An idiopathic scoliosis diagnosis can be scary, especially when doctors start talking about back braces and spinal fusion surgery. The good news is that informed parents are far more likely to achieve a positive outcome for their children.
It all starts with understanding what scoliosis in children is — and what it isn’t. Scoliosis is a complex condition that causes the spine to curve. Although most people think of the curve itself as the problem, it’s just the symptom of a deeper defect: genetic deficiencies that prevent the brain from detecting and correcting the spine’s abnormal posture and spinal deformity during growth spurts.
While a childhood curve of the spine isn’t common, it’s not as rare as you might think. Around 3-5% percent of kids develop some degree of adolescent idiopathic scoliosis during their teenage years. The vast majority of the time, it’s mild and only requires scoliosis-specific exercise treatment—about 10 percent of the time, the curves progress enough to require surgical intervention.
Type of Scoliosis
In many cases, doctors don’t know what causes a back curve to develop. However, several other types of spinal curvatures can arise during various stages of life, and their origins are less mysterious. Here’s a look at the main types:
In eight out of 10 scoliosis patients, the specific cause is unknown etiology. Idiopathic scoliosis most commonly develops during adolescence, during periods of rapid growth. While about 80 percent of cases of scoliosis occur between ages 10 and 18.
Congenital scoliosis or infantile scoliosis: ages 0 to 3 (Toddlers)
- May require an MRI or x-ray to determine vertebra deformity and, casting may be recommended.
- Often related to spinal cord tethering incases of infantile idiopathic scoliosis
Juvenile Idiopathic Scoliosis: ages 4 to 9 (Early onset scoliosis)
- Depending on severity on radiographs, physical therapy or veptr instrumentation or growing rods may be recommended until skeletal maturity.
Adolescent Idiopathic Scoliosis: ages 10 to 18 (Most common type of scoliosis)
- Mild scoliosis respond well to idiopathic scoliosis rehabilitation programs. At this stage (10-25 degrees), the curve is considered mild. Doctors will often recommend observation of small curves to determine how quickly they’re worsening. But the wait-and-see method has its risks. Below 19 degrees, there’s only a 22 percent chance the curves will continue to progress, but once the spinal curve reaches 20 degrees, the likelihood of progression jumps to 68 percent. Early intervention such as ScoliSMART’s Small Curve Camp can stop scoliosis before it reaches this threshold while reducing existing curvature. Because early detection has such a big impact on treatment outcomes, it’s wise to have your child screened if you suspect scoliosis. If you recently received a diagnosis, it’s never too early to start looking into non-surgical scoliosis treatment options.
- Progressive curves may be recommended for bracing and/ or an idiopathic scoliosis exercise program
- 25-40 degrees:If the child’s spine is still growing when the curve reaches 25 degrees, many doctors will recommend bracing to slow or prevent further progression — unfortunately there is growing evidence that bracing isn’t effective. Alternative therapies have had much greater success at halting spinal curves. For example, the Scoliosis Activity Suit combines active resistance exercises with other treatments to achieve a 90 percent success rate at stabilizing or reducing spinal curves. It’s important to start using such treatments as early as possible because once the curvature reaches 30 degrees, the odds of progression increase dramatically.
- Severe cases are often recommend for fusion surgery
- 50+ degrees: At 50 degrees, most spinal surgeons will recommend spinal fusion surgery in an attempt to reduce the curve and prevent further progression. However, this high-risk surgery can have devastating side effects and rarely leads to a positive outcome. Fortunately, there are many non-surgical scoliosis treatment options that can help support and strengthen the spine without fusing its bones together. It’s important to research all of the options so you can make an informed decision for your child.
To learn more about how to treat the whole scoliosis condition and not only the curve, connect with our passionate providers at ScoliSMART. To explore a non-brace/ non-surgical treatment for your child’s scoliosis problem, you may schedule a no-cost Zoom or phone consultation with a ScoliSMART doctor. Please get in touch with us today!
With functional curves, the spine itself is normal but is pulled into a curve by the surrounding muscles. This usually occurs because of a defect or imbalance in the patient’s posture. For example, children with one leg longer than the other or adults who engage in repetitive asymmetrical activities (such as tennis or golf) can develop this condition.
Adult or Degenerative
While it’s more common to diagnose scoliosis in kids than in adults, this particular type arises after the age of 40. It’s the result of weakening in the spine and vertebra due to age-related conditions seen on radiographs such as arthritis, bone spurs, osteoporosis, and disc degeneration.
Who’s at high Risk? Scoliosis identification & early sign of scoliosis
Although most of the time we don’t know exactly what causes scoliosis, scientists have identified several risk factors that increase the odds of developing it. For example, we know that scoliosis affects seven girls for every one boy. Most early cases occur in girls between the ages of 8 and 14 who have not begun menstruating and have thin, lanky bodies.
Genetics could be the cause of scoliosis. Around 30 percent of scoliosis patients have a family history of the condition, and while there are many factors involved in the developing a spine curve. This means kids who have siblings, parents, or grandparents with the condition should get screened.
Unfortunately, scoliosis is not preventable. Research has ruled out a connection between idiopathic scoliosis and specific behaviors such as poor posture or carrying a heavy backpack.
Visual Indicators of Scoliosis
Multiple visual indicators could suggest a problem. Uneven posture is probably the most obvious, but there are plenty of other visual signs a child may have a curvature, such as one hip being more pronounced, one shoulder blade sticking out more, one leg appearing shorter than the other, or the body leaning to one side.
Parents may also notice that their child’s clothes don’t fit quite right. For example, a shirt or blouse may hang unevenly on the child, or the neckline might be off-center. Along with uneven posture, this could be an indicator your child has an issue — and is undoubtedly a reason to talk to your doctor.
Part of why it is difficult to diagnose scoliosis is because the symptoms, especially early on, are so mild. Patients rarely suffer chronic back pain from scoliosis unless the curve becomes very severe. Still, though seldom associated with the condition, any unexplained and persistent back pain in growing children could well be a sign that they have a problem.
Any excess fatigue occurring after long periods of sitting or standing might also be a symptom of scoliosis. The back muscles have to work harder than usual when suffering from scoliosis to keep the body balanced and, as such, will become fatigued more quickly.
Alert parents can sometimes spot the early signs of scoliosis during a physical exam depending on the severity of the curve like:
- Uneven hemline, pant legs, or shirt sleeves
- Abnormal postures, such as tilted shoulders, rib cage, or hips
- Tilted eye line
- Unexplained back pain
- Low vitamin D levels
- Fatigue after long periods of sitting or standing
- The body that leans to one side
- Slight limp or one leg that appears longer than the other
- Ribs that stick out during a full forward bend
Many schools and pediatricians screen for scoliosis in children at the fifth- or sixth-grade level to catch more cases before they become severe. The Scoliosis Research Society, American Academy of Pediatrics, and American Academy of Orthopaedic Surgeons recommend that girls get screened twice at ages 10, and 12 and boys get screened once at age 13 or 14.
Screenings typically involve a using forward bend test to look for abnormalities in the spine and posture. If visible symptoms are found, the next step is to see a doctor for diagnosis, which typically requires an x-ray.
There are often few noticeable symptoms in the early stages of scoliosis. This can make it challenging to identify, but it also reflects that scoliosis need not be detrimental to your child’s health and well-being. If scoliosis is diagnosed correctly at a young age and treated adequately throughout a lifetime, your child should see no meaningful changes to their lifestyles and habits. They will still be able to perform the sports and activities they enjoy. They should suffer no serious complications (e.g., chronic back pain) as long as they develop a comprehensive treatment plan that they design with a knowledgeable spine specialist.
The sooner treatment begins, the sooner your child can get back to their life.
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