Many adults with scoliosis are asymptomatic and, in some studies, the incidence of low back pain is no higher than in the general population.

When a patient with scoliosis presents with acute low back pain, the pain generally is increased with walking or standing, and relieved when lying down. The pain may worsen the longer the patient is ambulatory. The patient may also complain of pain with certain movements.

Scapular asymmetry, lateral prominence, waist asymmetry, or asymmetrical shoulder levels suggest scoliosis.

Radiographs: The AP view is used to confirm and measure degree of scoliosis; the lateral view allows exclusion of spondylolisthesis.

If the curve is less than 40 degrees, treatment is generally non-surgical. Physical therapy is extremely helpful for appropriate strengthening and stretching exercises. Bracing may be helpful in some patients.

Eric Vanzura