Scoliosis is a condition characterized by a sideways curvature of the spine. While often mistakenly believed to affect only women, men can develop scoliosis at any age. The condition impacts individuals across all genders, and understanding its forms, indicators, and interventions is important for accurate diagnosis and management.
Scoliosis in Men
While adolescent idiopathic scoliosis (AIS) is more frequently diagnosed in girls, scoliosis is not exclusive to them. In fact, small curves are found almost equally in both boys and girls. The prevalence of scoliosis generally increases with age, affecting both men and women.
Different types of scoliosis can manifest in men. Adult degenerative scoliosis develops due to age-related wear and tear on the spine’s discs and joints, typically appearing after age 40 or 50. Men are also susceptible to its development. Congenital scoliosis, a rare type caused by spinal bone malformations present at birth, can occur in either sex.
Neuromuscular scoliosis arises from underlying nerve or muscle conditions like cerebral palsy, muscular dystrophy, or spina bifida, impacting spinal support. This type affects individuals regardless of gender. Idiopathic scoliosis, where the cause remains unknown, accounts for the majority of cases across all age groups. Men can experience any form of scoliosis.
Recognizing Signs and Underlying Causes
The signs of scoliosis in men can range from subtle to noticeable. Visual indicators may include uneven shoulders, with one shoulder blade appearing more prominent than the other. An uneven waistline or one hip being higher than the other, along with the body leaning to one side, are common observations. Sometimes, clothing may not fit correctly, or one side of the back might stick out more when bending forward.
Men with scoliosis might experience physical discomfort. Back pain and stiffness are frequent complaints, particularly in adults. Nerve compression in severe cases can lead to pain, numbness, or weakness in the legs. Fatigue from muscle strain, or in advanced cases, difficulty breathing due to reduced chest capacity, can also occur.
The underlying causes of scoliosis vary depending on the type. Idiopathic scoliosis, which constitutes about 80-85% of cases, has no identifiable cause, though genetic factors are thought to play a role, with nearly 30% of those affected having a family history. Congenital scoliosis results from abnormal vertebral development before birth, where spinal bones may not form completely or might fuse together incorrectly. Neuromuscular scoliosis stems from conditions that affect the nervous system or muscles, leading to inadequate spinal support. Degenerative scoliosis, common in older adults, is caused by the natural wear and tear of spinal discs and facet joints, which can lead to a gradual curvature.
Path to Diagnosis and Treatment Options
Diagnosing scoliosis in men begins with a physical examination. A doctor will observe the spine and posture, often performing the Adam’s forward bend test, where the patient bends forward at the waist to highlight any spinal asymmetry or rib prominence. If scoliosis is suspected, imaging studies are ordered. X-rays are the standard method to confirm the diagnosis and precisely measure the spinal curve.
The severity of the curve is determined by measuring the Cobb angle from an X-ray. A spinal curvature of 10 degrees or more on an X-ray indicates scoliosis. In some instances, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be used to investigate underlying causes or provide more detailed views of the spinal structures.
Treatment approaches for scoliosis are tailored to the individual, considering factors like the type and severity of the curve, its potential for progression, and the patient’s age and overall health. For mild curves, observation with regular monitoring is a common strategy. Physical therapy can be beneficial for managing symptoms and may help slow curve progression.
Bracing is primarily used for growing adolescents with moderate curves, typically between 25 and 40 degrees, to prevent the curve from worsening rather than correcting it. For adults, bracing is less common and physical therapy is often preferred to maintain core strength. Surgical intervention, such as spinal fusion, is reserved for severe or rapidly progressing curves, often exceeding 40-50 degrees, to correct the curvature and prevent further progression.