A 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 is — and what it isn’t. Scoliosis is a complex neuromuscular condition that causes the spine to curve. Although most people think of the curve itself as the problem, it’s actually just the symptom of a deeper defect: a neuro-hormonal imbalance that prevents the brain from detecting and correcting the spine’s abnormal posture.
While scoliosis isn’t common, it’s not as rare as you might think. Around 3-5% percent of kids develop some degree of 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.
Types of Scoliosis
In most cases, doctors don’t know what causes scoliosis. It most commonly arises during adolescence and can’t be attributed to a specific cause. However, there are several other types of scoliosis that can arise during various stages of life, and their origins are less mysterious. Here’s a look at the main types of scoliosis:
Idiopathic. In eight out of 10 scoliosis patients, the specific cause is unknown. Idiopathic scoliosis most commonly develops during adolescence, during periods of rapid growth. While about 80 percent of cases occur between ages 10 and 18, idiopathic scoliosis can be discovered at any age.
- Infantile: ages 0 to 3
- Juvenile: ages 4 to 9
- Adolescent: ages 10 to 18
- Adult: older than 18
Functional. With functional scoliosis, 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.
Degenerative. While it’s far more common to find scoliosis in kids than in adults, this particular type arises after the age of 40. It’s the result of weakening in the spine due to age-related conditions such as arthritis, bone spurs, osteoporosis and disc degeneration.
Who’s at Risk?
Although most of the time we don’t know 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 also play a role. Around 30 percent of scoliosis patients have a family history of the condition, and while there are many factors involved in the development of scoliosis, genetics account for about 38 percent. 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.
Stages of Scoliosis
The early signs of scoliosis in children can be difficult to detect. With mild curves, symptoms are subtle and easily overlooked. It’s often not until the curves become severe than the condition begins to cause pain or difficulty moving.
However, alert parents can sometimes spot the early signs of scoliosis:
- Uneven hemline, pant legs or shirt sleeves
- Abnormal posture, 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
- 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
To catch more cases before they become severe, many schools and pediatricians screen for scoliosis in children at the fifth- or sixth-grade level. The Scoliosis Research Society, American Academy of Pediatrics and American Academy of Orthopaedic Surgeons all 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.
The recommended treatment depends on the size of the curve, which is used to determine what stage the scoliosis is in. While not all scoliosis cases will continue to advance, the odds of progression increase dramatically as the curve grows.
0-10 degrees: No scoliosis is detected.
10-25 degrees: At this stage, scoliosis 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.
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 — despite growing evidence that bracing doesn’t work. Alternative therapies have had much greater success at halting scoliosis. 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 leap to 90 percent.
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.
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.