Beware that curve

If it seems as if your clothes are not fitting properly, or they hang in an irregular fashion, it could be more than just a matter of getting them altered – you may have scoliosis. Scoliosis is the curving of the spine usually in a S or C-like formation. The condition can occur on any part of the back, and varies in severity and grades. Females get it more often than males.

“The proper term is kyphoscoliosis, kypho meaning formal curvature of the spine, and scoliosis, meaning a tilt in the spine,” said orthopaedic surgeon Dr Warren Blake. “It really is a three-dimensional disorder.”

He added: “If you look at it from the side, you get the forward curvature; if you look at if from front or back, you get the side-to-side tilt; and if you look at it from the top, you get the rotation.”

Of course, some curves in the spine are normal, but signs of scoliosis include one hip being higher than the other, the shoulder blades being uneven, or a tendency to lean to one side.

“It is more common in women,” Dr Blake said. “But although there are some conditions that are more common in one sex than the other, this one is not sex-linked.”

Scoliosis may occur in children from birth, although such cases are rare. This is known as congenital scoliosis and the likelihood that the curve will worsen increases. The condition generally occurs during the growth spurt phase of the child. For females, this begins at about nine years and generally ends at 18 years old, and the onset usually results in huge confidence issues.

“It gradually increases as the child grows,” Dr Blake said.

And scoliosis is not a preventable condition, so all that advice about proper posture, while good etiquette, will have no bearing on whether or not one will get scoliosis.

“It is a condition that has been with us for a very long time,” Dr Blake said. He said that if the scoliosis is mild, then one may get the occasional backache, and he usually recommends that affected persons do physiotherapy to help with posture issues.

He said that fully grown women will not get scoliosis unless there is some form of injury caused to the spine. Neuromuscular disorders like cerebral palsy may also lead to scoliosis.

He also advises mothers to examine their children for any abnormalities in the spine.

“You need to have a look at the spine from the back straight down from the neck to the tailbone,” Dr Blake recommended. “If you just run your finger along the spinal column, it should go down in a straight line.”

Your doctor may do a physical examination and take X-rays to test for scoliosis. In one straightforward test, the patient bends forward with their hands hanging at their side, where the doctor will look for an unevenness in the back or ribs. The X-rays allow for a more precise measurement of the curve. If the curvature is greater than 70 degrees, lung and heart damage can occur and there is often back pain.

Unfortunately, the cause for scoliosis is unknown, although the risk factors include genetics, and simply being female.

Options for treating scoliosis include wearing a back brace, which needs to be worn on a full-time basis to improve curvature and prevent further progression.

“There are those people who advocate bracing, but people are now questioning how effective bracing is,” Dr Blake said. “They have to wear it for at least 20 hours a day and the compliance rate is very poor.”

And once a person stops wearing the brace, the spine returns to its original curve.

“The more severe cases need surgery,” Dr Blake said. This may include spinal fusions which may not give total correction, but can prevent the condition from getting worse.