Adolescent idiopathic scoliosis affects children between 10 and 18 years old. There are many theories as to why this type of scoliosis develops, but the root of the condition has yet to be discovered. Some of the theories include:

• Genetics— Scoliosis appears to run in certain families, so it may be hereditary. Significant research is ongoing in the field of genetics.
• Growth— Curves progress rapidly during growth spurts, perhaps showing a tie to hormonal causes.
• Structural and Biomechanical Changes— Differences in leg lengths have also been noted in adolescents with idiopathic scoliosis. But there is no clear evidence that this type of change causes scoliosis; it may simply be a secondary result.
• Central Nervous System Changes— Some forms of scoliosis are associated with central nervous system disorders, so a lot of research has been focused on this topic. To date, such disorders have not been proven as the root of idiopathic scoliosis.
• Equilibrium and Postural Mechanisms— Idiopathic scoliosis could be related to factors that affect body alignment. If a child has problems with posture, balance, and body symmetry, it could affect the way his or her spine is positioned. If the problems are chronic, it may disrupt the way the child's spine and muscles develop.

In many cases of adolescent scoliosis, the child will not even notice the problem. Because the majority of scoliosis patients do not suffer any physical pain from this disorder, it is often not discovered until the curves have progressed to become more obvious. In fact, if the child is suffering from severe back pain, a diagnosis other than idiopathic scoliosis must be considered.

hough the spine may curve sideways, in minor cases the curves are not obvious until the person bends over. Many schools currently screen young students for scoliosis, so referrals often come from school health workers. Parents or physical education instructors are also frequently the first to notice signs of scoliosis in a child. Signs of scoliosis may include the following abnormalities in appearance:

• One shoulder or hip may be higher than the other.
• One shoulder blade may be higher and stick out farther than the other.
• These deformities are more noticeable when bending over.
• A "rib hump" may occur, which is a hump on the back that sticks up when bending the spine forward. This occurs because the spine and ribs also rotate as the curve develops.
• One arm hangs longer than the other because of a tilt in the upper body.
• The waist may appear asymmetric.

Once scoliosis is diagnosed, concern may arise whether the curves will continue to grow bigger. There is no absolute way to tell, but this much is known.

Most cases of adult scoliosis are idiopathic, which means that the cause is not known. Sometimes adult scoliosis is the result of changes in your spine due to aging and degeneration.

The causes of adult scoliosis are further categorized into several subtypes:

• Idiopathic
• Congenital
• Neuromuscular
• Syndromic

Adult scoliosis is often painless. Patients with adult scoliosis commonly see a spine specialist because they notice a problem with the way their back looks. You may notice some of the following things about your body:

• One shoulder or hip may be higher than the other.
• One shoulder blade may be higher and stick out farther than the other.
• These deformities are more noticeable when bending over.
• A "rib hump" may occur, which is a hump on your back that sticks up when you bend your spine forward. This occurs because the ribs on one side angle more than on the other side.
• One arm hangs longer than the other because of a tilt in your upper body.

Back pain can eventually develop as the condition progresses. The deformity may cause pressure on your nerves and possibly even on your spinal cord. This can lead to weakness, numbness, and pain in your lower extremities. In severe cases, pressure on your spinal cord may cause loss of coordination in the muscles of your legs, making it difficult for you to walk normally. If your chest is deformed due to the scoliosis, your lungs and heart may be affected, leading to breathing problems, fatigue, and even heart failure. Fortunately these severe symptoms are rare.

Scoliosis developed in adulthood can be "secondary" to other spinal conditions that affect your vertebrae. Other conditions such as degeneration, osteoporosis (loss of bone mass), or osteomalacia (softening of the bones) can cause scoliosis. Scoliosis can also appear following spinal surgery for other conditions. The surgery may cause an imbalance in your spine that leads to scoliosis. Most of these secondary causes of scoliosis are considered degenerative adult scoliosis.

Degenerative adult scoliosis usually begins as low back pain. While there may also be a deformity that causes your back to look abnormal, usually pain is what motivates patients to seek treatment. The pain is probably not coming from the curve, but rather from the degeneration occurring in your spine.

A combination of the degeneration of your spine and scoliosis deformity may cause pressure on nerves and possibly even your spinal cord. This can lead to weakness, numbness, tingling and pain in your lower extremities. In severe cases, pressure on your spinal cord may cause loss of coordination in the muscles of your legs, making it difficult to walk normally.