Scoliosis: Spine Deformity and Disability

Abnormal sideways curvature (greater than 10 degrees on X-ray) of the spine is called Scoliosis. The curve can either be a C-shaped or S-shaped curve. The condition is often diagnosed in adolescents. While conditions like cerebral palsy and muscular dystrophy may cause scoliosis, the exact reason for scoliosis in most cases is not known. The curve develops gradually and normally does not cause any pain. Mild scoliosis, which happens in most cases, does not affect a person’s life much but severe scoliosis can be disabling.

In this article, we will discuss scoliosis in detail. We will discuss the causes, symptoms, complications, and treatments of scoliosis. Finally, we will discuss scoliosis as a disability.

Signs and Symptoms of Scoliosis

Scoliosis is the deformity of spine in dorsal plane. Scoliosis does not cause any major symptoms but its sign can be visible on a person’s body. You can observe the following signs of scoliosis on an affected person –

• Uneven shoulder
• One shoulder blade more prominent than the other
• Uneven waist
• One hip higher than the other
• One side of the rib cage extends forward than the other side

All these signs appear as the person with scoliosis bends on one side. The bend depends on the degree of curvature in the spine. The higher the degree of curvature the prominent will be the signs.

In most cases of scoliosis, the spine rotates or twists in addition to being curved sideways. This rotating or twisting of the spine causes the rib muscles on one side to protrude out of the other side.

Causes of Scoliosis

The exact cause of scoliosis in most cases is still unknown to medical science. Though there are some common causes that contribute to some of the cases of scoliosis. The following factors may be the causes of scoliosis.

• Hereditary – Though not established surely by any study, one of the common causes of scoliosis can be the genes. The exact gene has not yet been identified but scoliosis has been noted to run in certain families.
• Neuromuscular conditions – Certain neuromuscular conditions like cerebral palsy and muscular dystrophy can be the reason for scoliosis in some cases.
• Birth defects – A child may develop scoliosis due to a birth defect affecting the development of the bones of the spine.
• Surgery on the chest wall – Children who have undergone surgery on the chest wall are at the risk of developing scoliosis.
• Injuries or infection – An injury to the spine or infection may also be the cause of scoliosis in a few cases.

Risk Factors for Scoliosis

As discussed earlier, there’s no known and established cause of scoliosis. But, certain factors increase the risk of developing scoliosis in some cases.

• Family history – Someone with scoliosis running in their family is at an increased risk of developing scoliosis during their adolescence.
• Age – Scoliosis most commonly develops in adolescents. So, children in their teenage are at more risk of developing scoliosis.
• Gender – Though scoliosis affects girls as well as boys, girls are at more risk of developing scoliosis and getting it in the worse form. Girls are more likely to cross the mild level and need treatment for scoliosis.

Types of Scoliosis

Depending on the cause, scoliosis can be of several types. The following are the different types of scoliosis –

• Idiopathic Scoliosis – This is the most common type of scoliosis. Around 80% of the cases of scoliosis fall in this category. This is scoliosis for which the doctor cannot establish any exact reason.
• Congenital Scoliosis – This is one of the rare forms of scoliosis. This is caused when a child is born with some birth defect that causes an abnormal sideways curve in the spine either during infanthood or childhood.
• Neuromuscular Scoliosis – As the name suggests, this is scoliosis that happens due to one or the other neuromuscular disorders such as cerebral palsy, muscular dystrophy, and spina bifida.
• Degenerative Scoliosis – This type of scoliosis affects adults. The spine, in this case, curves due to the wear and tear of the bones.

Apart from the above-mentioned types, scoliosis is also divided into two categories – Structural and Non-Structural.

• Structural – It is scoliosis where the curve in the spine is rigid and cannot be reversed.
• Non-Structural – It is the kind of scoliosis where the spine looks curved but functions normally. This may happen for a variety of reasons like one leg being shorter than the other, muscles spasms, etc. When the cause is treated scoliosis goes away.

Complications caused due to Scoliosis

While most cases of scoliosis are mild, some people may develop severe scoliosis. People with severe scoliosis may experience certain complications. The following are the complications that people with scoliosis may experience –

• Breathing Problem – In case of severe scoliosis the rib cage may press against the lungs causing difficulty in breathing.
• Back Aches – People who developed scoliosis as a child may experience more backaches and other back problems like back stiffness in their adulthood. The issue of backaches is more prominent in people with larger scoliosis curves and those with untreated curves.
• Fatigue – A person with scoliosis may also experience fatigue due to muscle strain.
• Distinguished Appearance – Scoliosis, with larger curvatures, causes a person to look different from others – bent on one side, one hip higher than the other, etc. This may make the person self-conscious about their distinguished appearance.

Treatment of Scoliosis

People with mild scoliosis often do not need any treatment. Their spine is monitored frequently by the doctor to ensure that the curve is not getting worse.

People whose spinal curve tend to increase in degree may be prescribed braces. The brace can be worn under the clothes and the person can go on with their daily works. Some people may need to wear it for a few hours while others may be prescribed braces for 24 hours.

In rare and severe cases, a person with scoliosis may need to be operated on. The surgery can be of different types depending on the requirement and conditions of the patient. A rod may be attached to the spine for straightening it or some of the bones may be fused using surgical methods.

Prevention of Scoliosis

Scoliosis cannot be prevented. Tips on preventing scoliosis like keeping the posture right or avoiding carrying heavy loads or sleeping on your back are all myths. While the weight of heavy bags may cause back, shoulder, and neck pain to a child, it does not increase the risk of scoliosis in any way.

Scoliosis affects a person’s posture but a poor posture does not lead to scoliosis.

Is Scoliosis a Disability?

While most scoliosis cases are mild and do not cause many complications severe scoliosis may affect the lungs and heart by pressing on these vital organs. Due to its capability to cause side effects and health problems, scoliosis can be a disabling condition.

Scoliosis is considered a disability and falls under the category of locomotor disability. Not all persons with scoliosis will qualify as a person with a disability. But, those who do can get social security and disability benefits as per the rules of their respective country or state.