Scoliosis symptoms

Florian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.

More posts by Florian Tiefenböck All content is checked by medical journalists.

Many scoliosis symptoms only appear in old age, the extent of which depends on the strength of the curvature of the spine. Scoliosis only causes pain in a few cases, and slightly crooked spinal columns are often not noticed at all. For many sufferers, scoliosis is a purely cosmetic problem. However, the longer a crooked spine exists and remains untreated, the more likely it is that symptoms will develop over time. Find out everything about the possible symptoms of scoliosis here.

Cosmetic scoliosis symptoms

Some scoliosis symptoms can be seen with the naked eye, which often bothers those affected: the shoulders are at different heights, the pelvis is crooked or protruding on one side and some patients also hold their head crooked.

In the case of pronounced scoliosis, the so-called rib hump is particularly noticeable. It can be seen on the back, on the side towards which the spine curves. The twisted vertebral bodies pull the ribs backwards so that the chest arches at the back. A rib hump occurs primarily from a Cobb angle of around 40 degrees and is best seen when the patient bends over.

Muscle bulges also form in the lumbar region or on the neck, as the spinal muscles are pulled along by the scoliosis and are therefore more prominent on one side of the spine. A lumbar bulge is particularly noticeable from a Cobb angle of 60 degrees.

Cosmetic scoliosis symptoms can also lead to psychosocial problems, especially in children and adolescents, for example when they are bullied by their peers. As a result, they develop a decreased self-esteem and avoid uncomfortable situations, for example in the locker room or swimming pool.

Scoliosis Symptoms of the Infant

In the majority of cases, the scoliosis symptoms of an infant are only temporary and resolve on their own. Infant scoliosis is usually large, C-shaped and primarily affects the thoracic and lumbar spine. Twists of the vertebral bodies are atypical. Scoliosis in babies is usually caused by an uneven basic tension in the muscles. That is why it is rarely fixed and can be moved into the normal position.

However, infant scoliosis is often accompanied by other symptoms. Doctors summarize the possible overall picture under the seven syndrome:

• Scoliosis
• Lumbar hump (lumbodorsal kyphosis)
• Skull deformation / asymmetry (often uneven flattening of the back of the head = plagiocephaly)
• Head tilt (tilt, rotation)
• Mostly one-sided malformation of an acetabular cup (hip dysplasia),
• Pelvic asymmetry
• Malpositions of the feet

Symptoms of scoliosis: pain and restricted mobility

Children usually have little or no symptoms from scoliosis. They rarely complain of pain. However, if scoliosis persists for a long time and its curvature increases, further scoliosis symptoms can appear or become worse.

From the middle of the third decade onwards, some patients suffer more from their scoliosis. Back pain is then more common. On the one hand, these are due to increasing signs of wear and tear on the spine due to the permanent curvature (spondylosis deformans). On the other hand, the back muscles tighten. You are constantly trying to stabilize the unfavorable position of the spine.

Scoliosis pain is particularly typical in spinal curvatures in the lumbar region and in thoracolumbar scolioses. A hollow back (lumbar lordosis) can additionally strengthen it.

In addition, painful tendon-muscle irritations (tendomyosis) can occur at the muscle tendon attachments (spinous processes, iliac crest, etc.). Initially, patients complain about symptoms of scoliosis, especially after standing or sitting for a long time, for example at work. They usually indicate pain a little below the curvature of the spine.

Scoliosis pain often radiates to the sides and can also affect the shoulders, neck, and head. Furthermore, some patients feel restricted in their movements, especially if the joints become stiff due to spondylosis (growing bony marginal spikes on the vertebral bodies). With increasing wear and tear and overloading of the structures involved, these scoliosis symptoms often increase over time.

Scoliosis symptoms with severe curvature

Pronounced curvatures and twists in the spine also deform the thoracic or abdominal cavity. In severe cases, scoliosis restricts the function of the heart, lungs and digestive organs. A lung function test can often measure impaired breathing at an early stage. Most of the time, the patients do not feel any breathlessness or other symptoms of scoliosis.

Experts have found that lung function depends directly on the degree of scoliosis: for every ten degrees of Cobb's angle, the vital capacity (lung volume between maximum inhalation and exhalation) decreases by around ten percent. As a rule, the cardiovascular system is only stressed in the later course of the disease due to a strong curvature (about 90 degrees Cobb angle) or its increase.

The right ventricle pumps blood to the lungs, but the lung capacity is reduced due to scoliosis. As a result, blood backs up in the right heart, which becomes pathologically enlarged as a result of the permanent overload. This is how a chronic lung heart (cor pulmonale) develops. As a result, patients suffer from shortness of breath, especially when they are exerted. In addition, a feeling of pressure in the chest and a racing heart can be signs of cor pulmonale and thus late symptoms of scoliosis.

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