Have you noticed that one shoulder sits higher than the other, or that your waist or hips look slightly uneven? It might simply be how your body is naturally shaped, but sometimes these differences can be signs of scoliosis.
Scoliosis is a condition where the spine curves sideways, often with some rotation or twisting of the vertebrae as well. The curve may form a C or S shape and can vary considerably from one person to another.
It is more commonly identified during childhood or the teenage years, but adults can develop scoliosis too. And despite what you might have heard, it isn’t usually caused by poor posture or carrying a heavy schoolbag!
In this article, I’ll explain what scoliosis is, what causes it, the signs to look out for and what treatment options are available. I’ll also explain how osteopathy may help with some of the aches and discomfort that can accompany it.
What exactly is scoliosis?
A healthy spine has natural curves when viewed from the side, helping it balance the head and absorb everyday forces. When viewed from behind, however, it should generally appear relatively straight.
With scoliosis, the spine develops an abnormal sideways curve. The vertebrae may also rotate, which can make one side of the ribcage or back appear more prominent than the other.
The curve can be relatively mild, or more pronounced. Some people have a single C-shaped curve, while others have an S-shaped curve involving different sections of the spine.
Scoliosis affects around 2–3% of children and teenagers, although it can occur at any age. The important thing to remember is that having a curved spine doesn’t automatically mean you’ll have pain or significant problems.
What causes scoliosis?
This is where things get a little frustrating: in around 80% of cases, the exact cause isn’t known. This type is known as idiopathic scoliosis.
It most commonly develops during the growth spurt around puberty, often between the ages of 10 and 15.
There are other types too, including:
- Congenital scoliosis: where the spine doesn’t develop normally before birth.
- Neuromuscular scoliosis: associated with certain conditions affecting the muscles or nervous system.
- Degenerative scoliosis: which can develop in adulthood as age-related changes affect the discs and joints of the spine.
One common misconception worth clearing up is that scoliosis is generally not caused by sitting badly, slouching, standing unevenly or carrying a heavy schoolbag. So there’s no need to blame that favourite armchair just yet!
What are the signs and symptoms of scoliosis?
Scoliosis doesn’t always cause pain, particularly in children and teenagers. Sometimes the first signs are simply changes in the appearance or alignment of the back.
Things to look out for include:
- One shoulder appearing higher than the other.
- One shoulder blade looking more prominent.
- Uneven hips or a waistline that looks different on each side.
- One side of the ribcage appearing more prominent, particularly when bending forwards.
- The body appearing to lean slightly to one side.
In adults, scoliosis may be associated with back pain, stiffness, muscle fatigue or discomfort around the hips and shoulders. These symptoms can also have many other causes, so they don’t necessarily mean someone has scoliosis.
It’s also worth remembering that a slightly uneven posture doesn’t automatically mean there’s a spinal curve. Most of us aren’t built to look perfectly symmetrical – we’re not mass-produced on a particularly strict production line!
How is scoliosis diagnosed?
If you or your child has noticeable signs of scoliosis, it’s worth arranging an assessment with your GP.
A healthcare professional can examine the back, shoulders and hips and assess the shape and movement of the spine. If scoliosis is suspected, further assessment and an X-ray may be recommended to confirm the diagnosis and measure the size of the curve.
This is particularly important in children and teenagers, as the spine may continue to change while they’re growing. Identifying a curve and monitoring it appropriately can help guide decisions about whether treatment is needed.
Can scoliosis be treated?
Treatment depends on several factors, including the person’s age, the size and location of the curve, whether it’s changing and whether it’s causing symptoms.
For children and teenagers, options may include:
- Monitoring: smaller curves may simply need checking periodically as the child grows.
- Bracing: a specialist may recommend a brace to help prevent a curve from progressing in certain growing children.
- Surgery: in more severe cases, surgery may be considered to reduce the curve and prevent further progression.
For adults, treatment often focuses on managing symptoms, maintaining movement and improving everyday function. This may involve appropriate exercise, physiotherapy, pain management or, in selected cases, specialist treatment.
Exercise can be useful for maintaining strength, mobility and general fitness, but it’s important to understand that ordinary stretching or strengthening exercises won’t necessarily straighten a structural scoliosis curve.
Can osteopathy help with scoliosis?
This is a question I’m occasionally asked in the clinic, and it’s important to be clear about what osteopathy can and can’t do.
Osteopathy cannot straighten a structural scoliosis curve or reverse the underlying spinal changes. Anyone promising to correct scoliosis through manipulation alone is making a claim worth treating with considerable caution.
However, some people with scoliosis also experience muscular tension, joint discomfort, stiffness or restricted movement. These associated problems may be suitable for osteopathic assessment and treatment.
Depending on the individual and their symptoms, this might include:
- Assessing the muscles and joints contributing to discomfort.
- Appropriate hands-on treatment to help ease muscular tension and joint stiffness.
- Advice on exercises and movement to support strength and mobility.
- Guidance on managing everyday activities that may aggravate symptoms.
Treatment should always be tailored to the individual, taking account of their age, symptoms and any existing diagnosis. Where a child or teenager may have scoliosis, an appropriate medical assessment should come first.
The aim isn’t to make the spine perfectly straight – it’s to help manage associated discomfort and support the best possible movement and function.
When should you get your back checked?
If you’ve noticed changes in the shape of your back, uneven shoulders or hips, or a prominent ribcage, it’s sensible to seek advice rather than simply assume it’s down to posture.
This is particularly important for children and teenagers who are still growing. Early assessment can help establish whether scoliosis is present and whether monitoring or specialist care is needed.
For adults, persistent or worsening back pain, stiffness or changes in posture are also worth getting assessed. There are many possible causes, and identifying what’s contributing to your symptoms is the first step towards managing them.
A final word on scoliosis
Scoliosis can sound worrying, but it doesn’t automatically mean pain, disability or the need for surgery. Many people with a mild curve get on with life without significant problems.
The important thing is understanding what’s happening, getting the right assessment where needed and choosing an appropriate approach to managing it.
And if your spine does happen to take a few artistic liberties with its alignment, don’t just turn a blind eye!
If you’re experiencing back discomfort, stiffness or other musculoskeletal aches and pains, I can help assess what’s contributing to your symptoms and discuss suitable treatment and aftercare advice.
Speak to Nick at Nicholas Coysh Osteopathy & Wellbeing in Storrington to find out how I may be able to help.