What is scoliosis?
Scoliosis is a sideways curving and twisting of the bones of a child’s spine.
What causes scoliosis?
Idiopathic scoliosis
Most cases of scoliosis develop in otherwise healthy children and are idiopathic, which means there’s no obvious cause.
Idiopathic scoliosis can start at any age during childhood and adolescence, but it most commonly starts during a growth spurt, usually when children are 10-11 years old.
Neuromuscular scoliosis
Some children have neuromuscular scoliosis, which is caused by weak muscles or nerves. This type of scoliosis affects children with conditions like cerebral palsy, spina bifida, muscular dystrophy and osteogenesis imperfecta.
Congenital scoliosis
Congenital scoliosis is when scoliosis is present at birth and is caused by poorly formed bones in the spine. Sometimes congenital scoliosis might not show up until later in childhood.
Other causes and related factors
Conditions that affect connective tissue like Marfan Syndrome can also cause scoliosis.
Scoliosis tends to run in families, so genetics might play a part in causing it.
Scoliosis affects 1-5% of children. It’s more common in girls than boys, particularly in girls aged 10-13 years.
Scoliosis symptoms and signs
In a child with scoliosis, you might see:
- unevenness in the shoulders and waistline
- unevenness in the shoulder blades – one might stick out more
- the pelvis shifted to one side
- the head slightly tilted
- unevenness in the shape of the rib cage at the back, when the child bends forward.
Often a child with scoliosis doesn’t experience any symptoms. But common symptoms are a mild ache in the lower or middle back area.
Children grow very quickly so the curve can develop and get worse very quickly.
What to do if your child has scoliosis symptoms
If you think your child might have scoliosis, it’s a good idea to see your GP. You might be referred to a physiotherapist or an orthopaedic surgeon for further tests.
Early detection is very important.
Tests for scoliosis
Doctors or physiotherapists will look at the way a child stands, sits and moves to assess for scoliosis. They might also use the forward bending test.
This test involves the following steps:
- Stand with feet together and parallel.
- Place palms of hands together with arms straight.
- Bend forward towards feet with fingertips pointing between the big toes.
- The doctor or physiotherapist will check the shape of the back. If one side of the back is at least 1 cm higher than the other side, it might be scoliosis.
To confirm scoliosis, doctors usually order a scoliosis X-ray or a full spine X-ray with images of a child’s front and sides.
An MRI is sometimes ordered for children when there’s a chance of finding an underlying cause. Or an MRI might be ordered for children who need surgery.
Treatment for scoliosis
Treatment depends on how severe the scoliosis is and how mature the child’s bones are.
Children with scoliosis might get treatment and support from orthotists, physiotherapists, psychologists and orthopaedic surgeons.
Mild scoliosis
For children with mild scoliosis who are still growing, doctors usually recommend close monitoring and X-rays every 4-6 months.
Moderate scoliosis
For children with moderate scoliosis who are still growing, doctors might recommend a brace.
If your child needs a brace, they’ll wear it under their clothes for 23 hours a day, with one hour off for exercising and showering. A brace won’t correct a curve, but it might help to stop it getting worse as your child grows. Braces significantly decrease the need for surgery.
Severe scoliosis
Surgery is recommended only in severe cases of scoliosis, when doctors think the curve is likely to keep getting worse, even when a child has stopped growing. Or doctors might recommend surgery if a child has pain and poor quality of life because of the scoliosis.
Surgery most commonly involves fixing metal rods to the spine to realign and stabilise the affected areas. If your child has this surgery, they’ll usually stay in hospital for 5-7 days.
Back care like good posture and physical activity can help with managing any back pain that comes with scoliosis.
How to prevent scoliosis
There are no known ways to prevent scoliosis.