Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Scoliosis is defined as a lateral, or sideways, curvature of the spine that measures more than 10 degrees. It usually begins during childhood or adolescence and may continue to slowly worsen into adulthood. Typically, the greater the angle of the curvature, the greater is the risk that it will progress. Curves less than 30 degrees at the end of growth rarely progress and do not usually necessitate close observation. Curves greater than 50 to 75 degrees are at a high risk for progression and may necessitate aggressive therapy. Pain is the most common reason that adults seek treatment of scoliosis. Although the pain is believed to be caused by muscle fatigue along the outside of the curve, the true source of the pain remains unclear. Some patients may notice a loss of height, an increase in the prominence of a rib, or changes in their waistline, which can signal a progression of the curve.
A series of radiographs (x-rays) taken over several years is the most accurate method for monitoring the curve. A slowly progressive curve may remain nonpainful and as a result not necessitate formal treatment. However, a rapidly progressive curve that produces pain and deformity may necessitate more aggressive management.

Living With Your Diagnosis
The diagnosis of scoliosis includes a wide range of deformities from mild to painful and severe. Although the deformity may not be noticeable until late in the course of the progression of the curve, the emotional aspects of this disease may be quite severe, particularly for adolescents. Breathing difficulties may develop with large curves but are usually preceded by pain and fatigue.

Analgesics and anti-inflammatory drugs may reduce the pain of scoliosis. There are no medications, injections, diets, or exercises that affect the curve itself. The nonoperative management of scoliosis includes routine radiographs taken at regular intervals to monitor for progression. Bracing can be effective in preventing progression but does not correct a curve that has already developed. Exercises have not proved to be of benefit in this diagnosis, nor has electrical stimulation of muscles. An operation is indicated
when the curve progresses or results in severe pain. When the curve is not progressive, you have to decide whether the pain warrants a complex surgical procedure. The surgeon must be sure that there is not some other cause for the back pain that may be unrelated to the scoliosis.

The DOs
• Take your medications as prescribed.
• Wear your brace as directed, but be aware that many curves can progress despite bracing.

The DON’Ts
• Do not stop wearing your brace without your doctor’s recommendation.

When to Call Your Doctor
• If you notice a change in the deformity, such as an increased rib prominence, change in leg length, or new onset of pain.