Each case of scoliosis is unique, which is why individualizing each treatment plan is so important. A patient’s symptoms can be subtle or overt. Age of a patient, condition type (causation), curvature location, and severity, all factor into how symptoms manifest. Being equipped with a condition’s signs and symptoms may aid in early detection and consequent treatment success.
When it comes to scoliosis symptoms, there are a number of important patient/condition variables that are taken into consideration. The most common symptom of scoliosis in children and adolescents is postural deviation. Conversely, back/radicular pain is the most common sign of scoliosis in adults.
Let’s start our discussion of scoliosis symptoms by first defining the condition.
Scoliosis is a structural spinal condition that involves the development of an unnatural sideways spinal curvature, with rotation, and a minimum Cobb angle measurement of at least 10 degrees. A scoliotic curve doesn’t just bend to the side, but also twists from front to back and back to front (rotational component) which makes it a 3-dimensional condition.
The Cobb angle is a measurement taken during X-ray by drawing intersecting lines from the tops and bottoms of the curvature’s most-tilted vertebrae (apex of the curve). The resulting angle is measured in degrees. This analysis places a patient’s condition on a severity scale of mild, moderate, or severe. Scoliosis severity can be defined as:
It’s imperative to understand that scoliosis is a progressive condition. Its very nature is to worsen over time, especially if left untreated, or treated reactively.
The spine is made up of vertebrae (bones) stacked on top of one another in a straight and neutral alignment. Once an unnatural spinal curve develops, the spine can become misaligned and cause a number of symptoms. Moreover, if one or more of the spine’s natural curves are replaced with unnatural curves, this disrupts the entire spine’s biomechanics, affecting its health and function.
As mentioned previously, no two cases of scoliosis are the same. This is partially because there are different condition types with varying causative sources. The severity spectrum of scoliosis, mild to severe, contributes to the difference in scoliosis cases as well.
When scoliosis is first diagnosed, it’s classified based on a number of important patient/condition variables, and these variables shape a person’s experience of life with the condition, including related symptoms. The four variables are type of curve, age of patient, size of curve, and location of curve. This process is important because it classifies the condition so it can be clearly understood by the patient, their families and anyone involved in their care or treatment.
It’s integral to understand that the spine’s natural curvatures give it added strength, flexibility, and help it to absorb/distribute mechanical stress that’s incurred during movement. In addition, the spine is the body’s main support structure and works in tandem with the brain to form the central nervous system (CNS): a complex network that facilitates brain-body communication. As part of the CNS, the spine’s involved in the function of virtually every working system within the body, which is why spinal conditions can cause a myriad of symptoms felt throughout the body.
Let’s break up the topic of scoliosis symptoms into two categories: scoliosis symptoms in children and scoliosis symptoms in adults.
As mentioned, there are different types of scoliosis, based largely on causation, and 80 percent of known diagnosed cases are classified as idiopathic, meaning not clearly associated with a clear single causative source; the remaining 20 percent have known neuromuscular, congenital, degenerative, or traumatic causes. The most prevalent form of scoliosis is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18.
While we don’t fully understand what causes the initial development of AIS, here at the CLEAR Scoliosis Institute, we most certainly know how to treat it effectively, and we also know what triggers its progression: growth.
For children and adolescents who have not yet reached skeletal maturity, they are at risk for rapid-phase progression due to the phase of growth and development they are in, or entering into. For children and adolescents, managing progression is key to preventing increased condition severity, escalating symptoms, and the need for invasive treatment in the future.
While there are never treatment guarantees, early detection can help increase chances of treatment success. The treatment of mild scoliosis involves less complexity when the spine is more flexible because significant progression has not occurred, and the body has not had to adjust to an unnatural curve.
The earlier the detection, the better, but that isn’t always easy to accomplish. Generally, scoliosis may not physically manifest in its early stages. Consequently, early identification is challenging.
For those who have not yet reached skeletal maturity, the constant lengthening motion of a growing spine can counteract the compressive force of a scoliotic curve; it’s compression of the spine and its surrounding muscles and nerves that cause the majority of condition-related pain. As the condition doesn’t commonly cause noticeable pain in children and adolescents, the visual symptoms of scoliosis are what to watch for in this age group.
As scoliosis introduces a lot of uneven forces to the body, the condition’s telltale early signs in children involve the body’s overall symmetry. Here are some signs of scoliosis to watch for:
In addition, as the body’s symmetry is disrupted, clothing can become ill-fitting with asymmetrical arm/leg lengths and necklines favoring one side. Balance, equilibrium, and coordination can also be affected, as can a person’s gait. This also applies to adults.
Now that we’ve touched on the main scoliosis symptoms in children, let’s compare them to the main scoliosis symptoms in adults.
Unlike the child and adolescent experience of scoliosis, pain is the main symptom of scoliosis in adults.
As adults have reached skeletal maturity, their spines have settled due to growth and maturity, which is when scoliosis becomes a compressive condition.
When the spine is exposed to compression, so too is its surrounding muscles and nerves. This can cause varying levels of back, muscle, and radicular pain.
Remember, nerves are like limbs on a tree. They branch off in multiple directions. Even if a nerve is irritated at its root in the spine, its effects can radiate throughout the body and are commonly felt in the legs and feet.
For example, when the condition develops along the lumbar spine (lower back), sciatica can be a common symptom of scoliosis in adults. This pain is felt along the pathway of the sciatic nerve (lower back, buttocks, back of leg, and foot) due to sciatic-nerve impingement. In addition, as the muscles that surround the spine struggle to provide it with support as it bends and twists unnaturally, they can become tight and painful.
Headaches that reach migraine status can also be a symptom of scoliosis in different ages. This is due to disruptions to the flow of cerebrospinal fluid (CSF) in and around the brain.
If left untreated, and/or in severe cases, scoliosis may cause a myriad of physiologic symptoms. Those individuals with scoliosis can experience sleep problems, digestive issues, and lung impairment.
For adults, postural changes can involve a prominent lean to one side, uneven shoulder height, and the presence of a rib arch; postural deviation of this nature is generally the most noticeable when in a forward-bend position.
The most prevalent type of scoliosis to affect adults is idiopathic. These cases are extensions of AIS that went undiagnosed and untreated during adolescence. In many cases, these patients matured with scoliosis unaware, and as the condition became compressive, it started to cause noticeable symptoms, like pain. This is what brings the majority of adult patients into the office for diagnosis and treatment. It is a generally accepted thought that, had these patients been diagnosed earlier and proactive treatment provided in adolescence, their condition severity would have likely never progressed.
As stated previously, when it comes to identifying the early signs of scoliosis in children and adolescents, in mild forms, the condition’s not known to cause noticeable postural changes and/or functional deficits. The condition isn’t commonly described as painful in those who are still growing, which can make early detection even more challenging. Scoliosis in adults generally presents with more pronounced symptoms, such as back and radicular pain.
Our hope is to enhance education surrounding identification of scoliosis, in an effort to spread awareness and consequently increase early detection and intervention. The best time to treat scoliosis is when the condition is mild, but in order for that to occur, people have to know the signs of scoliosis.
Most notably, for children and adolescents, postural changes that disrupt the body’s overall symmetry are common early signs. In adults, back and radicular pain are common symptoms.
While recognizing the condition’s early signs is important in terms of early detection, the only way to definitively know if you have scoliosis is to be assessed and/or diagnosed by a medical professional.
As a CLEAR-certified scoliosis chiropractor, I have received specialized training in how to recognize scoliosis’ subtle early signs. As a result, at Clear Life Scoliosis Reduction & Chiropractic and other CLEAR clinics, we assess, diagnose, and treat scoliosis effectively.
For children and adolescents, when it comes to how to know if you have scoliosis, while each case is unique, the condition’s earliest signs are postural changes that disrupt the body’s overall symmetry, such as uneven shoulders and hips.
In addition to postural changes, for adults, back and/or radicular pain is the first indication of the presence of scoliosis, but we can help.
Regardless of age, the best time to start treatment is always now. As a progressive condition, a person’s scoliosis severity at the time of diagnosis is not an indication of where it will stay. However, the benefits of early detection are only available to those who respond to a diagnosis with proactive treatment.
If you are concerned that you, or someone you care about, has scoliosis, don’t hesitate to reach out to the CLEAR Scoliosis Institute or CLEAR Life Scoliosis & Chiropractic for further guidance. We can help!