What Is Scoliosis?
Scoliosis is a condition where the spine curves to the side instead of running straight down the back. It can involve changes to the bones and soft tissues that support the spine, and it may develop during growth or after injury or illness.
This page explains what scoliosis is, what might cause it, common symptoms to watch for, and when to seek orthopaedic care. The goal is to help you understand the condition and what our orthopaedic specialists at Princeton Orthopaedic Associates look for when evaluating scoliosis.
What You Should Know About Scoliosis?
Scoliosis causes a sideways curve of the spine that can affect the vertebrae, ligaments, muscles, and other supporting soft tissues. The curve may be mild and stable, or it can get worse over time, especially during periods of rapid growth. Most people with scoliosis do not have pain at first, but the shape of the back or shoulder level may change.
Doctors classify scoliosis by its cause and by the age at which it appears. Treatment depends on the curve size, the chance it will progress, and any symptoms that affect daily life. Options range from monitoring and physical therapy to bracing or surgery in more advanced cases. Your orthopaedic team will recommend a plan based on your individual needs.
What Causes Scoliosis?
- Idiopathic Scoliosis: The most common type, especially in adolescents, and the exact cause is not known.
- Congenital Scoliosis: A curve present at birth because vertebrae did not form normally during fetal development.
- Neuromuscular Scoliosis: Caused by conditions that affect nerves and muscles, such as cerebral palsy or muscular dystrophy, which can lead to imbalanced forces on the spine.
- Degenerative Scoliosis: Develops in adults as spinal discs and joints wear down, which can change the shape of the spine over time.
- Traumatic Scoliosis: Follows an injury or operation that alters the alignment of the spine or the supporting tissues.
What Are the Symptoms of Scoliosis?
- Uneven Shoulders
- The top of one shoulder may appear higher than the other, often noticed in clothing fit or in photos.
- Uneven Waist or Hips
- One hip may stick out more, or the waist may look uneven when standing straight.
- Prominent Rib or Back on One Side
- When bending forward, a rib hump or prominence on one side of the back can appear due to spinal rotation.
- Back Pain
- Pain may be mild at first but can increase with larger curves or as the spine ages; pain is more common in adults with degenerative curves.
- Reduced Range of Motion
- Some people notice stiffness or difficulty bending, which can affect daily activities.
When to Seek Orthopaedic Care for Scoliosis
- Visible Change in Posture or Back Shape: If you or a family member notices uneven shoulders, hips, or a new rib prominence, it is reasonable to have an orthopaedic evaluation.
- Rapid Progression During Growth: If a curve appears to be getting worse quickly, especially in a child or adolescent, prompt assessment is important to determine next steps.
- Persistent or Worsening Back Pain: Ongoing pain that affects daily activities should be evaluated by an orthopaedic specialist to identify the cause and treatment options.
- Difficulty Breathing or Reduced Endurance: Large spinal curves can affect chest shape and breathing; report any shortness of breath or reduced exercise tolerance.
- New Neurological Symptoms: Numbness, weakness, or changes in bowel or bladder function require urgent orthopaedic or neurological assessment.
How Scoliosis Is Evaluated and Treated
An orthopaedic evaluation begins with a medical history and a physical exam that looks at posture, spine shape, and flexibility. Your clinician may use standing X-rays to measure curve size and check for progression. Additional imaging or tests are sometimes needed to clarify the cause.
Treatment varies with age, curve size, and symptoms. Small, stable curves are often observed over time with periodic checkups. Bracing may be recommended for growing children to reduce the risk of progression. Physical therapy focuses on posture, core strength, and mobility, which can help symptoms and function. Surgery is considered for larger curves or when a curve is causing pain or affecting organs or function.
Your orthopaedic team at Princeton Orthopaedic Associates will discuss the expected benefits and risks of each option and tailor care to your needs. Treatment decisions are shared between you and your clinician to support the safest and most effective outcome.
If you have concerns about the shape of your spine or new symptoms, an orthopaedic assessment can help clarify the cause and outline appropriate steps. Early evaluation is often helpful when curves are discovered in children and adolescents.
This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.
