Scoliosis in Children and Adolescents

The spine normally has a S shaped curvature when viewed from the side but when viewed from the back or front, it should always be straight. Scoliosis is a condition in which the spine develops an abnormal sideways curvature in a C or S pattern. The condition is common, affecting 3-5 children in every 1000. It usually develops between the ages of 10 to 15 but may occur at any age due to injury, trauma or other reasons. In most cases, however there is no identifiable cause.

Scoliosis is usually first noticed by the parents or during a general medical checkup. Sometimes just a mild asymmetry is noticed requiring no treatment. Such cases are carefully monitored to see if the curvature progresses. Girls are more likely to have progressive disease.

Though the condition is not usually serious, it may produce some discomfort and affect your child’s posture, movement and self-esteem. Chronic pain and activity limitation may occur with progressive disease.

If you suspect scoliosis in your child, it is best to get it evaluated and treated early to arrest deformity and prevent complications. Your child’s spine is closely examined for strength, flexibility and areas of pain. Functional limitations are noted. An X-ray or MRI is obtained to determine and measure spine curvature and look for any other abnormalities.

Treatment is advised based on the degree of spine curvature, the skeletal maturity of the child and onset of symptoms. If the spine is curved lesser than 25 degrees, a wait and watch approach is employed. For moderate curvature beyond 25 degrees, a brace is prescribed to prevent the disease from progressing. Braces are usually recommended for children and adolescents whose bones are not fully developed and are worn until the child reaches skeletal maturity. Physical therapy may be recommended to improve range of motion and strength. Manual therapy or massage can help restricted muscles and joints and improve movement patterns. Specific therapy addresses any functional or activity limitations. Your doctor or therapist may also include other modalities such as heat, ice, ultrasound or electrical stimulation as part of your child’s individualized treatment program. The condition and progress of your child are monitored throughout the course of treatment to ensure he or she reaches their personal best and improves their quality of life significantly. Though rarely necessary, surgery is recommended to manage advanced cases of scoliosis.