4 days ago
Not just bad posture: The hidden toll of scoliosis on health and life
IT starts with a slouch, a shoulder higher than the other or a subtle curve that few notice. For individuals living with scoliosis, the condition goes beyond a curved spine. Often overlooked are the physical discomfort, restricted breathing, and emotional toll that quietly shape daily life.
When people hear the word "scoliosis," most envision a curved back or uneven posture. But this spinal condition, which affects between 600,000 to 900,000 Malaysians, goes far beyond the visible, weaving its way into the lungs, gut and even mental health.
The most common type, idiopathic scoliosis, often emerges in adolescence. Yet its impact can stretch far into adulthood. Less common forms like congenital (present from birth), neuromuscular (linked to disorders like cerebral palsy) and degenerative scoliosis (typically affecting older adults) add further complexity to the condition.
While early diagnosis is key, awareness around scoliosis' broader effects remains limited, especially in Malaysia.
Recognising this, Sunway Medical Centre Damansara (SMCD) is working to shed light on the hidden consequences of scoliosis through a more holistic approach to spine care; one that considers the full person, not just the curve.
SMCD Consultant Orthopaedic and Spine Surgeon, Dr Tan Jin Aun, emphasised that scoliosis is more than just a spine issue.
'Secondary health effects tend to occur when curvature becomes severe, generally between 70 to 100 degrees. At this stage, the impact can vary depending on several factors of which include the age and overall health of the patient.
'The location of the curve and the type of scoliosis also influence whether respiratory or digestive complications arise,' he said.
Understanding scoliosis: From detection to treatment Scoliosis may begin as a slight slouch or curve, but for those living with it, it often means enduring breathlessness, discomfort, emotional strain and quiet resilience. Photo: Edited via Canva
For example, in moderate to severe cases, the spine's abnormal curve can distort the ribcage, pressing into the lungs. This can cause what is known as restrictive lung disease, where patients find it harder to take deep breaths.
Dr Tan added, for thoracic curves, an angle of 70 degrees or more may start limiting lung expansion while a curve of more than 100 degrees can lead to severe pulmonary restriction and thus, difficulty in breathing or decreased effort tolerance.
In the abdomen, similar curvature — especially lumbar curves beyond 90 degrees — can create pressure that leads to digestive issues such as bloating, acid reflux and constipation. These symptoms are frequently misdiagnosed or brushed off as unrelated gut problems.
While physical discomfort is often acknowledged, the emotional and psychological toll of scoliosis frequently goes unnoticed. Living with a visible difference or chronic fatigue can affect more than body image, it can deeply impact mental well-being.
'In my experience, patients with mild scoliosis are generally healthy and often unaware of the condition. They usually do not present with anxiety or depression linked directly to scoliosis.
'That said, self-esteem issues do arise, especially in cases where bracing is required,' Dr Tan shared.
Bracing is one of the primary non-surgical treatments for growing children with scoliosis. But while it can slow or halt curve progression, it comes with its own emotional challenges, especially when worn up to 23 hours a day over several years.
Dr Tan mentioned it is important to prepare both the patient and their parents beforehand.
'The decision to move forward with bracing should always consider both physical outcomes and psychosocial wellbeing. There is no one-size-fits-all answer; it has to be a shared, well-informed decision,' Dr Tan emphasised.
At SMCD, scoliosis care is not just about straightening a spine, it is about protecting quality of life. With a comprehensive, multidisciplinary approach, the hospital considers respiratory health, digestive function and mental wellness as part of the treatment journey.
Diagnosis typically begins with a clinical evaluation and spinal X-rays to assess curvature type and severity. For patients whose spines have stopped growing, observation combined with physiotherapy and strength training may be sufficient.
'Patients with mild curvature – especially those who have reached skeletal maturity – are often managed conservatively.
In these cases, we monitor the spine annually, refer for physiotherapy to improve posture and muscle strength and support families with accurate, realistic guidance,' Consultant Orthopaedic Surgeon (Spine Surgery and Interventional Pain Management) Dr Deepak Ajit Singh said.
For those requiring surgery, SMCD leverages advanced tools such as spinal navigation and neuromonitoring to increase precision and reduce surgical risk. Yet, no matter the treatment, Dr Deepak stressed one crucial element.
'A simple spinal radiograph is often all that is needed to determine whether scoliosis is present. If we detect it early, we can plan the right course of action. Whether it is monitoring, bracing or in some cases, surgical correction.
'After all, it is not just about treating the spine but rather protecting long-term quality of life,' he added.
In many cases, early signs of scoliosis — such as uneven shoulders, a tilted pelvis or a visible back hump — go unnoticed or are dismissed as poor posture. This leads to many Malaysians delaying a check-up until the condition is advanced.
By highlighting the full scope of scoliosis' impact, SMCD hopes to encourage more timely intervention and foster a broader public understanding of what it truly means to live with the condition.
