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Scoliosis is a condition in which the spine, in addition to the normal front to back curvatures, has an abnormal side-to-side “S”- or “C”-shaped curvature. The spine is also rotated or twisted, pulling the ribs along with it. The condition isn’t rare. It mainly affects girls — many of whom have mild forms of scoliosis, are never even aware of it, and never need treatment.
Idiopathic scoliosis is the most common type of scoliosis, most commonly seen in adolescent and pre-adolescent girls. “Idiopathic” means that there is no definite cause. Nothing you or your child did caused it, and there’s nothing you could have done to prevent it. There are different degrees of severity, but most cases require no intervention. Scoliosis tends to run in families, and girls are eight times more likely than boys to develop the condition.
Because of all the possible combinations of curvatures, scoliosis can look quite different from child to child. Common signs and symptoms of scoliosis may include:
• uneven shoulder heights
• head not centered with the rest of the body
• uneven hip heights or positions
• uneven shoulder blade heights or positions
• prominent shoulder blade
• when standing straight, uneven arm lengths
• when bending forward, the left and right sides of the back appear asymmetrical
Symptoms that suggest scoliosis can resemble those of other spinal conditions or deformities or may result from an injury or infection.
Most spinal problems are detected by a child’s parents or pediatrician or during school screenings.
Scoliosis is a spinal abnormality. It’s neither a cause nor a result of poor posture.
Three to five out of every 1,000 children develop spinal curves that are considered large enough to require treatment. Idiopathic scoliosis is the most common type, and more common in girls than boys.
Most scoliosis isn’t painful in adolescents and children. But there is the potential for significant risk of pain developing in adulthood.
The lungs may be affected by severe scoliosis, particularly early-onset scoliosis. But even a severe spinal deformity doesn’t usually affect the function of other organs.
The possibility of a genetic component of spinal defects is still being studied. What’s known is that idiopathic scoliosis does tend to run in families. If you have a child with a spinal defect, it’s advisable to consult a geneticist, who can take a family history and discuss your particular situation.
In most cases, there is no definite cause (idiopathic scoliosis) of, or way to prevent, the spine’s failure to grow as straight as it should. Heredity may play a part, but no one genetic link has been confirmed.
Scoliosis will usually become apparent as your child grows. Consult your pediatrician if her:
• shoulders are of uneven heights
• head isn’t centered with the rest of her body
• hips are of uneven heights or positions
• shoulder blades are of uneven heights or positions
• arms hang beside her body unevenly when she stands straight
• left and right sides of her back appear different in height when she bends forward
Some of the questions you may want to ask your doctor are:
• What is happening to my child, and why?
• What tests are needed to diagnose my child?
• What actions might you take after you reach a diagnosis?
• What will happen with growth over time?
• Will there be restrictions on my child’s activities?
• Will there be long-term effects?
• What can we do at home?
Risk factors for developing idiopathic scoliosis (the most common form) include:
• age: With the onset of puberty, during the maximum growth spurt, signs and symptoms of scoliosis may begin to manifest themselves.
• gender: Girls are five to eight times more likely than boys to develop scoliosis.
• heredity: Idiopathic scoliosis tends to run in families.
Besides the typical issues any teenager faces — from social acceptance to body changes and more — if you’re undergoing bracing and physical therapy for scoliosis, you’ll also have to deal with medical appointments, feeling different and assuming a big personal responsibility for maintaining your own good health. If your scoliosis is mild or moderate, you may wonder why we need to monitor and treat it, since it may not be painful or bothersome.
It’s important for you to know that if left untreated until you’re an adult, your moderate or severe scoliosis can worsen, resulting in curves that cause cosmetic disfigurement, back pain and, in severe cases, difficulty breathing.
Treatment in adulthood after the curve has already become severe may be somewhat less successful than treatment during adolescence. By treating your progressive curves early, we hope to keep them from becoming problems when you reach adulthood.
It also may help you to know that you can participate in sports and other normal activities; your general health will improve with an active lifestyle. If you’ll be wearing a brace, most braces can be worn, unseen, underneath your clothes and can be removed for sports.
If you feel overwhelmed, depressed or anxious through this important time in your transition to adulthood, speak to your doctor or counselor to get help. Check out Curvy Girls for teens with scoliosis and be sure to find a group in your area.
As your child grows, your orthopedist will monitor her curve through regular check-ups. Be sure to follow the regular well-child checkup schedule. Encourage her to participate in sports and/or school activities. These will add greatly to her general health and sense of well-being.
Click here to view the Scoliosis Glossary.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”