Scoliosis is the word used to describe a side bending distortion or curvature of the spine often involving a rotational element.
There is no known cause behind this disorder and it is usually noticed once the child has reached puberty, seen in girls more than boys.
It can be pain free and simply give rise to a poor posture, and in many instances it will be outgrown by adulthood or the curvature will be barely noticeable. In some children whose scoliosis is noticed when they are very young it can be associated with dramatic rotational changes especially in the thoracic spine.
Occasionally there may be a congenital abnormality e.g. hemivertebra. If the child is asked to bend forward and observed from behind it will be possible to see that one side of the back is more prominent and higher than the other. There may also be a postural, compression element to the rib cage on one side.
In severe cases it is necessary to control the rotational curvature in a developing child, by the wearing of a brace which restricts and controls the spinal movement. If there is a severe deformity, even after trying a brace, then occasionally surgery is the other option.
It is also possible to develop a scoliosis as an adult. Here there is usually no structural underlying cause but the curve has developed as a result of a combination of factors including trauma, poor posture, weak spinal muscles (occasionally as a result of another illness), sciatica or a difference in pelvic tilt or leg length.
The latter problem is frequently seen and if discovered at the age when growth is not quite finished, its course can sometimes be changed by the use of a heel lift or adapted shoe to correct leg length discrepancies.
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