Scoliosis is a complex condition characterized by an abnormal curvature of the spine. While it’s most common in younger people, older people can also develop the condition. The symptoms associated with scoliosis depend on a number of factors, such as where the condition lands on the severity scale and the age of the individual.
Like many conditions, scoliosis can range from mild to severe. The main factor that determines where the condition lands on that range is the degree of the individual’s spinal curvature. Symptoms that present with the condition depend very much upon whether the condition is classed as mild, moderate, or severe.
Before we explore the different symptoms associated with each severity level, I think it’s important to understand just how doctors and specialists make those determinations.
The Cobb angle is the most common way to measure a scoliosis curvature. A Cobb angle assessment involves taking a measurement of how far the curvature moves from a straight spine. A Cobb angle is most commonly determined by X-ray.
While X-rays are effective in diagnosing and monitoring a number of conditions, I find there is a shortfall when it comes to scoliosis. Scoliosis is a three-dimensional condition, but X-rays are measurements taken of a two-dimensional space. What that means is that a Cobb angle measurement determined by a single X-ray is not going to give a full picture of the condition.
In addition to the Cobb angle, I take a number of other X-rays and measurements taken from multiple angles to gain a comprehensive understanding of the curvature in three dimensions.
What this means to you, as someone who has recently received a scoliosis diagnosis, or as the parent or caregiver of someone with a diagnosis, is that there is nothing wrong with asking exactly how a measurement was taken. If your doctor or specialist has given you their diagnosis based on a single X-ray, it's good to request multiple measurements are taken from a variety of angles.
Many people don’t know to ask these kinds of questions, which is why my life’s work and book Scoliosis Hope is about empowering people with information. Once a person fully understands the condition, they can become the best possible advocate for themselves and their loved ones.
A mild scoliosis designation refers to cases where the Cobb angle measures a 25-degree curvature or less. The thing to remember is that even if a curvature is measured at 10 or 15 degrees, this mild stage is the time to act, not watch and wait.
A traditional approach would likely advise monitoring the condition’s progression with X-rays and waiting for it to progress. The issue I have with this conventional advice is that while the condition is still mild, there can be a lot of success in starting treatment early.
Mild scoliosis can be difficult to diagnose, and often, scoliosis is not diagnosed until it has progressed past the mild stage into moderate or severe. This is partially because the majority of cases are adolescent, and as adolescents grow, their spine is growing upwards, meaning there isn’t the compression factor present that leads to pain and discomfort.
This can be a tricky one as every parent and caregiver knows how quickly adolescents grow out of their clothes; however, if clothing suddenly seems to be fitting unevenly, it might be time to consider the possibility of something more going on. If one arm of a shirt seems to hang lower, or the cuffs are uneven, or the neckline seems to be sloping to one side, this can be cause to investigate further.
While adolescents and teenagers are known for their slumpy posture, if there seems to be a sudden noticeable change in posture and balance, this could be another red flag. Issues with proprioception (the sense of the body’s place in its environment) can also appear.
I can tell a lot about a patient’s condition by the way they walk. If you are noticing a change in how your teenager walks, such as arms swinging less, or a reduction in the counter-rotating motion of the hips and shoulders, or just an asymmetrical appearance to their gait in general, seeking the help of a specialist is a good idea.
This is a big one and is the easiest to recognize. Any asymmetrical appearance to the body or its parts could be an indication that scoliosis is present. There are a lot of ways in which uneven posture due to a spinal curvature presents itself:
The majority of my adolescent scoliosis patients don’t complain of pain because of the upward motion of their growing spine. In my adult patients, however, even a mild curvature can cause pain and discomfort. Pain is more prevalent in scoliosis patients once growth has stopped, which is why it’s not characteristic with adolescent scoliosis.
A moderate scoliosis diagnosis would be given when a patient’s Cobb angle is measured between 25 and 40 degrees. This group makes up the largest number of people living with scoliosis.
Once a patient has progressed from mild to severe, this is the time that symptoms become more noticeable. A large number of my patients come to me with a moderate scoliosis diagnosis because it was missed during the mild stage.
Traditional squeezing braces are often recommended at this stage in an attempt to stop the curvature’s progression by holding and squeezing the spine in alignment; this is different to the 100-percent customized bracing we use here at the Scoliosis Reduction Center that is designed with correction and reduction, rather than just holding, in mind.
In cases of moderate scoliosis, postural changes that are slight in the mild stage become far more noticeable. If you have a teenager with posture changes that are more extreme than their peers, it’s time to take action and make sure proactive and functional treatment is under way.
Moderate scoliosis is very likely to continue its progression, but the rate of that progression differs from case to case.
A person with severe scoliosis would have a Cobb angle measurement of 40-plus degrees in adolescents and 50-plus in adults. This is where most patients undergoing traditional treatment would find themselves awaiting and undergoing spinal-fusion surgery, but there are still less invasive and costly treatment options available that are highly effective in treating the condition.
Severe scoliosis has a 90-percent chance of progressing; those aren’t good odds. For those living with severe scoliosis, life is undoubtedly more complicated and challenging. Our treatment of adolescents and adult patients with severe scoliosis takes on the many levels of life that are affected by the condition into account.
Here at the Scoliosis Reduction Center, our patients with severe scoliosis have found a lot of success with our functional and patient-centered chiropractic approach. While patients with a severe scoliosis diagnosis might have to work harder than those with a mild form of the condition, that hard work can pay off in a big way and help them avoid invasive surgery.
As the spine is connected in some way to practically every system in the body, a severe spinal curvature can lead to a host of complex issues and symptoms:
Pain is also more prevalent, especially as severe curvatures are more common in older patients or once growth has stopped, which means compression of the spine is causing pain and discomfort.
Many symptoms associated with severe scoliosis are the same as those associated with moderate forms of the condition, just on a more extreme and noticeable level.
With a condition as complex as scoliosis, often the symptoms and their severity vary from patient to patient. There are, however, symptoms that are fairly common across the board, and these are the ones to monitor closely. As early diagnosis is a huge benefit in terms of successfully treating the condition, understanding scoliosis symptoms and what to look for is the best way to ensure you are staying ahead of the curve.
Regardless of whether a condition is classed as mild, moderate, or severe, there are highly effective alternative treatment options that keep patients off the surgeon’s table. Here at the Scoliosis Reduction Center, the keystone to our treatment approach is being proactive, which is why I advise avoiding conventional advice to simply watch and wait while the condition progresses unimpeded over time and through growth spurts.
If the aforementioned symptoms and condition descriptions are feeling familiar to you or a loved one, the Scoliosis Reduction Center team is here to answer any questions you might have about moving forward with a scoliosis diagnosis or customized and comprehensive treatment plan. Our unique multifaceted approach combines scoliosis-specific chiropractic care, exercises, rehabilitation, therapy, and custom 3-D bracing to help our patients manage their condition actively and positively.
Nalda, Tony - Scoliosis Hope