.

1. Overview scoliosis, NHS
2. Scoliosis, NHS Inform
3. Scoliosis: Review of diagnosis and treatment, PubMed 
4. Scoliosis, American Association of Neurological Surgeons
5. Scoliosis Causes: Is it Hereditary, Genetic, or Environmental?, ScoliSMART