Tag: scoliosis cause

What is the main cause of Scoliosis?

Posted on February 10, 2020 by - Blog

One of the most common questions which we are asked is perhaps an obvious one, “what causes scoliosis?”. While this seems a simple question, it’s actually quite a complex issue – the exact cause of many scoliosis cases is not known, although there are some factors which are known to be a risk. So today, rather than one answer, let’s look at a few.

 

Answer number one – “We don’t know”.

While this might seem like a shocking answer given all the modern science we are able to bring to bear on the issue, the honest answer is that science is still to determine why some people develop scoliosis, and why some people don’t. Stranger still, about 85% of all scoliosis cases fall into this “idiopathic” (meaning without known cause) group.[1]

There are a number of working theories as to factors which may predispose individuals to scoliosis – much research (and the bulk of scientific opinion at the moment) points towards genetic inheritance, but everything from vitamin and mineral deficiencies to certain types of exercise have been suggested as a potential cause. It has at least been confirmed that scoliosis certainly can run in families[2]–  which is why we recommend that anyone who has a parent or sibling with scoliosis should have regular screenings

Most idiopathic scoliosis cases occur in children between the ages of 10 and 18[3] and many adult scoliosis cases (as opposed to de-novo, see below) are in fact cases which started at this age and progressed into adulthood. There are certain trends which suggest a pathology here – most cases are female, in their early teens and often come from scoliosis affected families – but alone, that information is not enough to attribute a cause. Hopefully, research will reveal the real answer in the near future!

 

Answer number two – “It’s ageing”

Back pain, stiffness and reduced mobility are often expected as part of the ageing process (although it certainly does not have to be this way!), so can scoliosis also be caused by age? Actually, yes it can – a specific type of scoliosis, known as “de novo” scoliosis, occurs as the spinal discs wear and tear with age. De-novo scoliosis tends to be less aggressive than teenage scoliosis, and presents a far lower risk for extreme progression – but its much more common than you might think. Recent estimates suggest that about 30% of those over 60 may be suffering from scoliosis. [4]

Answer number three – “it’s a comorbidity”.

While scoliosis is often a “standalone” condition, and this is what we tend to mean when we talk about the condition, it can also occur as a co-morbidity, that is to say, a condition which arises from the presence of another.

Some of the more common explanations are scoliosis caused by an underlying genetic or neurological condition, by a spinal issue such as a problem affecting bone growth or development or simply by injury. Some scoliosis cases can even be caused by issues with hip alignment, or by uneven leg growth. The correct treatment path in each case will depend entirely upon the underlying condition – and this is why it’s vital to see a scoliosis specialist whenever scoliosis is suspected.

 

I think I may have Scoliosis, What should I do?

If you think you or a loved one may have scoliosis – it’s important to seek a scoliosis specialist consultation as soon as possible. While a consultation may not be able to explain exactly why you have developed scoliosis, we are typically able to rule out other underlying conditions, leaving you with a clear diagnosis and a path to treatment.

Despite what many people say, today, it’s entirely possible to treat scoliosis without surgery – at the UK Scoliosis clinic, it’s all we do – however, the earlier scoliosis treatment is started, the better outcomes tend to be. Don’t delay, book a consultation today!

 

 

 

 

[1] ‘Adolescent Idiopathic Scoliosis: Screening, Treatment and Referral’
Gutknecht S, Lonstein J & Novacheck T 2009, A Pediatric Perspective, vol. 18, no. 4, pp. 1-6.

[2] ‘Understanding Genetic Factors in Idiopathic Scoliosis, a Complex Disease of Childhood’
Carol A Wise, Xiaochong Gao, Scott Shoemaker, Derek Gordon, and John A Herring, Curr Genomics. 2008 Mar; 9(1): 51–59. doi:  10.2174/138920208783884874

[3] ‘School Scoliosis Screening Programme – A Systematic Review’
Sabirin J, Bakri R, Buang SN, Abdullah AT & Shapie A 2010, Medical Journal of Malaysia, December issue, vol. 65, no. 4, pp. 261-7.

[4] ‘Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender‘
Kebaish KM, Neubauer PR, Voros GD, Khoshnevisan MA, Skolasky R, Spine 2011 Apr 20;36(9):731-6.

‘The prevalence and radiological findings in 1347 elderly patients with scoliosis‘
Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH.,  Journal of bone and joint surgery 2010 Jul;92(7):980-3

 

What causes scoliosis? (and what doesn’t)

Posted on March 1, 2019 by - Blog

Perhaps one of the most common questions we are asked about scoliosis is simply “what causes scoliosis” – a quick google search yields far less information than you might think since in many cases the answer is still “we aren’t sure”. At the UK Scoliosis clinic, we like to provide all the information we can, however, so here’s a bit more detail on the latest thinking as to what does and does not cause scoliosis.

 

What does cause scoliosis?

While research is ongoing, it’s a sad fact that it’s still not possible to say for sure what causes the majority of scoliosis cases. At this point, however, there are 5 major possibilities to consider:

 

Possibility number 1 –  we don’t know.

80% of scoliosis cases are idiopathic – which means we don’t really know the cause!

Scoliosis can be a frustrating diagnosis, especially for many parents, since in young people at least 80% of cases are what’s known as “idiopathic” – this literally means “without known cause”.  There is much research going on to determine the case of scoliosis, but (as unhelpful as it might be) we’ve put this answer first because when dealing with young people, it’s overwhelmingly likely to be the answer. To all parents reading this, we can at least reassure you that the presence of scoliosis is certainly not an indicator that you “did something wrong” – all of the evidence so far points to a genetic cause or one of the following other conditions.

Today, treating idiopathic scoliosis is easier than ever before- and with specialist clinics like the UK Scoliosis clinic, success rates are very high.

 

Possibility number 2 – Neurological or congenital causes.

If 80% of scoliosis cases (in children) are idiopathic, that leaves about 20%. Of this 20 %, neurological or congenial causes are one of the major possibilities. Scoliosis can be a symptom of conditions such as Cerebral palsy or Muscular dystrophy or of Genetic disorders like Marfans syndrome and Downs syndrome.

Congenital scoliosis begins as a baby’s back develops before birth. Problems with the formation of the bones which make up the spine (called vertebrae), can cause the spine to curve. The vertebrae may be incomplete, fail to divide properly or develop in an abnormal shape. Doctors may detect this condition when the child is born but it is also often detected during scoliosis screening.

Depending on the underlying condition, different treatments will be required to achieve the best results.

 

Possibility number 3 – Genetics

It is generally accepted amongst the scoliosis treatment community that having a family history of scoliosis does predispose you to a higher risk of developing scoliosis yourself. This is common with many conditions, so seems like a reasonable assumption. Since we don’t know the exact mechanism which causes scoliosis, to begin with, it’s also hard to say for certain that genetic inheritance is certainly a risk factor, but it seems highly likely. Possible genetic markers for scoliosis are one of the most intense fields of research at present, so hopefully, we will know more soon.

 

Possibility number 4 – Degeneration of the spine

Degenerative scoliosis is very common in the over 60’s

“De-novo” or degenerative scoliosis is a common form of scoliosis, which affects nearly 40% of the population over 60. Unlike childhood scoliosis, de-novo scoliosis is well understood. It’s the result of the gradual degeneration of the spinal bones due to wear and tear with age.

Many of the same treatments used for idiopathic scoliosis are effective in slowing and preventing de-novo scoliosis from developing.

 

Possibility number 5 – Non-structural scoliosis

All of the above conditions result in what is collectively called “structural scoliosis” – that is to say a condition where the spine itself is actually curved as a primary condition. Another possibility is the presence of “non-structural scoliosis” – a condition where the spine appears to be curved, but only as the result of an associated condition. Whereas structural scoliosis treatment cases required direct intervention to correct scoliosis, non-structural cases will usually resolve when the root cause is addressed.

Non-structural scoliosis might be apparent on a short-term basis as a result of a condition causing significant inflammation, such as appendicitis – over the long term, factors such as a leg length discrepancy can cause the spine to curve as the body tries to compensate.

 

Possibility number 6 – Some activities

It’s possible (but not confirmed) that some activities which involve significant distortion to the spine may cause scoliosis. At least one study has suggested that dangers and gymnasts are up to 12 times more likely to develop scoliosis than individuals who do not participate in these activities[1] – but it’s important to remember that correlation does not necessarily mean causation.

 

What does not cause scoliosis?

Perhaps just as important as the question of what does cause scoliosis, is the question of what does not. There is much misinformation to be found in this realm, so let’s clear up a few common ones now!

Posture

While many of us associate young people with poor posture – and scoliosis can cause postural issues, there is no evidence which suggests that having poor posture can actually cause scoliosis (although it is much more strongly associated with kyphosis – read more about that here).

 

Injury

While it has been suggested that childhood injuries could be responsible for scoliosis, there is no strong evidence to suggest this is the case. While recent research has suggested that being involved in impact sports, or even “heading” the ball too much when playing football could predispose the cervical spine to degeneration later in life[2] there is no evidence that scoliosis can result.

 

Diet

Heavy backpacks don’t cause scoliosis (but should be avoided anyway!)

 

For some time, some researchers have suggested that certain diets may help to improve scoliosis. Although there is currently no evidence which suggests that diet can improve scoliosis, at least one study has noted that many idiopathic scoliosis patients also have lower selenium levels than normal.[3] While this is an interesting observation, there is nowhere near enough evidence to suggest that selenium deficiency or any other nutritional factor is responsible for scoliosis.

 

Heavy backpacks

While heavy backpacks are to blame for many childhood spinal complaints, (ideally, keep backpacks to less than 10% of body weight) scoliosis isn’t one of them. Similarly, while it’s best for patients with scoliosis to avoid uneven loading of the spine (so carrying a backpack on one shoulder isn’t a good idea) there no research to suggest that carrying your back this way can cause scoliosis in the first place.

 

 

 

[1] Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers’

Longworth B., Fary R., Hopper D, Arch Phys Med Rehabil. 2014 Sep;95(9):1725-30. doi: 10.1016/j.apmr.2014.02.027. Epub 2014 Mar 21.

[2] Pain Physician 2005:8391-7

[3] Yalaki, Zahide et al. Investigation of Serum Levels of Selenium, Zinc, and Copper in Adolescents with Idiopathic Scoliosis Dicle Medical Journal / Dicle Tip Dergisi. 2017, Vol. 44 Issue 1, p35-41.