Medicines for Scoliosis

What it is

Scoliosis is a condition where the spine curves and sometimes twists to the side, rather than being straight when viewed from behind. It is common and can affect people of any age, but it most often develops in children and teenagers, particularly around the growth spurt of puberty. In most cases of scoliosis in children (called idiopathic scoliosis), the cause is not known; less commonly, scoliosis is related to other conditions (such as conditions affecting the nerves or muscles, or present from birth), and in older adults it can develop due to age-related "wear and tear" of the spine (degenerative scoliosis). The signs of scoliosis can include: a visibly curved spine; one shoulder or hip being higher than the other; the shoulder blades being uneven or one sticking out more; the body leaning to one side; a rib or back prominence when bending forward; and clothes not hanging evenly. In many cases, particularly mild ones, scoliosis causes no pain and few problems, and may be noticed by a change in appearance; in adults, degenerative scoliosis can cause back pain and stiffness. The severity varies a great deal, from mild curves that need no treatment to more significant curves that benefit from treatment. Scoliosis is assessed by specialists, and management depends on the person’s age, the size of the curve, and whether it is likely to get worse: many mild curves are simply monitored, while more significant or progressing curves (especially in growing children) may be treated with a back brace, and larger curves may need surgery. The key messages are that scoliosis is common and varies widely, that many cases need only monitoring, and that effective treatments are available for more significant curves — and that a curved spine or uneven posture in a child should be checked so it can be assessed.

How it is treated

Scoliosis is assessed and managed by specialists (such as spinal or orthopaedic teams), and the approach depends on the age of the person, the size and location of the curve, and how likely it is to progress. Assessment usually involves an examination and X-rays (which measure the degree of the curve), and monitoring over time to see whether it is changing, particularly in growing children. Management options include: monitoring (observation) — for mild curves, or those unlikely to progress, regular check-ups without active treatment may be all that is needed, as many curves stay mild and cause few problems; bracing — for growing children and teenagers with moderate curves that are at risk of getting worse, a back brace worn as advised can help prevent the curve worsening while the child is still growing (it does not usually straighten the spine, but aims to stop progression); and surgery — for larger curves, curves that are progressing significantly, or those causing problems, an operation to correct and stabilise the spine (spinal fusion) may be recommended, particularly in more severe cases. The specific approach is tailored to the individual. For adults with degenerative scoliosis, management focuses on relieving symptoms (such as back pain), with physiotherapy, pain relief, and other measures, and surgery considered in some cases. Physiotherapy and staying active can help with function and symptoms. The reassuring messages are that scoliosis is common and varies widely, that many cases (especially mild ones) need only monitoring and cause few problems, and that effective treatments (bracing for growing children, surgery for larger curves) are available when needed. Because early assessment allows monitoring and timely treatment if needed, a curved spine, uneven shoulders or hips, or a change in a child’s posture or back appearance should be checked by a GP, who can arrange assessment.