As it’s the pelvic region that’s engaged during pregnancy, not the spine, in most cases, pregnancy doesn’t impact a patient’s scoliosis and vice versa. That being said, just as there is much we still have to learn about scoliosis in general, there is a lot we don’t fully understand about the effects of pregnancy on scoliosis and scoliosis on pregnancy. One thing we do know is that a person’s overall health and the severity level of their scoliosis plays a role in how they experience their condition during pregnancy. What we don’t know is just how direct, or indirect, that relationship is.
As is likely the case with most medical conditions, a person’s overall level of health and fitness will play an important role in how their body responds to the condition and its treatment. The same can be said for scoliosis and pregnancy, so let’s start by talking about the concept of how a healthier body overall is better equipped to handle the rigors of the condition and pregnancy.
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When people discuss natural approaches to treating scoliosis and scoliosis during pregnancy, in addition to meaning treatment that avoids invasive procedures, they are often also referring to diet and exercise.
When it comes to scoliosis, the issue is structural. This means that any effective treatment, first and foremost, has to address and treat the structural component of the condition.
For people wondering if scoliosis-related exercise and a scoliosis-friendly diet alone can impact scoliosis on a structural level, the answer is no. However, if those regimes are integrated as aspects of a conservative treatment approach that includes other disciplines such as chiropractic, therapy, rehabilitation and corrective bracing, they can all work together to strengthen the body and achieve a curvature reduction.
It is still possible to continue treatment and achieve a curvature reduction safely during pregnancy. Even without corrective bracing as an option, our other disciplines complement one another and have the power to impact scoliosis structurally.
Now, if a patient, pregnant or non-pregnant, comes in to see me with 100 extra pounds on their frame, it’s that much harder to diagnose scoliosis because it’s harder to see the spine. It’s also harder for them to withstand the rigors of treatment as they are not in prime physical shape.
The same can be said of pregnancy for women with or without scoliosis. The better shape they are in and the healthier their overall body is prior to getting pregnant, the less likely they are to struggle with aspects of their pregnancy, withstand the rigors of delivery, and to recover from it afterwards.
Generally speaking, scoliosis, as far as we know, doesn’t have a huge impact on pregnancy: not in the ability to get pregnant, nor in causing extra complications. However, I do think that for women with scoliosis, their experience during pregnancy is likely governed more by their overall health-and-fitness level going into the pregnancy than their scoliosis, but scoliosis can impact the overall health of the body in some instances.
Another main determining factor of how scoliosis is experienced in general, and throughout pregnancy, is the severity of the condition: an important aspect of classifying a patient’s scoliosis.
When Scoliosis is first diagnosed, it’s classified based on a number of its most important characteristics: age of patient, location of curvature, type of curvature, and its severity. These characteristics tell us what we need to know about the condition and help guide us on the right treatment path.
Age of Patient
Scoliosis can develop at any age, so classifying it by age tells us a lot about the patient and their condition. Age can reflect the patient’s level of strength and health and how they are likely to respond to active treatment.
Age also indicates the most likely rates of progression. While there’s no specific formula for calculating rates of progression, we know that growth and development are the condition’s biggest trigger for progression. This explains why the condition’s most common form is adolescent idiopathic scoliosis diagnosed between the ages of 10 and 18.
When a condition is classified as ‘adolescent’, we know that a big focus in treatment is going to be monitoring for progression and designing a treatment plan that stays ahead of it.
A patient’s age also indicates some of the symptoms they are likely to experience. With rapid progression comes postural changes characteristic of the condition. We also know that in younger patients, pain is not likely going to be an issue, but the older a patient is, the more likely they are to experience scoliosis-related pain.
As younger patients are constantly growing, their spine is experiencing an elongating motion. In older patients, having reached skeletal maturity, their spines are vulnerable to the compressive forces of the curvature and affect the spine and its surrounding nerves and muscles.
These condition characteristics related to age are also important to our pregnant patients. In younger patients, we know that scoliosis-related pain is less likely, so if they start developing back pain throughout pregnancy, we know it’s more likely due to the pregnancy, and not the scoliosis.
We also know that we will have to continue monitoring for progression throughout the pregnancy and adjust the treatment plan to accommodate the changing needs of the patient.
Location of Curvature
That initial scoliosis X-ray tells us everything we need to know about a patient’s condition, pregnant or otherwise.
Scoliosis can develop anywhere along the spine, but it most commonly develops along the thoracic spine (middle back).
Knowing the location of the curvature tells us where our treatment efforts need to be concentrated, as well as some likely symptoms.
Thoracic curves are heavily related to rib deformities as the curvature pulls on the ribs and causes the characteristic rib arch associated with scoliosis.
When it comes to pregnancy, this is why scoliosis rarely causes complications because the pregnancy involves the pelvis, not the spine. While scoliosis can develop along the lumbar spine (lower back), it is less common and isn’t known to complicate a pregnancy any more than curves that develop higher up the spine in the thoracic or cervical sections.
Type of Curvature
‘Type of curvature’ refers to the cause, if known. While the most common form is adolescent idiopathic scoliosis, which has no known single cause, there are other forms of the condition that necessitate different types of treatment.
Known causes include neuromuscular, congenital, degenerative, and traumatic. When scoliosis develops due to these known causes, the scoliosis is a secondary complication of another medical issue, so treatment would include addressing the primary medical condition or issue that caused the scoliosis.
If a pregnant patient has scoliosis related to one of these known causes, their treatment during pregnancy could be suspended, especially if it involves medications or procedures deemed unsafe, or necessary treatment could be modified to account for the pregnancy.
When we get into degenerative scoliosis, we’re talking about adult scoliosis, and there are two main forms: adolescent scoliosis that was carried, undiagnosed, into adulthood, or adult ‘de novo’ scoliosis.
In the majority of cases involving pregnant patients with scoliosis, we’re talking about adults. Most of the time, when an adult comes in to see me with indicators for scoliosis, the condition didn’t develop recently, but was carried with them from adolescence into adulthood.
This type of adult scoliosis is far more common because adolescent idiopathic scoliosis can be hard to diagnose. As we’ll discuss further shortly, scoliosis develops across a wide severity spectrum, ranging from mild to severe.
Often, the main signs of scoliosis in adolescents (changes to posture and gait) aren’t particularly noticeable to anyone other than a specialist who knows the signs to look for. This is especially the case with mild and moderate forms of the condition.
Often, by the time these adolescents have reached adulthood and skeletal maturity, their condition has progressed in severity and starts to show noticeable symptoms, such as postural changes and pain.
For a pregnant patient with this form of scoliosis, back pain is likely going to be an issue, either due to their scoliosis, their pregnancy, or a combination of both. Again, there are no noticeable links between this type of scoliosis in adult patients and pregnancy complications.
In adult de novo scoliosis, the condition has developed fresh in adulthood with no prior history of scoliosis in adolescence. Most often, these cases are the result of one of the aforementioned known causes and often is degenerative.
For a pregnant patient with adult de novo scoliosis, conservative treatment could be safely continued throughout the pregnancy and any related back pain would be addressed with natural treatment methods such as chiropractic, therapy, and rehabilitation.
As touched upon earlier, part of the complex nature of scoliosis is how much it can differ from one patient to the next.
When a patient’s condition is being classified, it’s rated as mild, moderate, or severe, and that classification is based on the X-ray results and a measurement taken known as the ‘Cobb angle’.
A patient’s Cobb angle is a measurement taken that indicates, in degrees, how far their spine deviates from a straight alignment. It’s taken at the apex of the curve from the most-tilted vertebrae.
A measurement of 25 degrees or less is considered mild scoliosis; moderate scoliosis indicates curvatures measured between 25 and 40 degrees; severe scoliosis is present when a patient’s Cobb angle measurement is 40+ degrees.
A scoliosis patient’s pregnancy experience is likely to be guided by their overall health and fitness level going into the pregnancy, and scoliosis severity can be a factor in that.
Let’s move on to talking about how scoliosis severity can impact people’s overall health and pregnancy experience.
To re-cap, there aren’t any known correlations between scoliosis and pregnancy-related problems such as difficulty conceiving, causing complications during pregnancy/ delivery, or noticeably affecting the condition’s progression. That being said, there haven’t been many studies done on the subject due to the obvious risks of conducting studies on pregnant women.
What I do believe is that a person’s overall health has more to do with their pregnancy experience than their scoliosis would. Depending on the severity of a patient’s condition, their overall health going into that pregnancy could be impacted by their scoliosis, indirectly impacting the pregnancy experience.
In cases where a curvature is considered mild and moderate, just as in non-pregnant scoliosis patients, they’re not known to cause many functional issues. The more severe a curvature is, however, the more likely it is to cause related issues and complications; the same can be said of pregnancy and scoliosis.
Pregnant patients with mild and moderate scoliosis are less likely to notice any related pregnancy/delivery complications because their overall health is likely less affected by their condition going into the pregnancy.
Pregnant patients with severe scoliosis, especially curvatures that measure 65, 70 ,80 degrees are likely to be entering their pregnancy with some residual health issues related to their scoliosis, which may or may not influence the course of their pregnancy.
The bottom line is if you have scoliosis but your body is functioning well, meaning you do all the right things like getting treatment, eating well, and exercise, your overall health is good, and I don’t believe the condition will impact the pregnancy.
If a person with severe scoliosis isn’t doing those things due to pain or mobility issues and isn’t getting active treatment, they might be more likely to experience increased symptoms due to the added strain of pregnancy; however, if they are doing everything right in terms of lifestyle and treatment, I do firmly believe they can carry a baby and deliver that baby with no issues.
Now, if we were to take that same patient with severe scoliosis and say they are 100 pounds overweight, aren’t fit, and don’t exercise, whether they are getting treatment or not, their scoliosis is going to have more of a potential impact on their pregnancy due to their overall health.
A healthy body responds better to treatment, pregnancy, and quite simply has more resources available to draw from to deal with what comes at it. If a person with severe scoliosis doesn’t have a well-functioning body to begin with, it’s like their resource bank account is empty going into the pregnancy.
Really, in treatment, we’re using the patient’s body to correct their curvature naturally, which is why our conservative treatment approach is especially ideal for pregnant patients for whom medications and invasive procedures are not an option.
Due to the lack of studies done on pregnancy and scoliosis, there is no conclusive evidence that finds correlations between pregnancy complications and scoliosis. What I do think is that there might be an indirect correlation between a patient’s overall health, which can be affected by their scoliosis, and their experience of pregnancy.
What many people wonder about scoliosis and pregnancy is whether or not scoliosis would cause excessive back pain during pregnancy.
This is a good question to ask because, obviously, we know that back pain accompanies many normal pregnancies, and we also know that back pain can be a part of many peoples’ experience of scoliosis, especially in adults.
So the issue is this: even if a pregnant scoliosis patient expresses a concern over increasing back pain, how are we to know whether it is related to their scoliosis, or just average pregnancy-related back pain?
We can only suppose there is a connection, whether direct or indirect, between scoliosis and pregnancy back pain; again, the more severe the scoliosis is, the more likely it is that the condition is causing extra pain.
Treating Scoliosis Back Pain During Pregnancy
If a patient has struggled with scoliosis-related back pain prior to getting pregnant, there is a good chance that back pain will continue to be an issue throughout the pregnancy, possibly at elevated levels.
For these patients, they are wondering how to treat this pain. This is important to address because, clearly, surgery isn’t an option for pregnant patients, even if that was the treatment path they were choosing prior to their pregnancy.
The best way to address scoliosis-related back pain during pregnancy is also the best way, in my opinion, to treat scoliosis generally: with a more natural, less-invasive conservative approach.
Conservative Treatment Approach During Pregnancy
As a doctor who treats scoliosis patients conservatively, I’m biased towards this approach, but that bias comes from years and years of training, certifications, and experience.
Before alternative methods of scoliosis treatment were explored and implemented, I saw patient after patient being told to watch and wait while their condition got worse, only to be told, when it reached a certain point, that they now had to undergo invasive spinal-fusion surgery: this seemed crazy to me.
I felt patients deserved a better option, one that was more natural, safer, less costly, and more corrective. That’s why I took my chiropractic training in the direction of becoming scoliosis-specific. I learned everything I could about the condition, its progression, and its treatment.
Opening the Scoliosis Reduction Center was the fruition of all those thoughts, ideas, experience, and years of training.
The conservative approach has gained more and more respect over the years and is backed by impressive results. This approach is ideal for all scoliosis patients, and for scoliosis patients that are pregnant, it is even more ideal.
This is because the main treatment tools used in the conservative approach don’t involve medications, surgery, or invasive procedures that would be unsafe to undergo during pregnancy.
Tools of the Conservative Approach
When I say ‘tools’, I mean ‘disciplines’. A conservative approach is so effective in treating scoliosis because it’s integrative, meaning it combines the benefits of multiple forms of treatment.
Here at the Center, the main disciplines we use are all scoliosis-specific: chiropractic, therapy, rehabilitation, and corrective bracing. We recognize that there is no one-size-fits-all treatment for scoliosis because scoliosis is a complex condition that can take many forms and develops across a wide severity spectrum.
What an integrative approach facilitates is customization. When multiple disciplines are included in a treatment plan, those tools can be apportioned accordingly. A treatment plan can be tweaked and adjusted easily to address the individual characteristics of each patient’s condition.
The ease of customization in the conservative approach is ideal for adjusting treatment for pregnant patients, as aspects such as corrective bracing can be omitted and others such as chiropractic, exercise, stretches, and diet can be easily modified to suit the needs of the pregnant patient.
The big goal of treating any case of scoliosis is to achieve a curvature reduction and restore as much of the spine’s healthy curves as possible. As this occurs, the overall biomechanics of the spine are improved and any related issues, such as pain and spinal rigidity, are also eased along the way.
The big challenge of treating scoliosis is staying ahead of its nature to progress. While no one can tell just how fast or slow a condition is going to progress, we know that every case is almost always guaranteed to get worse at some point.
As a curvature progresses, the spine loses its flexibility and becomes more and more rigid. This can cause pain as the spine and its surrounding nerves and muscles face compression.
Pregnancy causes the body’s ligaments to naturally soften and stretch in preparation for delivery. This puts extra strain on the pelvis and the joints of the lumbar spine (lower back). This is why back pain is a common sign and symptom of pregnancy.
It’s the softening of the ligaments that leads to an interesting debate about scoliosis treatment during pregnancy and progression.
Two Viewpoints on Scoliosis Progression During Pregnancy
There are two ways to view scoliosis progression during pregnancy, in relation to the effect of softening ligaments on the spine’s malleability.
One theory is that as pregnancy produces relaxants in the body that naturally soften the spine and pelvis, it seems logical to assume that treatment during pregnancy would be more successful.
With a spine that’s more malleable due to the release of the pregnancy relaxants, continuing treatment efforts to straighten the spine could be more effective and achieve a greater reduction.
The flip side of that perspective is that as we know progression is the natural tendency of scoliosis, a spine that’s softened by the pregnant body’s relaxants and hormones would be that much more likely to progress.
The problem is we can only speculate as to which, if either, theory is correct. For obvious reasons, doctors are hesitant to do research on pregnant scoliosis patients, so scoliosis progression during pregnancy becomes another aspect of the condition we don’t fully understand.
For pregnant scoliosis patients, another common concern is if their condition will affect their ability to deliver or has the potential to cause complications.
As babies are carried in the pelvis, and not the spine, scoliosis has little, if any, affect on a patient’s ability to deliver their baby safely and without complication. The curvature of the spine doesn’t engage the pelvis and is located well above the areas involved in the delivery.
There was a time when it was assumed that scoliosis patients would have to undergo C-sections and weren’t able to deliver vaginally, but that time has long since past. We’ve since gained a better understanding of scoliosis in general, as well as its role in pregnancy.
One area of delivery where scoliosis can have an affect is in pain relief. As one of the main forms of pain relief during labor is administered through a needle inserted into the spinal nerves of the lower back, it’s natural that a scoliosis curve could cause some complications.
Scoliosis and Getting an Epidural
First off, for those who have yet to experience one, what exactly is an epidural? An epidural is a means by which pain medication is delivered during labor that numbs the lower half of the body.
Scoliosis causes the spine to become misaligned, meaning it doesn’t bend in the same direction as an average person, pregnant or otherwise.
If a woman with scoliosis is in labor and the anesthesiologist administering the epidural is unaware she has scoliosis, this can cause problems as it might result in missing the ideal injection site. However, this is easily remedied by ensuring that your doctor informs and provides the anesthesiologist with a current X-ray of your spine.
Any pregnancy comes the risk of complications for those with or without scoliosis. In my experience, the scoliosis patients I’ve treated through pregnancy didn’t experience any unusual progression, side effects, or additional complications.
I’ve also never witnessed patients having any complications during delivery that were scoliosis-related. In the patients I’ve actively treated with our conservative approach throughout their pregnancy, we were still able to achieve the levels of success we are accustomed to.
It’s only natural for pregnant women with scoliosis to wonder if their condition will impact their childbirth experience.
Any childbirth comes with risks, just as any surgery, no matter how minor, always carries risks; for pregnant women with scoliosis, there is no direct relationship between scoliosis and an increase in childbirth complications. There is, however, a large gap in scoliosis research documenting the effects of pregnancy on scoliosis, and vice versa, due to the obvious challenges of conducting tests on pregnant women.
As pregnancy and labor involves the uterus and pelvis, and not the spine, and an abnormal spinal curvature is located well above the areas engaged in childbirth, scoliosis doesn’t directly affect a woman’s ability to deliver her baby safely and without complications.
I do feel, however, that a patient’s overall health and fitness level going into their pregnancy, whether they have scoliosis or not, does influence their pregnancy and childbirth experience.
Now, depending on how severe a patient’s scoliosis is, and how that condition is affecting their overall health, could have an indirect relationship on their ability to handle the rigors of their condition, pregnancy, and childbirth.
If a patient is doing everything they should be doing prior to getting pregnant, such as getting active treatment for their scoliosis and living a healthy and active lifestyle, I feel it’s a very small chance that their condition will influence their pregnancy and/or their delivery experience; however, if a patient is already 100 pounds overweight going into their pregnancy, isn’t getting their scoliosis actively treated, and as a result is experiencing mobility restrictions that make exercising difficult, this can affect their overall health and ability to withstand the strain of pregnancy and childbirth.
In the pregnant scoliosis patients that I have treated here at the Scoliosis Reduction Center, our conservative approach is safe and effective, and as far as I have seen, there is no direct relationship between scoliosis and negative childbirth outcomes.
As a progressive condition with no known cure, active treatment efforts are designed to stay ahead of the nature of scoliosis to worsen over time. Again, this is a natural question for pregnant women with scoliosis to ask as they are concerned that progress made through active treatment and reducing their curvature could be lost during pregnancy.
For those pregnant scoliosis patients undergoing our conservative approach here at the Center, it is perfectly safe to continue treatment throughout their pregnancy; this is because our approach is integrative, natural, and 100-percent customized so is easily adjusted to respond to the evolving needs of our pregnant patients.
When it comes to the theories regarding progression and pregnancy, there are two interesting answers to the question of how scoliosis progression is affected by pregnancy.
We know that hormones are released in the pregnant body to soften joints and ligaments in preparation for delivery, and we know that this includes the spine and pelvis. We also know a spine that is more malleable is easier to treat and manipulate out of an unhealthy curvature and back into a natural healthy one.
One theory suggests that the hormones and relaxants that course through a pregnant body could soften the spine, making it better able to withstand weight gain without progressing, and making it more responsive to treatment; conversely, there are other theories that suggest a softened spine could be more vulnerable to progression as that’s the condition’s natural tendency.
Unfortunately, due to a lack of research, we really don’t know which, if either, theory is correct. In my experience, I haven’t seen any significant progression increase during pregnancy that would lead me to think it’s a common scoliosis-related complication.
For women diagnosed with a disease or condition that affects their life, they are bound to wonder if they could be responsible for passing it down to their child.
While there has been a lot of focus on the debate of whether there is a genetic component to scoliosis or not, the general consensus amongst experts is that scoliosis is considered ‘familial’, rather than ‘genetic’.
While this distinction seems subtle, it’s quite important to understand, especially in the context of scoliosis and pregnancy.
Despite all the research and studies done over the years to find a concrete genetic link, there has yet to be a single gene, or genetic mutation, found responsible for the development of scoliosis.
That being said, there does seem to be an increase of scoliosis incidence within a family, but one thing that many people forget is that families share a lot more than just genetics. Families share common socioeconomic factors, health and lifestyle habits, responses to stress, and even posture.
So while there does appear to be an elevated chance of developing scoliosis if another member of the family has been diagnosed, we have yet to find the evidence that the connection is genetic, rather than familial.
In terms of a pregnant patient ‘passing on’ scoliosis to their unborn child through genetics or the process of childbirth, the answer is no, you can rest assured that just because you have scoliosis does not mean your child is guaranteed to develop it as well.
While the most common form of scoliosis is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18, it can develop in adulthood as well.
When discussing pregnancy and scoliosis, the majority of cases would be involving adults, so let’s focus on the two main forms of adult scoliosis: adult idiopathic scoliosis and degenerative scoliosis.
When the vast majority of adults come to me for a scoliosis diagnosis, they have what’s known as adult idiopathic scoliosis, and these cases are extensions of AIS cases that went undiagnosed until adulthood.
In these cases, a pregnant patient could find out they have scoliosis before or after a pregnancy, but the condition’s development would have nothing to do with their pregnancy as their scoliosis was pre-existing.
The other main form of adult scoliosis, degenerative scoliosis, is common in older individuals aged 40+. This form of the condition is caused by the natural degenerative changes experienced by the spine, and its discs, as part of the aging process.
While back pain can be a common symptom of pregnancy, even in older individuals, pregnancy-related back pain is not known to cause permanent degenerative effects, so wouldn’t be a contributing factor to the development of adult degenerative scoliosis.
While some theories question the softening effects of pregnancy hormones and relaxants on existing scoliosis, I have yet to see a patient develop scoliosis directly related to changes that pregnancy is known to produce.
So can you develop scoliosis after pregnancy: yes, it can develop at multiple stages and ages. Is it likely that its development could be caused by pregnancy-related changes or complications: no.
Pain relief is a big component of many childbirth experiences. Getting an epidural is one of the most common delivery methods for pain-relief medication, and it is administered through a needle injected near the spine at a precise location, which then results in numbing the lower half of the body.
As is the case with any medical procedure, regardless of how minor or unlikely, there are always risks involved, and getting an epidural is no exception. However, other than making sure the doctor is aware of your condition, there are no known additional risks to getting an epidural if you have scoliosis.
As a spine with scoliosis has an abnormal bend and twist that causes a misalignment to occur, it is important that the anesthesiologist performing the epidural is aware of your condition.
This is easily done by providing the doctor with a current X-ray image of your spine; this way, they can ensure precision as they are performing the epidural. Other than ensuring the needle enters the epidural space where it needs to, there are no known additional scoliosis-related complications that increase the risk factors associated with getting an epidural.
Just as a person’s overall health has the power to impact multiple areas of life, the same can be said of a person’s scoliosis. The better shape a person is in when they are diagnosed with scoliosis, the better their chances of successfully responding to treatment are.
When it comes to the context of scoliosis and pregnancy, while there aren’t a lot of studies that make conclusive claims of how one affects the other, the general consensus is that scoliosis is unlikely to cause notable complications throughout pregnancy or delivery.
The relationship that I do think is there is an indirect one. I believe it’s a person's overall health that most directly guides their pregnancy experience, but the severity of their condition combined with the person’s overall health and course of treatment, can impact their overall health.
I do feel the conservative treatment approach we offer here at the Center is the best option for anyone with scoliosis, but especially for pregnant women with scoliosis. Our approach is natural, non-invasive, and as it’s integrative, can easily be adjusted to suit the different needs of our pregnant patients.
