Expert: Dr. J. Shawn Leatherman - 11/3/2006

Question
Can poor posture, talking on the phone with your head tilted, leaning on one side, carrying a purse, things of the such cause scoliosis?

Answer
Dear Marie,

The short answer is yes and no...let me explain.

The first thing we need to do is understand that scoliosis is not merely an abnormal curvature of the spine. In fact, the laterally displaced curve you see is only one of the many symptoms of a greater genetic/systemic disease. Scoliosis affects most of the major systems of the body: the digestive, musculoskeletal, endocrine, nervous, immune and many times causes associated complications with the respiratory and cardiovascular systems, because of the altered shape and function of the spine, spinal cord and exiting spinal nerves.

Although scoliosis has many different classifications, idiopathic genetic scoliosis accounts for the majority of cases or about 80-85%. While 4% of the general population (male and female) has scoliosis, it is statistically adolescent females who present with greater disease symptomatology at an 8:1 ratio over their male counterparts. Congenital (From Birth) alterations in bone development are common in the development of small scoliotic curves, but are easier to remedy than idiopathic causes.

It is difficult, if not impossible, to accurately predict the amount of curve progression over time in the untreated individual. We do know, however, that scoliosis does not correct itself, and will require an active treatment. Therefore I would have to say that poor posture, poor head position, etc... can not cause a true scoliosis.

Conversely, abnormal types of postural loads can cause changes in the normal curvature of the spine.  Changes seen on radiographic examination may have the appearance of a scoliotic curve, an even be measured in accordance to the published normal values of the spine, but this is not a true scoliosis.  Rather this is a deformation of the spinal structure in response to increased and asymmetrical demands.  So the long answer is yes you can cause structural problems to the spine due to poor posture, carrying a purse or backpack, and other abnormal activities, but this is not a true scoliosis.

The bottom line is that the activities you had mentioned in your questions can and will have negative effects on the spine if they are not stopped.  Your body will deform under pressure, even if the pressure is applied in a small manner continually over time.  This is called Wolf's law and basically states that bone will remodel to increased stress over time.  A high quick stress breaks bone, lower stresses cause deformation...like how a tree will grow crooked if weighted to one side.

Marie, if you are worried about your postures, you should be.  Having proper posture and limiting the amounts of abnormal body positioning will alleviate large amounts of stress from your vertebral column and all the associated muscles.  The result is that your body will be able to function at a higher level, will have less degeneration, and less pain over time.  Any more questions?...feel free to write back.

Respectfully,
Dr. J. Shawn Leatherman