scoliosis

Scoliosis is an abnormal twisting and curving of the spine. It can start at any age, but it's most common in children aged 10 to 15.

Scoliosis usually shows up first as a change in how the back looks. The signs people most often notice are:

• a visibly curved spine
• one shoulder sitting higher than the other
• one shoulder or hip standing out more than the other
• clothes not hanging properly
• a prominent ribcage
• legs of different lengths

People with scoliosis may also have back pain, and this is more common in adults.

If you or your child show signs of scoliosis, see a doctor. They can examine the back and decide with you what the best next steps are.

Once scoliosis has been diagnosed in you or your child, you should see a specialist to talk about the treatment options.

Scoliosis can rarely lead to a condition called cauda equina syndrome. It's a serious back condition, and it can cause permanent damage or disability. If you develop it, you'll need to be seen urgently by an emergency specialist spinal team.

Phone a doctor or the 16263 health line if:

• there has been a new, significant injury within the last 7 days, for example a fall from height or a direct blow to the back

Or you have had a new onset of any of these symptoms:

• loss of feeling or pins and needles between your inner thighs or genitals
• numbness in or around your back passage or buttocks
• altered feeling when you use toilet paper to wipe yourself
• increasing difficulty when you try to pee
• increasing difficulty when you try to stop or control your flow of pee
• loss of sensation when you pee
• leaking pee, or a recent need to use pads
• not knowing when your bladder is either full or empty
• inability to stop a bowel motion, or leaking
• loss of sensation when you poo
• change in your ability to get an erection or ejaculate
• loss of sensation in the genitals during sexual intercourse

In most people with scoliosis, nobody knows the cause, and it usually can't be prevented. Doctors call this idiopathic scoliosis, and about 80% of cases are of this kind.

It isn't thought to be linked with things like bad posture, exercise or diet.

Some people with idiopathic scoliosis have a family history of the condition, which suggests there may be a genetic link.

Some cases of scoliosis are caused by conditions that affect the nerves and muscles, like:

• cerebral palsy, a condition that affects the brain and nerves and happens during or shortly after birth
• muscular dystrophy, a genetic condition that causes muscle weakness
• neurofibromatosis, a genetic condition that causes benign tumours to grow along your nerves

In rare cases, babies can be born with scoliosis. This is known as congenital scoliosis. It's caused by the bones in the spine not developing properly in the womb.

In adults, scoliosis can sometimes be caused by age related changes to parts of the spine. This is known as degenerative scoliosis.

You can read more about the types of scoliosis from Scoliosis Support and Research.

A doctor will first check for scoliosis with a physical examination of your spine, ribs, hips and shoulders.

You may be asked to bend forward so the doctor can see whether any areas stand out. One shoulder may sit higher than the other, for example, or there may be a bulge in your back or ribs.

After this assessment, you may be referred to a spinal specialist. They will talk with you about any further tests and treatments.

The specialist will usually take an X-ray to confirm a diagnosis of scoliosis. It shows the size and shape of the curve. In some cases, the doctor may also recommend a scan, such as a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan.

Scoliosis can sometimes lead to further emotional and physical problems.

Having a visibly curved spine or wearing a back brace can cause problems with body image, self-esteem and overall quality of life. This is particularly the case for children and teenagers with scoliosis.

If this is a problem for you or your child, you may find it useful to contact a scoliosis support group or association. These groups are a good source of information and support for people with the condition.

In young children with severe scoliosis, the rib cage can be pushed against the heart and lungs. This can cause breathing problems, and it can make it difficult for the heart to pump blood around the body.

It also raises the chance of lung infections such as pneumonia, and it can lead to problems like heart failure.

In some cases of scoliosis, especially in adults, the bones of the spine press on nearby nerves. When this is severe, it can cause problems such as:

• back and leg pain
• numbness or weakness in the legs