Scoliosis FAQ: Questions Asked and Answered About Scoliosis
Common general questions about Scoliosis
1. What are different types of scoliosis?
- Idiopathic scoliosis: The word "idiopathic" means the cause is unknown. Even though in most cases (80%-85%), we don't know for sure what causes scoliosis, studies have shown it tends to run in families. Scoliosis is not contagious, so it cannot be spread from person to person like a cold or the flu. It also cannot be prevented.
- Congenital scoliosis: The word "congenital" means a condition is present at the time of birth. Congenital scoliosis begins when the spine is developing as a fetus is growing inside the womb. The vertebrae may not properly divide or they may not be formed completely. Sometimes this type of scoliosis is associated with other health problems, such as kidney and heart disorders.
- Neuromuscular scoliosis: Other medical disorders and conditions that affect the muscles and nerves can cause scoliosis to develop. Most often this is due to muscle weakness or imbalance. Typical neuromuscular disorders that result in scoliosis are muscular dystrophy, cerebral palsy and spinal cord injuries.
2. My child has scoliosis. How serious is this condition?
Most curves don't cause serious complications and adolescent scoliosis is not a life-threatening condition. However, if a curve is severe, it may affect the child's growth.
If a spinal curvature continues, it can eventually affect the position of the lungs and heart. Severe curvatures can also cause compression of the spinal cord or the nerve roots. This is extremely rare but could result in paralysis. With adequate treatment, the progression of scoliosis can be prevented.
3. Is scoliosis a painful condition?
Usually, adolescent scoliosis does not cause pain. Occasional discomfort may be caused by larger curves. If severe pain develops or if discomfort is associated with numbness or weakness in the arms or legs, call your doctor or pediatrician.
4. Does scoliosis get better without treatment?
Spinal curves caused by idiopathic scoliosis will not straighten without treatment. If a child has only mild curves, they may not require treatment and only be monitored for changes. These curves have little, if any, impact on the child's life, but they never go away. Larger curves, left untreated, may continue to worsen as the child grows. Curves in older adolescents may stop getting worse, but they will not improve.
5. What treatments prevent my scoliosis from getting worse?
Surgery and bracing are the only two treatments that can prevent idiopathic scoliosis from progressing. Treatments such as physical therapy, chiropractic, electrical stimulation or other forms of treatment have not been shown to have any effect on scoliosis curves.
6. Can my child to exercise and participate in sports?
It's good for children to be physically fit and scoliosis does not disqualify your child from participating in any sport as long as they don't have any back pain or discomfort associated with their activity.
7. Will my child be able to live a normal life?
Yes. People who have scoliosis live normal lives, whether or not they require surgery. If your child does not require surgery, it is unlikely his or her activities will be restricted. People who have scoliosis surgery also live normal lives and can usually participate in the same sports and activities as they did prior to their operation. They should contact their physician before starting any new job or sporting activity to make sure there are no specific restrictions.
8. I have scoliosis. Will my children inherit it?
Your child has a greater chance of developing the condition than the general population. About one in every three children born to parents who have scoliosis will develop scoliosis according to recent studies. We don't know what gene causes the disease, but it is considered to be partially genetic.
A family history of scoliosis exists in approximately 30% of patients with adolescent idiopathic scoliosis (AIS). Scientists are studying this hereditary link. Currently, there is no test available to predict the likelihood of passing the disorder to your children. A test is currently used to predict the likelihood of an existing case of scoliosis progressing. This test is specific to certain ethnic groups.
9. Did my child's posture cause the spinal curve?
Poor posture may be caused by scoliosis, but it does not cause the condition. If your child learns to one side, it may be because this is more comfortable due to scoliosis.
10. Does difference in leg length cause scoliosis?
The appearance of a significant difference in the length of the legs can be caused by a severe curvature. A difference in leg length does not cause scoliosis. A shoe lift is sometimes recommended if idiopathic scoliosis is severe. Shoe lifts are also sometimes used when x-rays are taken to help correct imbalances in the trunk.
11. Do heavy backpacks cause scoliosis or make it worse?
Carrying heavy loads do not cause idiopathic scoliosis or make it worse. However, heavy backpacks can cause back pain. Even light bookbags should be carried with the straps placed over both shoulders.
12. Is scoliosis caused by an injury?
Injuries or accidents do not cause idiopathic scoliosis.
Common Questions About Screening for Scoliosis
Scoliosis is often first noticed during a routine visit to the doctor or pediatrician.
1. How early should my children be tested for scoliosis?
According to The Scoliosis Research Society, girls should be screened when they are 10 years old and again when they are 12 (5th and 7th grade), and boys should be screened once when they are 12 or 13 years old (8th or 9th grade). The basis for this recommendation is that idiopathic scoliosis is generally discovered during a child's period of most rapid growth, which is between the ages of 10 and 15 years. Children can be tested at any age. There is much debate over the benefit of scoliosis screenings in schools.
2. Do siblings of children with scoliosis need to be screened?
Scoliosis tends to run in families. For this reason, it's wise to have brothers and sisters of those with scoliosis screened with their annual examinations, especially when they are between 10 and 15 years old.
It's easy to check for scoliosis yourself. When your child is barefoot and has a swimming suit on, ask him or her to stand in front of you, facing away. Have them bend over forward from their waist. If one shoulder is higher than the other, or if the ribs protrude up further on one side, call your doctor or pediatrician.
3. I have scoliosis. When should my child be examined?
Children of people who have scoliosis should have yearly screening exams. This is especially important during the pre-adolescent and adolescent years.
4. Why didn't we notice the curve sooner?
Many times, small curves are not noticed until the child grows rapidly, usually during puberty. Sometimes curves don't start to appear until the child is a teenager. Since scoliosis does not typically cause pain, there are no symptoms until the curve becomes obvious.
Many adolescents are healthy, so they don't see the doctor on a routine basis for examinations. In addition, the baggy clothing young teens enjoy wearing covers any abnormalities that may develop in the spine. It's not until bathing suits or close-fitting tee-shirts are worn that the curves become noticeable.
5. Why didn't our doctor notice the curves?
Scoliosis can progress very quickly, especially during your child's growth spurt. Your physician may not have seen your child during this time.
Common Questions About Scoliosis Research
1. Is scoliosis research currently being conducted?
At this time, the focus of research related to idiopathic scoliosis is the cause of the disease. Causative factors being studied include heredity and genetics, vertebral growth problems, problems in the soft tissues (ligaments, discs, bones, and muscles) and disorders of the central nervous system.
2. Are children who have idiopathic scoliosis born with the disorder?
It is theorized that people who develop true adolescent idiopathic scoliosis (AIS) are born with genetic markers that cause the disease. It is not known which genes carry these markers. Researchers are working on finding these.
3. Is there genetic testing available?
A genetic test is only available to help determine if an existing curve will progress, and only for a select group of children. These children are Caucasian females who are 9 to 13 years old with curves that measure 10-25 degrees. Studies are on-going to improve the test so it can be used in children of all ages and from all ethnic groups.
Common Questions About Adult Life With Scoliosis
1. What health problems might I have later in life as a result of scoliosis?
Health problems later in life that are a result of scoliosis depend on where in the spine the curve is located and also on the extent of the curve. If your curve is less than 30 degrees, you most likely have the same risk of developing back pain as people who do not have scoliosis. If you have a curve of over 50 to 60 degrees and your scoliosis has never been treated, you are more likely to develop lower back pain than people without scoliosis.
2. Will I have a humpback when I get older?
Whether or not a "hump" develops depends on how the extent of the spinal curvature and whether or not it is corrected.
3. One of my hips looks higher than the other. Can I do anything to correct this?
If the difference between your hips is more than 2 cm, your physician might recommend a shoe lift to try to correct your uneven posture.
4. What effect will scoliosis have on pregnancy and delivery of a child?
There are usually no differences between women who have scoliosis and those who don't when it comes to pregnancy. Studies have shown no negative associations between scoliosis and labor and delivery; in fact, in one study, women with scoliosis needed Cesarean section less often than the national average.
Also, pregnancy does not typically affect existing scoliosis in an unfused spine: the degree of curvature does not increase significantly during pregnancy.
5. Can I have an epidural in the future?
Yes. If you have a severe curvature, an epidural may be difficult but still possible for delivery as an anesthetic. Be sure your anesthesiologist and obstetricians are aware of what levels of fusion have been performed.
6. Does having scoliosis make me more likely to develop osteoporosis?
There is no firm evidence to prove the relationship between scoliosis and bone loss (osteoporosis). It is essential to do all you can to maintain healthy bones by getting plenty of calcium and vitamin D, avoid smoking and participate in weight-bearing exercise several times weekly.
7. Will having scoliosis influence my career choice?
No. People with scoliosis can choose the same careers as those who do not have the disease.
8. If I have back surgery with rods placed in my spine, will they set off metal detectors at airport security gates?
Typically, this does not happen but you should have a letter from your surgeon that explains your medical implants just in case you have problems.
9. If I have a spinal fusion, will I need to take antibiotics before having dental procedures?
Your surgeon is the best person to answer this question, as it is controversial. It refers to the risk of infection developing in the spinal hardware following dental work. There are efforts being made to develop guidelines related to the use of antibiotics prior to dental procedures.