More than 300 members of MyMSTeam report living with scoliosis — a curvature of the spine. Multiple sclerosis (MS) can cause scoliosis, but it’s also possible to develop scoliosis for other reasons.

Does MS increase the risk of scoliosis? What can you do to reduce back pain and improve the posture and mobility issues associated with scoliosis? Read on to learn more about the relationship between scoliosis and MS.

What Is Scoliosis?

Scoliosis is a sideways curving of the spine, usually in the thoracic or lumbar areas (middle to lower back). A person can be born with scoliosis or develop it as a teenager or an adult. Degenerative scoliosis, developed from wear and tear on the joints, is the most common type of adult scoliosis.

Like anyone else, people with MS may have scoliosis which is unrelated to multiple sclerosis. However, they can also develop neuromuscular scoliosis when MS attacks the central nervous system and interferes with communication between the nerves and the muscles around the spine. MS is one of several neuromuscular diseases associated with neuromuscular scoliosis.

Back pain is very common for people with and without MS, and it can have many causes. Between 10 percent and 16 percent of people with MS have back pain, and it’s often related to muscle pain and having to sit or stand for long periods of time. MS back pain due to scoliosis is rare.

What Causes Scoliosis in MS?

Neuromuscular scoliosis that develops as a complication of MS is also referred to as secondary scoliosis, since it is caused by another health condition.

Scoliosis can also be linked to degenerative arthritis from wear and tear of the vertebrae. Curvature of the spine is also associated with osteoporosis, a condition caused by low bone density — which people with MS have a greater risk for. Degenerative scoliosis may be worsened by weakness of the muscles that support the spine.

MS can also cause numbness or paralysis, damage to the spinal cord, or other neurological issues that affect the mobility of the spine. All of these factors can make it difficult for the muscles and nerves of the spine to properly align. This can lead to balance impairment. In other words, one could have degenerative scoliosis from arthritis or osteoporosis, which could then be made worse through damage caused by MS lesions, leading to more serious spinal curvature and dysfunction.

How Does Scoliosis Affect People With MS?

“It’s hard having problems with my back due to my scoliosis, and my MS is no help,” one MyMSTeam member wrote. “I’ve had to accept a wheelchair into my life just a few weeks ago. I can still walk several steps, but my balance is shot due to MS and scoliosis,” another member said.

Most adults with scoliosis have mild symptoms and don’t need treatment. Typically, the neuromuscular scoliosis associated with MS does not cause back pain, unless the curve in the spine is severe.

In severe cases of scoliosis, the curvature is so pronounced that it can affect posture or cause pain and neurological problems. The shoulders or waistline may appear uneven, with one hip higher than the other or a protruding rib cage. Some people living with scoliosis lean to one side or lean forward while sitting in a wheelchair or while standing. People who use a wheelchair and have scoliosis often have more severe curvature.

The effects of scoliosis vary widely, but it can cause significant disability for some. Some people can experience loss of height, numbness, weakness, or an abnormal alignment of their pelvis and hips. The spinal curve for people with neuromuscular sclerosis does tend to get worse over time.

If scoliosis is severe, there can be complications from the condition. These may include:

• Fatigue
• Poor posture
• Balance problems
• Difficulty walking
• Bladder and bowel issues
• Muscle weakness
• Numbness

Extreme cases of scoliosis can also limit breathing.

When To Speak to Your Doctor

If you’re experiencing changes in your posture, worsening back pain, or more difficulty walking, it’s time to speak to your doctor. If you have sudden new weakness or numbness in your arms or legs, or urinary or bowel incontinence, it could be the sign of a more serious problem. Ask your doctor for an evaluation right away.

Diagnosis

Your doctor will perform a thorough physical exam of your spine and a neurological exam to test your nerves, muscle function, and reflexes. They will also ask about your family history, pain, and any symptoms you may be having. If your doctor suspects scoliosis, they will order X-rays of the front and side of your spine while you’re standing up, as well as when you’re bending over.

Treatment

Treatment for adult scoliosis is geared toward treating symptoms, decreasing pain, and improving quality of life. Fixing the abnormal curve of the spine is not necessarily the goal. Treating symptoms of scoliosis usually includes:

• Over-the-counter pain medications
• Strength exercises to improve posture and flexibility
• Physical therapy
• Maintaining a healthy diet and appropriate physical activity
• Steroid injections around the nerves or spinal cord, if oral medications don’t help

If you smoke and are concerned about your scoliosis, consider quitting. Smoking can worsen the process of spine degeneration. Most experts recommend avoiding chiropractors, as studies show that there is no evidence that chiropractic treatment improves scoliosis.

Surgery is a last-resort option, since recovery can be challenging. The goals of surgery are to stabilize the spine, help with balance, and alleviate pressure on nerves. Surgery is reserved for severe cases, including when:

• Severe pain is not relieved by other treatment options
• Spinal curvature affects your breathing, walking, and daily living
• Disability is worsening over time

It’s worth noting that people with neuromuscular conditions like MS tend to have more complications than other people after surgery to correct spinal deformities.

General Tips To Maintain Good Posture

You can make small changes to help your postural stability while walking or standing. These include:

• Keeping your head and shoulders as upright as possible
• Looking a few feet in front of you, instead of looking down at your feet
• Keeping your head in line with your shoulders and not off to one side
• Keeping your knees slightly bent and your feet slightly apart, so as not to shift your weight to one side

Ask your doctor how to best protect your posture and manage back pain over time.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 198,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS and scoliosis? Have you found helpful ways to manage both? Share your experience in the comments below, or start a conversation by posting on your Activities page.