Scoliosis (Child)

Scoliosis is a problem that causes an S-shaped or C-shaped curve of the spine. The most common type is called idiopathic scoliosis. Idiopathic means that it has no known cause. It usually first appears in children at a time of rapid spine growth. This is from age 10 to the early teens. Scoliosis can rarely happen in younger children and infants.

A mild curve may get worse as a child grows. This may be until ages 18 or 20. Therefore regular exams are recommended. At some point the curve may become bad enough to require the use of a brace. This will be used to stop it from getting worse. With moderate curves, muscles are overworked. This can cause spasms or pain when standing or walking for a long time.

Scoliosis can run in families. Mild scoliosis causes no symptoms and may go unnoticed. A child who has a parent, brother, or sister with the condition should have yearly checkups to screen for early signs of this problem. 

The variety of treatment options for scoliosis includes physical therapy, bracing, and surgery. Determining the best course of treatment is based on the type of scoliosis, how severe the curve is and, the patient’s age.

Outpatient Physical Therapy with Scoliosis specific exercises, at home exercises and observation may be used as a conventional treatment for early and mild spinal curvatures to keep them from getting worse. Physical Therapy may also be indicated for strengthening and stretching the back muscles in order to reduce spasms and control pain.

A brace may be used for mild to moderate spinal curves to keep them from getting worse. Children who must wear a brace will have to do so for all but a few hours per day. The brace will be worn until their spinal bone growth is complete. This is about ages 17 to 18 in girls and ages 18 to 19 in boys. 

If bracing doesn’t work or if the curve is advanced at the time it is first noticed, surgery may be recommended. Surgery involves fusing the bones of the spine together to make the spine straight. A metal rod or other device may be left in the body to support the spine after surgery.

Regular exercise is a healthy activity for overall physical and emotional health. Your child's physical activity shouldn’t be restricted because of scoliosis, unless told otherwise. Ask your child’s healthcare provider if any sports or activities are off limits when the brace is worn.

Home care

• Encourage your child to walk, run, and participate in sports. Soccer and gymnastics are good examples. These activities keep the body strong and give a sense of well-being. They also strengthen the abdomen and back muscles. This will help support the spine and may prevent or reduce pain.
• If physical therapy is part of your child’s treatment for scoliosis, encourage your child to perform the at home exercises as prescribed by the therapist.
• If your child needs to wear a brace, stress the importance of wearing it as directed. At the same time, be sensitive to body image issues associated with wearing a brace.
• It is not unusual for children to refuse to wear a brace. This can cause heated discussions and stress for you and your child. In this case, ask your healthcare provider, pediatrician, or orthopedic doctor for the name of a mental health professional who helps children and families deal with chronic medical problems.  
• Massage may help with muscle soreness and pain.  
• Keep all follow-up appointments. Your child’s spinal curvature can be measured and, if needed, changes can be made to treatment plans.
• If your child has idiopathic scoliosis and has siblings, have them screened yearly for early signs of scoliosis.

Follow-up care

Follow up with your healthcare provider, or as advised.