Scoliosis is also known as ‘curvature of the spine’. The lower back or lumbar spine is made of a stack of 5 block-like bones called vertebrae with a triangular bone attached underneath. These bones are separated by five oval cushions called discs which are made of cartilage with a softer substance in the center. From front to back, the spine normally is fairly straight, however when a C-shaped or S-shaped curve is found, a diagnosis of scoliosis is made. This may cause one hip to seem higher than the other when looking in a mirror, or the appearance that one leg is longer than the other. The shoulders may not be level. Most scoliosis especially in children occurs in the middle part of the back, where the ribs are attached. In adults sometimes uneven narrowing of discs due arthritis in the lower spine may cause curvature. If a vertebra collapses from osteoporosis, a curvature may result as well.
The symptoms of degenerative scoliosis in adults include a nagging, dull low back pain. It is usually worse standing or walking. The back muscles may tire easily. If severe, nerves may be pinched causing sciatica, or the spinal cord may be compressed (stenosis), causing leg weakness with walking.
Usually a history and physical exam may strongly suggest that scoliosis is present. X-rays of the lumbar spine may confirm the diagnosis. They may also show unexpected conditions causing the pain.
Scoliosis specialists should be involved in children and adolescents with scoliosis. Mild scoliosis with no symptoms may not require treatment. In untreated adults with pain, their symptoms and the curvature may worsen. Treatment depends on the severity of the pain, and whether any nerves are affected. Some individuals find the condition is helped with regular exercise and certain types of stretching. Aquatic exercise classes frequently are very helpful. Licensed physical therapists are experts in supervision of these exercises. For severe cases, specialized back braces may be tried. Rarely the spine is stabilized and trapped nerves are released with surgery.