Scoliosis is a side-to-side curvature of the spine. It can be caused by congenital, developmental or degenerative problems, but the vast majority of cases of scoliosis actually has no known cause.

By far the most common form of scoliosis is idiopathic scoliosis which develops in adolescents and progresses mostly during the adolescent growth spurt. The cause of idiopathic scoliosis is unknown (idiopathic literally means “cause unknown”).

Scoliosis usually develops in the thoracic spine (upper back) or the thoracolumbar area of the spine, which is between the thoracic spine and lumbar spine (lower back). It may also occur just in the lower back. The curvature of the spine from scoliosis may develop as a single curve (shaped like the letter C) or as two curves (shaped like the letter S).

It is important to note that scoliosis is not typically a cause of back pain. The condition represents a deformity of the spine but is usually not painful.

• Symptoms and diagnosis of idiopathic scoliosis • Understanding scoliosis • Back pain in kids and teens

Idiopathic scoliosis is a relatively common disorder and affects approximately 1 in 1,000 adolescents. It’s categorized into three age groups, from birth to 3 years old (infant), from greater than 3 to 9 years old (juvenile), and from greater than 9 to 18 years old (adolescent). This last category accounts for 80 percent of the cases. Girls tend to be affected slightly more often than boys. More importantly, girls are eight times more likely to need treatment for scoliosis, because they tend to have curves that are much more likely to progress. For both boys and girls, the risk of curvature progression is increased during puberty, when the growth rate of the body is the fastest.

Scoliosis is a term used to describe a condition, but is not a disease, or a diagnosis. Because idiopathic scoliosis is considered a deformity, treatment is largely centered on reducing or limiting the progression of the deformity and is not focused on treatment of pain.

Diagnosis
Many cases of idiopathic scoliosis are diagnosed using the Adam’s forward bend test. Students are routinely given this examination in school to determine whether or not they may have scoliosis. A physician may also perform this test as part of a routine physical. The test involves the patient bending forward with arms stretched downward, while being observed by a healthcare professional. If a “rib hump” or asymetry is seen, or if the shoulders are different heights, scoliosis may be suspected. If so, an x-ray may be ordered to determine the degree of severity of the curve. In rare cases, especially if the scoliosis may be causing a problem for the neurological functions of the spinal cord, an MRI may be ordered so the physician can get a better look at the situation. A diagnosis of scoliosis does not mean the activity level of the individual should be restricted, since activity does not affect the degree of the curve.

Next: Treatment Options for Idiopathic Scoliosis