When Scoliosis is a Red Flag 🚩- Signs You Shouldn’t Ignore

Scoliosis, a sideways curvature of the spine, is commonly seen in adolescents and often doesn’t cause serious issues. However, in some cases, scoliosis can be a red flag indicating an underlying condition that requires urgent attention. Understanding these warning signs can help in early detection and proper management.

When to Be Concerned About Scoliosis

While many cases of scoliosis are idiopathic (with no known cause), certain features suggest a more serious underlying pathology. Here are the red flags to watch out for:

1. Age and Onset

• Early onset (<10 years old) – Scoliosis that appears before puberty can be associated with congenital spine anomalies or neuromuscular conditions.

• Rapid progression – If the curvature increases by more than 1 degree per month, it may indicate a more serious issue, such as a tumor or infection.

2. Pain Characteristics

• Severe or persistent pain – Most idiopathic scoliosis cases are painless. Constant, worsening, or nighttime pain is a warning sign.

• Pain not relieved by rest or worsens when lying down – This may indicate an underlying spinal tumor, infection, or inflammatory process.

3. Neurological Symptoms

• Abnormal reflexes – Hyperreflexia, clonus, or a positive Babinski sign could signal spinal cord involvement.

• Weakness, numbness, or bowel/bladder dysfunction – These symptoms may indicate conditions like syringomyelia, tethered cord syndrome, or a spinal tumor.

• Gait abnormalities – Difficulty walking, coordination issues, or leg spasticity may suggest a neuromuscular disorder affecting the spine.

4. Atypical Curve Patterns

• Left thoracic curve – Most idiopathic scoliosis cases involve a right thoracic curve. A left thoracic curve raises suspicion for syringomyelia, Chiari malformation, or other neurological conditions.

• Short, rigid, or sharply angled curves – Unlike flexible, gradual curves seen in idiopathic scoliosis, a rigid and abrupt curvature might indicate a congenital vertebral anomaly.

5. Systemic Symptoms and Other Findings

• Unexplained weight loss, fever, or night sweats – These could be signs of an underlying infection or malignancy, such as leukemia or spinal tumors.

• Skin abnormalities – Café-au-lait spots, axillary freckling, or neurofibromas suggest neurofibromatosis, a genetic condition associated with scoliosis.

• Dysmorphic features – Short stature, a webbed neck, or joint hypermobility may point to genetic syndromes such as Marfan syndrome, Ehlers-Danlos syndrome, or Turner syndrome.

When to Seek Immediate Medical Attention

If any of these red flags are present, it’s crucial to seek further evaluation. A chiropractor or healthcare provider should refer the patient for MRI, CT scans, or neurological assessment to rule out serious conditions. Early diagnosis and intervention can significantly improve outcomes.

Final Thoughts

While most scoliosis cases are mild and manageable, recognising red flag signs can be life-saving. If you or someone you know has scoliosis with any of these warning signs, consult a healthcare professional as soon as possible. At Epoch Health, we take an evidence-based approach to assessing and managing scoliosis. If you have concerns, book a consultation today.