What is scoliosis
Scoliosis means that the spine is curved sideways instead of being straight. In addition to the lateral curvature, a rotation of the vertebrae often occurs, which can cause the rib cage to push out and create an unevenness in the back. The condition is often detected during the growth years in puberty, but can also arise or worsen in adults due to age-related changes.
Common symptoms of scoliosis
Symptoms of scoliosis can vary depending on the severity of the curve. Here are the most common signs to look out for:
- Uneven shoulder height – one shoulder appears to be higher than the other.
- A prominent shoulder blade – one shoulder blade sticks out more than the other.
- Uneven waist – the waist looks asymmetrical, or the pelvis tilts to one side.
- "Back hump" when bending forward – when the person bends forward, a clear elevation is visible on one side of the back, usually the thoracic spine.
- Back pain and fatigue – the muscles have to work harder to keep the body upright, which can lead to aching.
- Breathing difficulties – in cases of very severe scoliosis, the rib cage can become narrow, affecting lung capacity.
3 typical characteristics of scoliosis
- Asymmetry: The body looks "crooked" in the mirror or when viewing the back from behind.
- Rotation: It is not just a side curve; the vertebrae have often twisted along their own axis.
- Early detection: Most cases are discovered between the ages of 10–14 during a regular school check-up.
When should you seek care?
Contact healthcare services or a physiotherapist if:
- You notice a clear crookedness in the back of yourself or your child.
- You experience increasing back pain that affects your daily life.
- You notice that clothes fit unevenly or that one leg feels shorter.
What happens in the body with scoliosis?
In scoliosis, the spine often forms a C-curve or an S-curve. In most cases—about 80%—the cause is unknown, which is called idiopathic scoliosis. What happens physically is that the vertebrae and discs are loaded unevenly. The muscles on one side of the curve often become shortened and strong, while the muscles on the other side become stretched and weaker.
Different types of scoliosis
- Idiopathic scoliosis: The most common form (approx. 80%) affecting otherwise healthy children and adolescents. It is divided by age: infantile (0–3 years), juvenile (3–10 years), and adolescent (over 10 years). The cause is unknown but often hereditary.
- Neuromuscular scoliosis: Occurs as a result of diseases in the nervous system or muscles, for example, in cerebral palsy (CP) or muscular dystrophy. These curves often become more extensive and require specific monitoring.
- Congenital scoliosis: Present from birth and due to malformations of the vertebrae during fetal development, such as a vertebra being only half-developed (hemivertebra) or vertebrae having fused together.
Treatment of scoliosis
Treatment is guided by the patient's age, the location of the curve, and the size of the angle (Cobb angle).
- Observation: For small curves, the back is checked regularly to ensure it does not worsen.
- Physiotherapy: Specific exercises, such as according to the Schroth method, to strengthen supporting muscles and improve posture.
- Brace treatment: Primarily used on growing individuals to prevent the curve from increasing.
- Surgery: For severe scoliosis, often exceeding 45–50 degrees, surgery may be necessary to straighten and stabilize the spine using rods and screws.
Exercises can reduce discomfort
The goal of training for scoliosis is to create balance in the musculature and maintain mobility.
5 good exercises for scoliosis:
- The Plank (side plank): Strengthens the deep core muscles that stabilize the spine.
- The Bird Dog: Stand on all fours and extend the opposite arm and leg. Trains balance and control.
- Stretch of the short side: If you lean to the right, stretch the left side to open up the rib cage.
- Pelvic tilts/Glute bridges: To strengthen the glutes and lower back.
- Breathing exercises: Consciously breathing "into" the side of the chest that is compressed to increase mobility in the ribs.
Avoid this with scoliosis
- One-sided loading for long periods (e.g., carrying a heavy bag on only one shoulder).
- Activities that cause severe pain in the back.
- Avoiding movement entirely – strong musculature is the best protection against pain.
How can you find out if you have scoliosis?
An investigation begins with a doctor or physiotherapist performing an Adams test, where you bend forward while the examiner looks for an unevenness in the back, a so-called rib hump.
X-ray: Required to measure exactly how large the curve is in degrees (Cobb angle).
Magnetic Resonance Imaging (MRI): Sometimes performed to rule out underlying causes in the spinal cord, especially in cases of unusual curve patterns or rapid deterioration.