Many people assume scoliosis, as a structural spinal condition, would solely affect the back, but in reality, as the spine plays so many roles in how the body functions, its effects can be felt throughout. Keep reading to learn about the surprising ways scoliosis can affect the body.
As the spine is part of the body’s central nervous system, scoliosis can affect virtually every working system within the body. While each case is unique and develops across a wide severity spectrum, the most direct way scoliosis affects the body is by disrupting its natural symmetry and alignment.
To start the discussion on how scoliosis affects the body, let’s first look at the condition itself for a better general understanding of its effects.
Scoliosis has been around for hundreds of years, and although treatment has, thankfully, evolved over those years, we still don’t fully understand this complex condition.
A scoliosis diagnosis means the spine has an abnormal sideways curvature, with rotation, and a minimum Cobb angle of 10 degrees.
Part of the reason scoliosis is considered so complex is that there are multiple condition types, with different causative sources and characteristics.
When a condition is first diagnosed, the process involves comprehensive assessment to further classify the condition.
Scoliosis is classified in the interest of streamlining treatment and informing the design of effective treatment plans.
Conditions are classified based on important patient/condition characteristics such as patient age, curvature location, type, and severity level; each of these classification points tells us something important about the condition and shapes how it will affect the body.
Patient age is always a big factor when it comes to being diagnosed with a medical condition; not only does it indicate overall health, but in the context of how scoliosis affects the body, it’s hugely important.
Part of the reason patient age is such an important factor is because scoliosis is progressive, meaning it’s virtually guaranteed to get worse over time, especially if not treated proactively.
It’s also important because we know that the biggest trigger for progression is growth, so the younger a patient is, the more growth they have yet to go through, and the more at risk they are to progress with maturity.
While progression can still occur in adults, especially when natural age-related spinal degeneration comes into play, they are not generally as at risk for rapid-phase progression as adolescents because of pubescent growth spurts.
Patient age is also a huge indicator of how a condition will affect the body in terms of condition-related pain, and this is due to whether or not the condition is compressive.
In patients who are still growing, this means they have not yet reached skeletal maturity, and it's the lengthening motion of a growing spine that keeps the condition from becoming compressive. In adults who have reached skeletal maturity, the condition becomes compressive because there is no lengthening motion in the spine to counteract the compressive force of the scoliotic curve.
Compression is the main source of condition-related pain as scoliosis introduces uneven forces to the body and compresses the spine and its surrounding ligaments, muscles, and nerves.
The spine has three main sections: cervical (neck), thoracic (middle/upper back), and lumbar (lower back).
While scoliosis can develop in any of these sections, the thoracic spine is the most commonly affected. Again, the way scoliosis affects the body will depend on where the curvature is located along the spine, as different curvature types and locations are associated with various symptoms.
For example, with thoracic scoliosis, as the unnatural spinal curve is in the middle/upper back, the spine’s largest section, I know that one way the condition is likely to affect the body is by causing the development of a rib arch.
I also know that when there is an unnatural curvature in the cervical spine, depending on the type, it can lead to the development of another postural issue: forward head posture.
Forward head posture can cause sore shoulder and neck muscles, not to mention headaches.
When the lumbar spine develops scoliosis, we know that a common complication is a sciatica, as scoliotic curves can affect the body by irritating nerve endings and causing compression of the spine and its surrounding nerves.
Curvature location doesn’t just tell me where along the spine to concentrate my treatment efforts but also informs the design of effective treatment plans.
So you can see there are many factors that shape a person’s experience of life with the condition and how it affects the body.
Part of the reason scoliosis is a complex condition to treat is because there are different types a person can develop, based on their causation.
The most prevalent type of scoliosis is classified as idiopathic, not clearly associated with a single causative source. This doesn’t mean a complete lack of causation, but instead, scoliosis is considered to be multifactorial, meaning caused by a combination of factors that can vary from one person to the next.
The way scoliosis affects the body will vary with the different condition forms, and the most prevalent is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18.
With 80 percent of known diagnosed cases classified as idiopathic, the remaining 20 percent have known causative sources and are classified as either neuromuscular, congenital, degenerative, or traumatic.
So as I’m answering the question, how does scoliosis affect the body? Let’s touch on some of the variations in how different condition types affect the body.
As mentioned, adolescent idiopathic scoliosis is the condition’s most-prevalent type, and while each case of scoliosis is unique, the main way in which the condition affects the body is postural.
Due to the uneven forces introduced to the body by scoliosis, it disrupts the body’s overall symmetry, which is one of the earliest and most common signs of scoliosis: postural changes.
Uneven shoulders and hips are telltale signs of scoliosis, and for adolescents, these often cause changes to how clothes fit, how they walk, balance, and coordinate movements.
Adolescent idiopathic scoliosis is also closely associated with rapid-phase progression due to the rapid and unpredictable growth spurts characteristic of the puberty stage.
When severe, AIS can affect the body by progressing quickly and increasing related symptoms such as postural changes.
While idiopathic scoliosis is most common in children and adolescents, it does also affect adults; in fact, idiopathic scoliosis is the most prevalent type diagnosed in adults.
When an adult is diagnosed with idiopathic scoliosis, this means it was carried with them through adolescence and into maturity, when the condition becomes compressive and more noticeable.
So as you can see, AIS isn’t always easy to diagnose early because it’s not always noticeable, and this is largely related to condition severity, which we’ll explore shortly.
It’s not uncommon for adolescents to live for years with the condition unaware, and when it becomes compressive in adulthood and starts to produce noticeable symptoms like pain, this is when most adults come in to see me for a diagnosis and treatment.
My neuromuscular scoliosis patients are among some of the most challenging to treat because this form is caused by a larger medical issue: the presence of an underlying neuromuscular condition such as muscular dystrophy or cerebral palsy.
In neuromuscular scoliosis (NMS), the underlying cause, the neuromuscular condition itself, that has to be the guiding force of treatment.
Neuromuscular conditions involve a disconnect between the brain, muscles, and connective tissues that support the spine, so I know that these patients will be more challenging to treat due to the complex nature of their condition.
In this form, the scoliosis develops as a secondary complication of a more serious neuromuscular condition, and it can affect the body by further disrupting the brain-body connection because the spine and brain form the central nervous system (CNS), which is why an abnormal spinal curve can interfere with brain-body communication.
While I can’t offer my neuromuscular scoliosis patients as positive a prognosis as I can with more typical forms of scoliosis, there are always improvements that can be worked towards through proactive and customized treatment plans.
Congenital scoliosis is a condition infants are born with, and it’s due to a bone malformation in the spine itself that occurs in utero.
The spine is made of up vertebrae (bones) that are stacked on top of one another in a neutral and natural alignment, but when congenital scoliosis is an issue, it affects the body by affecting the spine’s structural formation.
In a healthy spine, the vertebrae all form in the same way and are rectangular in shape; in patients with congenital scoliosis, a vertebra is more triangular in shape, and this shifts the spine out of alignment, causing the development of an abnormal spinal curvature.
Another type of spinal-bone malformation in utero occurs when the vertebrae fail to form into separate and distinct bones and instead become fused together.
Congenital scoliosis is relatively rare, affecting approximately 1 in 10,000.
After idiopathic scoliosis in adults, degenerative scoliosis is the most prevalent scoliosis type to be diagnosed in adults.
In degenerative scoliosis, patients tend to be over the age of 40 and are experiencing natural age-related spinal deterioration, and the cumulative effect of certain lifestyle choices such as carrying excess weight, leading a sedentary lifestyle, chronic poor posture, and repeatedly lifting heavy objects incorrectly can also be a factor.
Degenerative scoliosis is often caused by deteriorating intervertebral discs, and this affects the body by making the spine less flexible, affecting its structure, and disrupting the spine’s ability to handle stress.
The spine’s intervertebral discs sit between adjacent vertebrae, giving it structure, flexibility, and acting as the spine’s shock absorbers, so mechanical stress is evenly absorbed/distributed along the spine.
As the discs start to erode, they can become desiccated and change their shape, which affects adjacent vertebrae that are attached to it, and this can cause the spine to shift out of alignment and develop an unnatural sideways curve.
So in some cases of scoliosis, its development is the body’s response to another condition, as in the case of neuromuscular scoliosis, or issues such as spinal degeneration, as is the case with degenerative scoliosis.
Traumatic scoliosis is not a typical form as it’s caused by spinal injury or trauma affecting the spine adversely.
The most common causes include surgeries, accidents, and falls. In addition, traumatic scoliosis can develop in response to the presence of tumors pressing on the spine, forcing it out of alignment and causing a scoliotic curve to develop.
So traumatic scoliosis is another example of how the condition can develop in response to other conditions/body issues.
Now, let’s move on to the last classification point for scoliosis, and it’s an important one that shapes how scoliosis will affect the body: condition severity.
One of the reasons there is no clear-cut answer as to how scoliosis affects the body is because it develops across a wide severity spectrum from mild to moderate and severe to very severe.
Condition severity is determined by a measurement taken during X-ray known as Cobb angle. This measurement is regarded as the orthopedic gold standard in diagnosing and assessing scoliosis.
The measurement is taken by drawing intersecting lines from the tops and bottoms of the most-tilted vertebrae at the apex of the curve and is measured in degrees.
The higher the Cobb angle, the more out of alignment the spine is. Cobb angle tells us how a condition is likely to affect the body in terms of how severe the condition is: mild, moderate, severe, or very severe.
From the range in those numbers, you can see why cases vary so much from one patient to the next.
In terms of shaping a person’s experience of life with the condition, severity is a defining condition characteristic.
Let’s talk about the general ways in which scoliosis affects the body at each severity level, from mild to severe.
In mild scoliosis, this means a patient is at the mild stage of the condition, and remember, as a progressive condition, where a condition is at the time of diagnosis is not indicative of where it will stay, which is why proactive treatment is so important.
Mild scoliosis means the curve is between 10 and 25 degrees. At this level, the ways in which the condition affects the body can be barely noticeable.
While every case is different, in general, there are no functional deficits at this point, postural changes are subtle, and it’s not commonly painful, at least not in AIS patients because it’s not yet a compressive condition.
So it’s understandable why mild scoliosis is not always easy to detect. As the telltale signs of scoliosis in adolescents are postural changes such as uneven hips and shoulders, at the mild level, these changes are not always noticeable to anyone other than an expert trained in precisely what to look for.
Mild scoliosis affects the body by introducing it to uneven forces, and although mild, these will increase over time, especially if left untreated and is known to affect the body’s posture in the following ways:
The subtlety of these signs, at the mild level, is why it’s not always easy to achieve early detection. While there are no treatment guarantees, early detection increases the chances of treatment success.
Now let’s explore moderate scoliosis and its effects on the body.
A person with moderate scoliosis has a Cobb angle measurement of between 25 and 40 degrees; it’s at this level that the subtle signs of mild scoliosis become more overt and easier to spot, which is why the majority of patients are diagnosed in the moderate stage.
The reality of moderate scoliosis is that once a condition has progressed from mild to moderate, it’s virtually guaranteed to continue progressing, and even if it progresses slowly over time, it is still steadily worsening.
Moderate scoliosis affects the body by progressing past mild levels and causing more noticeable changes:
As a result of the body’s increasing asymmetry, clothing can become ill-fitting at this level, with shirt necklines favoring one side and arms and legs hanging at different lengths.
A straight and healthy spine marks the body’s center of gravity as it extends through the torso’s center point, but when the spine is abnormally bent to the side, this shifts the body’s center of gravity, and this, coupled with postural changes, can cause changes to gait, balance, and coordination.
At the moderate stage, adolescents with scoliosis are set apart from their peers, and as mentioned, without treatment, it’s only a matter of time until moderate scoliosis becomes severe scoliosis.
Once a person progresses into the severe level of scoliosis, this means their abnormal spinal curvature has a Cobb angle measurement of 40+ degrees, and at this stage, postural changes are overt, and the ways in which it affects the body become more extreme.
Life with severe scoliosis can be complicated by causing daily pain and disrupting the quality of life.
While most discussion of scoliosis centers around how the condition affects the body physically, the emotional/psychological component is also an important feature.
Due to how noticeable conditions can be at this stage, patients can also become quite self-conscious, thus experiencing a heightened emotional response to the condition: making them more vulnerable to depression and negative self-image issues.
At this level, the uneven forces the condition introduces to the body have become severe and, in addition to postural changes and pain, can cause mobility issues and a number of related complications:
Even adolescents for whom the condition isn’t known to be painful can experience condition-related pain at the severe stage.
For adults, severe scoliosis can cause daily chronic pain, which can be felt in the back and as radicular pain felt throughout the body due to nerve compression, which is commonly felt in the legs and feet.
In addition, muscle pain is another way in which scoliosis affects the body, and at the severe level, this is likely to be an issue for all ages.
It’s not just the spine that’s in charge of maintaining its healthy alignment and curvatures; it’s also core and spinal muscles that help provide optimal spinal support and stabilization.
Scoliosis is also associated with headaches, some reaching migraine status, and this is because of cerebrospinal fluid (CSF) irregularities.
CSF protects and nourishes the brain and spine, and as it flows through the central spinal canal, an abnormally-curved spine can disrupt that flow, lowering levels in the brain and causing headaches and/or migraines.
It’s easy to underestimate, but the body’s natural symmetry is an important feature, not just in terms of looks, but also in function.
As you now know, scoliosis introduces uneven forces to the spine and body, and as the spine and brain work in tandem to form the central nervous system, the spine is involved, in some way, in virtually every working system within the body.
Scoliosis affects the body by disrupting its natural symmetry and alignment, and this can cause pain, postural changes, and once it reaches the severe level, there are a number of complications that can develop.
The best approach to treating scoliosis is to be more proactive than reactive, and while this might seem like a subtle distinction, it holds the key to treatment success in the context of scoliosis.
While there are no treatment guarantees, here at the Scoliosis Reduction Center, I believe in starting treatment as close to the time of diagnosis as possible; this is so I can work towards preventing further progression and save my patients the hardships associated with increasing condition severity.