Scoliosis usually does not start with subjective symptoms. Instead, the curvature of the spine, which increases sharply during puberty, is often noticed first. A curvature of the spine forward and backward is normal, at least within certain limits. However, if it is bent laterally and twisted at the same time, it is always pathological and is called scoliosis (in Greek, "scolios" means crooked).
Scoliosis: Pain due to curvature of the spine
Most scoliosis is due to the growth processes at the beginning of puberty, but also congenital and later courses of scoliosis occur. Girls are four times more likely and often more seriously affected than boys. Accurate statements on how often scoliosis occurs are difficult, as the criteria for when to speak of scoliosis vary.
It is estimated that nearly half a million people in Germany suffer from scoliosis. It is important to recognize scoliosis in children as early as possible - the sooner the therapy starts with scoliosis, the better the long-term consequences of this chronic disease can be counteracted.
In principle, a distinction is made between scoliosis and a scoliotic maladjustment. These curvatures may look the same at first glance. The difference, however, is that in the case of scoliosis, the lateral bending and twisting can not be compensated in the examination - neither by the active efforts of the affected person nor by external force.
The scoliotic malposition, on the other hand, is a compensation mechanism for legs of unequal length - the body tries to compensate for this difference by a pelvic obliquity, which results in a lateral curvature of the spine. If the cause of the obliquity is corrected, for example, by shoe inserts, the curvature can be remedied in the case of a scoliotic malposition.
A special form is the infant scoliosis, a Seitverkrümmung without simultaneous twisting. Usually, this form of scoliosis returns in the first few months of life, sometimes supportive physiotherapy and storage therapy is necessary.
Scoliosis: causes mostly unknown
Nine out of ten people have no cause for scoliosis - this is called idiopathic scoliosis. One differentiates depending on the age, in which the scoliosis first occurs:
- Infantile idiopathic scoliosis (up to the age of three)
- Juvenile idiopathic scoliosis (up to the age of ten)
- Idiopathic adolescent scoliosis (from the age of ten until the end of growth)
The remaining 10 percent of cases are either congenital due to miscarriage (congenital scoliosis) or due to nerve or muscle disorders (neuromuscular scoliosis). Examples are the Scheuermann's disease (a growth disturbance in the area of the vertebral bodies), muscle wasting or muscle paralysis as well as disorders due to tumors or inflammations, after amputations or accidents (the scoliosis caused by scar band).
Congenital scolioses are quite rare, but often have severe spinal deformities. That's why they often require early scoliosis surgery. Studies have shown that the risk of scoliosis is increased in children under 12 years of open thorax due to heart failure. After such operations, therefore, it is important to have orthopedic follow-up with annual check-ups, especially during periods of growth, in order to prevent possible scoliosis.