What is scoliosis (spinal curvature)?

To understand what scoliosis is, let’s first give a simple definition of the spine. The spine is the skeletal structure that extends from the bottom of the skull to the tailbone, keeping the body upright and enabling movement. When viewed from the back, the spine appears straight, but when viewed from the side, it is curved.

Scoliosis is a deformity of the normal structure of the spine described above. In patients with scoliosis, the spine may appear curved in an S or C shape when viewed from the back, rather than continuing straight downward. This abnormal curvature of the spine can range in severity from mild to severe deformities.

Although scoliosis mostly appears in children and adolescents, it can also occur in adults. Due to the curvature of the spine, especially in severe cases of scoliosis, individuals may experience posture problems and asymmetry in various areas such as the lower back, shoulders, and hips. The discomfort is not limited to physical appearance but can also lead to complications in lung or heart function.

Scoliosis can occur due to an abnormal shape of the spine itself. In some cases, the curvature may be caused by other underlying and non-structural causes such as muscle imbalance or inflammation.

What causes scoliosis?

Scoliosis can have various causes, and it may not always be possible to determine the exact cause in each case. Sometimes the cause of scoliosis may be structural abnormalities in the spine or certain neuromuscular diseases, while in other cases the cause cannot be identified. In such cases, scoliosis is referred to as idiopathic scoliosis. This type of scoliosis is quite common and usually appears in children and adolescents.

Other possible causes of scoliosis include:

Abnormal development of the spine in the womb (congenital scoliosis)
Cerebral palsy or muscular dystrophy (neuromuscular scoliosis)
Age-related wear and tear of the spine (degenerative scoliosis)
Injuries or infections
Genetic factors
Muscle and nerve diseases
Cases where the cause of scoliosis is unknown (idiopathic scoliosis)

Understanding the underlying cause is very important in determining the appropriate treatment plan.

What are the symptoms of scoliosis?

The symptoms of scoliosis may vary depending on how mild or severe the deformity of the spine is. While mild deformities are asymptomatic, significant curvatures can cause physical and functional problems.

The most common symptoms of scoliosis are as follows:

Irregularity or asymmetry in the shoulders or waist
One shoulder blade is more prominent than the other
One hip is higher than the other
Curvature of the rib cage
Inability to align the head
Leaning to one side while standing
Back pain or fatigue after standing or sitting for long periods of time

In severe cases where the curvature is advanced, breathing or heart function may be affected due to narrowing of the chest area. Regular follow-up is important to determine whether the curvature is progressing and whether intervention is necessary. With regular follow-ups and treatment, the progression of the curvature can be controlled.

Scoliosis treatment: how is spinal curvature treated?

When planning scoliosis treatment, doctors consider the patient’s age and the degree of spinal curvature.

When the curvature is not too severe, non-surgical scoliosis treatment methods are considered. Various scoliosis exercises, physical therapy applications, and scoliosis braces are among the non-surgical scoliosis treatment options evaluated in this context. Doctors may plan to use several or all of these methods together, depending on the patient’s condition.

In cases where the curvature is very severe and shows a tendency to worsen, surgical intervention may be necessary. Let’s take a closer look at the methods used in scoliosis treatment below.

Observation: In mild cases, especially in children who are still growing, doctors may recommend regular check-ups to monitor progression.
Braces: In adolescents with moderate curvature, wearing a brace may help prevent progression. Braces do not reverse scoliosis, but they can stabilize the condition until the spine matures.
Physical therapy and exercises: These aim to improve posture, muscle strength, and spinal alignment.
Surgery: In severe or progressive cases, spinal fusion surgery may be necessary to correct the curvature and stabilize the spine.

Choosing the right treatment plan requires a comprehensive evaluation by a specialist and consideration of both physical and emotional health.

Can scoliosis be treated without surgery?

Scoliosis is usually treatable without surgery, especially when diagnosed early or when the curvature is not severe. Non-surgical treatments aim to control the progression of the curvature, relieve symptoms, and maintain function and quality of life.

Non-surgical approaches to scoliosis treatment commonly include:

Braces: Brace use is particularly effective in adolescents who are still growing.
Scoliosis exercises: These include the Schroth Method, which focuses on realigning the spine, breathing techniques, and posture correction.
Physical therapy and posture training: Physical therapy methods are used to improve muscle balance and support the spine.
Chiropractic care or massage therapy: While this method does not correct the curvature, it can help reduce pain and tension.

These methods may not eliminate the curvature, but they can often successfully manage the condition and delay or eliminate the need for surgery.

Is scoliosis surgery appropriate for children?

Since children are still going through developmental stages, any decision regarding surgery should be taken very seriously and evaluated thoroughly. Scoliosis surgery may be appropriate for children in certain situations. Surgery may be recommended if the child’s health is deteriorating rapidly, the spinal curvature has reached severe levels, or the current condition is causing other health issues.

Pediatric scoliosis surgery typically involves spinal fusion, a procedure in which two or more vertebrae are permanently joined together to correct the curvature and stabilize the spine. In very young children, growing rod techniques or expandable implants may be used to control the curvature while allowing the spine to continue growing. These rods are designed to be adjusted as the child grows.

As mentioned earlier, the decision to undergo surgery is usually made when the curvature cannot be stopped with non-surgical methods. The decision is made after careful consultation between orthopedic and pediatric specialists and the family.

How are scoliosis exercises performed?

Exercise is primarily used to improve the patient’s posture, spinal mobility, and muscle strength. The exercise program is typically tailored to the type of curvature and the patient’s physical condition. Exercises are performed under the supervision of a physical therapist.

Scoliosis exercises may include:

Abdominal strengthening exercises: Such as planks and pelvic tilts to support the spine.
Posture correction exercises: To realign and balance the body.
Breathing techniques: Especially in methods such as the Schroth Method, to help expand the rib cage on the concave side of the curvature.
Stretching exercises: To reduce tension in the muscles around the spine and increase flexibility.

Regular exercise under the supervision of a physical therapist is crucial in supporting scoliosis treatment and managing symptoms. Of course, these exercises cannot replace medical intervention on their own, but they play an important role in increasing the effectiveness of ongoing treatment.

What should scoliosis patients avoid?

Physical activity is generally encouraged for scoliosis patients. However, in some cases where the curvature is severe, certain movements and habits should be avoided.

Activities to be cautious of include:

Lifting heavy objects and carrying unbalanced loads, as this can put pressure on the spine
Sports such as football or gymnastics that involve repetitive bending or compression
Sitting in an unhealthy posture for a long time
Yoga or dance that involves excessive bending, twisting, or arching

Patients with scoliosis, or their relatives, should consult a physical therapist before starting any new physical activity, to ensure that their health is not put at risk.

What Are the Symptoms of Scoliosis? How Are Scoliosis Exercises Performed?