Imagine waking up one day and realizing your spine isn’t as straight as it once was. For many, scoliosis starts as a subtle change—an unexplained curve that gradually alters posture and movement. But what truly causes this condition? Is it genetics, lifestyle, or something else entirely? The answer is more complex than you might think, and uncovering the truth could transform the way spinal health is understood.
Get expert advice on scoliosis treatments and improving posture.
How Does Scoliosis Develop in Children and Adults?
Scoliosis is an abnormal curvature of the spine that can develop at different stages of life. In most childhood cases, the cause is unknown, though the condition can worsen during growth periods. In adults, scoliosis is often linked to degenerative changes in the spine.
Scoliosis in Children and Adolescents: Childhood and adolescent scoliosis typically arises due to an asymmetry in spinal and muscle growth. In many cases, no specific cause is identified, so it is classified as idiopathic scoliosis.
- Develops during growth and may worsen during puberty.
- Can cause postural changes and affect muscle balance.
- Detected through routine medical exams.
- Severe cases may require bracing or surgery.
Doctors monitor children to track spinal curvature changes since early diagnosis helps prevent long-term complications.
Scoliosis in Adults: In adults, scoliosis may result from degenerative changes in the spine. It can also develop due to neuromuscular diseases.
- Muscle weakness and reduced flexibility with age.
- Postural compensations due to leg-length discrepancies.
Lifestyle changes, such as low-impact exercise (swimming, walking, or cycling), can help manage scoliosis and reduce discomfort.
1. Genetic Factors: Can Scoliosis Be Inherited?
Scoliosis may have a genetic component, though it is not always hereditary. In some cases, it runs in families, while in others, it appears with no known family history.
Certain genetic mutations have been identified as risk factors. Additionally, factors such as sex and age of onset play a role in development.
Idiopathic scoliosis, the most common type, may be inherited through a polygenic multifactorial pattern linked to the X chromosome. About 30% of scoliosis patients have a family history of the condition.
Treatment depends on the patient’s age and the severity of the curve. Mild cases require monitoring, while more advanced cases may need bracing or surgery.
2. Neuromuscular Conditions That Lead to Scoliosis
Neuromuscular scoliosis develops due to conditions that affect the nerves and muscles supporting the spine.
These disorders cause muscle weakness, loss of control, or paralysis, leading to spinal imbalances and progressive curvature. Unlike idiopathic scoliosis, which has no known cause, neuromuscular scoliosis is directly linked to underlying medical conditions.
Neuromuscular scoliosis can be caused by a wide variety of neurological and muscular diseases. Among the most common include:
| Condition | Description |
| Cerebral palsy | A congenital disorder affecting muscle control, the most common cause of neuromuscular scoliosis. |
| Muscular dystrophy | A group of genetic diseases that progressively weaken muscles. |
| Spina bifida | A congenital spinal defect exposing the spinal cord. |
| Spinal cord injury | Damage that can cause loss of motor and sensory function. |
| Tethered spinal cord syndrome | A condition where the spinal cord is stuck within the spinal canal, affecting motor control. |
| Friedreich’s ataxia | A genetic disorder causing progressive coordination loss and scoliosis. |
In these cases, muscle weakness and impaired motor control contribute to the formation of spinal curves, which may worsen over time.
3. Congenital Scoliosis: When Spinal Curvature Starts Before Birth
Congenital scoliosis is a spinal deformity present at birth. It occurs when vertebrae fail to form correctly during fetal development, resulting in an abnormal lateral curvature.
Congenital scoliosis is the least common form of scoliosis, affecting approximately 1 in 10,000 newborns. Because the deformity originates in the embryonic or fetal period, its clinical presentation may vary depending on the severity of the vertebral anomalies.
Common Symptoms
- Spinal curvature noticeable at birth.
- Uneven posture with misaligned shoulders or hips.
- Difficulty maintaining balance or posture when walking.
Many children with congenital scoliosis have additional medical concerns, including:
- Kidney and bladder issues: The spine and urinary system develop simultaneously, making malformations possible.
- Neurological conditions: Some spinal defects can affect the spinal cord, leading to muscle weakness or sensory issues.
- Thoracic insufficiency syndrome (TIS): Severe spinal deformities can impact lung capacity and breathing.
Some cases are diagnosed at birth, while others go unnoticed until adolescence. Since congenital scoliosis often occurs alongside other health conditions, early diagnosis and proper management are necessary to prevent complications.
4. Degenerative Changes: How Aging Affects the Spine
As people age, the spine undergoes degenerative changes that may lead to scoliosis. This type, called de novo scoliosis, is not present in childhood or adolescence but develops due to gradual deterioration of spinal discs, facet joints, and ligaments.
Degenerative scoliosis results from asymmetric degeneration of spinal discs and facet joints, creating uneven pressure on the spine and causing lumbar curvature.
Symptoms can vary in severity depending on the progression of the deformity and the presence of other associated conditions, such as osteoporosis or spondyloarthritis.
| Symptom | Description |
| Back pain | Caused by disc degeneration and joint wear. |
| Breathing difficulty | Occurs if the curve affects the ribcage and lungs. |
| Uneven shoulders or hips | The spinal curve disrupts body alignment. |
| Progressive curvature | The spine increasingly leans to one side, leading to postural imbalance. |
Spinal degeneration can also cause spinal stenosis, where bony overgrowth (osteophytes), ligament thickening, and facet joint deterioration narrow the spinal canal. This can lead to nerve compression and neurogenic claudication, causing leg pain and walking difficulties.
5. Idiopathic Scoliosis: The Most Common Yet Mysterious Cause
Idiopathic scoliosis is the most common type and is defined by an unexplained lateral spinal curvature. Its cause remains unknown, but research suggests a genetic link.
This condition primarily affects children and adolescents, occurring more frequently in girls. Since the exact cause is unclear, it cannot be prevented, but early detection can help manage its progression.
In many cases, mild scoliosis has no obvious discomfort, but as it progresses, visible signs and physical symptoms may appear.
- Uneven or rounded shoulders.
- Misaligned hips, with one side higher.
- Back pain or discomfort extending to the legs.
- Fatigue after prolonged standing or sitting.
- Breathing difficulties in severe cases.
Regular medical exams during puberty help detect scoliosis early and prevent further progression.
Get Expert Care to Manage Your Scoliosis
Scoliosis treatment requires a specialized approach that addresses spinal curvature from multiple angles. Physical therapy is a key method, with treatments like the Schroth method, which includes customized exercises, breathing techniques, and therapeutic tools to improve posture and strengthen muscles.
At Buddies In Motion, specialized treatment is available for children and adolescents, tailored to each patient’s needs. Initial evaluations determine the curve type and guide treatment plans. Alternative therapies are also provided to expand treatment options.
The commitment to scoliosis care is reflected in the expertise of the therapy team, personalized attention, and a supportive environment for patients and families. With flexible scheduling, same-day appointments, and evidence-based approaches, quality and accessible care is ensured.
Sources:
- Cassar-Pullicino, V. N., & Eisenstein, S. M. (2002). Imaging in scoliosis: what, why and how?. Clinical radiology, 57(7), 543-562.
- MacLennan, A. (1922). Scoliosis. The British Medical Journal, 864-866.
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