This is the first post in Women’s Voices’ upcoming three-part series on scoliosis—“curvature of the spine,” a condition that can cause postural abnormalities and back pain. Our expert is Dr. James F. Wyss, an Assistant Attending Physiatrist in the Department of Physiatry at the Hospital for Special Surgery in New York City—a member of our site’s Medical Advisory Board. His consultant was Dr. Matthew Cunningham, Assistant Attending Orthopedic Surgeon at HSS.

This post will cover the basic aspects of the condition; the second will go over its medical management (from a physician’s perspective); the third will discuss physical therapy and exercise-based treatments that are utilized to treat scoliosis (from a physical therapist’s perspective). —Ed.

 

As a physiatrist I treat many conditions, including scoliosis, that impact mobility and function in teenagers and adults. When patients come to my office with a known history of scoliosis, their stories vary a great deal. Some recall exactly when they were diagnosed and what treatment they received as a child or teenager. Others only recall being told, “You have a mild curvature of the spine, don’t worry about it.” Some adults come to my office explaining that they have recently been diagnosed with scoliosis, and others are diagnosed with scoliosis at the end of my physical and X-ray examination of their spine.

 

What Is Scoliosis?

Scoliosis is a lateral (side-to-side) curvature of the spine.  The Scoliosis Research Society defines scoliosis as a lateral curvature that is greater than 10 degrees. Several factors help to describe the location, side, shape, and severity of the curvature.

SCImages 1A and 2A show normal alignment of vertebrae versus scoliosis.
(Source: Scoliosis Research Society)

Location: The mid-back (thoracic spine) is the most common location of scoliosis. The thoracic spine has attachment sites for the ribs; therefore, curvatures of the thoracic spine cause asymmetries of the ribs—often described as a rib hump.

Side: Either right or left— determined by the side of the convexity to which the curvature commonly points; the most common type is located on the right side in the thoracic spine.

Shape: S-shaped or C-shaped. S-shaped scoliosis has two curves that face opposite sides, usually with a primary (or larger) curve. C-shaped scoliosis has a curve to only one side.

Severity or degree of curvature: Finally, and possibly most important, scoliosis is defined by the degree or severity of the curve. The vast majority of scoliotic curves are considered to be mild (11 to 20 degrees). This is important because many decisions regarding treatment are based on the severity of the curvature, especially during adolescence.

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  • Susanna Gaertner January 12, 2015 at 1:22 pm

    This is a problem I commonly see in my practice as well as in my own body. Pilates can be very beneficial in minor cases by strengthening the spinal muscles as well as the rib muscles (serratus anterior) that feed into it.
    While my scoliosis is visible on X-rays, it is not visible to the naked eye and I have no pain. I hope that your readers will explore this often helpful modality.

    Reply