Key takeaways
- Scoliosis is a sideways curve of the spine of 10 degrees or more.
- It's far more common in older adults than most people realize, and adult curves can slowly progress.
- Structural causes such as a leg-length difference or an uneven sacrum are sometimes overlooked.
- Non-surgical care focuses on balancing the spine, correcting contributing factors and monitoring the curve.
What is scoliosis?
Most of us feel a little twisted at times, and some of us really are. Scoliosis is a sideways curve of the spine, measured in degrees on an X-ray. When the curve is 10 degrees or more, it's called scoliosis.
Common myths about scoliosis
Myth: scoliosis is rare.
Fact: it's often quoted at 2 to 3 percent, but that figure is for teenagers. In adults over 60, studies have found that more than half have a curve of at least 10 degrees.
Myth: curves stop changing once you're an adult.
Fact: adult curves can slowly progress, especially as the discs and joints wear with age.
Myth: scoliosis is harmless unless it's severe.
Fact: even moderate curves can add uneven wear to the spine, contributing to arthritis, disc problems, stenosis, nerve irritation and pain.
Just as tires wear faster when a car is out of alignment, an unbalanced spine tends to wear unevenly.
What causes scoliosis?
Most teenage scoliosis is "idiopathic," meaning no single cause is found. In adults, scoliosis is often degenerative, developing as discs and joints wear unevenly. Contributing factors that are sometimes overlooked include:
- A leg-length difference - when one leg is longer, the pelvis tilts and the spine curves to compensate (see leg length and back pain).
- An uneven sacrum - the sacrum (the base of the spine) forms from five bones that fuse before birth. If they fuse slightly unevenly, the spine above can curve.
- Muscle imbalance - uneven strength or tightness on one side.
Less common types appear in infancy or with conditions such as cerebral palsy, muscular dystrophy or spina bifida.
Can bad posture cause scoliosis?
Not usually. Poor posture causes misalignment and plenty of pain, but it isn't usually enough to cause a true scoliosis. Habits worth avoiding anyway:
- Sitting on one foot
- Always crossing the same leg
- Working with your hips and shoulders facing different directions
- Sleeping on your stomach with one leg pulled up
- Carrying a heavy bag on the same shoulder
How we approach scoliosis
- Find and correct contributing factors, such as using a heel lift or orthotic for a true leg-length difference
- Use precise chiropractic and physical therapy techniques to balance the spine and the muscles around it, including traction and decompression where appropriate
- Correct postural habits that add to the problem
- Re-check the curve with X-rays at intervals
Surgery is generally reserved for large or rapidly progressing curves, or for curves causing serious nerve problems. If you have scoliosis and back pain, a thorough evaluation can tell you what's contributing and what can be done.