Scoliosis in Children & Adolescents

What Is Scoliosis

When looking at the spine from behind, it usually descends in a straight line from the base of the skull to the pelvis.  With scoliosis, the spine curves to the side(s) into a C shape or a reverse S shape.  Scoliosis is present when the spine has one or more curves greater than 10° when measured on an x-ray.

Scoliosis is 3-dimensional. Not only is the spine curving it’s also rotating.  This rotation may affect the shoulder girdle, rib cage, and pelvis.

Signs of Scoliosis in Children & Adolescents

Sometimes children and adolescents with scoliosis have the following signs:

  • One shoulder looks higher than the other
  • One shoulder blade appears larger or pokes out more in the back body
  • One hip looks higher than the other
  • The pelvis shifts to one side
  • One side of the back may have a prominence, sometimes called a rib hump
  • Head is not centered over the body
  • Clothes hang unevenly on the body
Signs of Scoliosis

What Causes Scoliosis in Children & Adolescents

Adolescent Idiopathic Scoliosis

Idiopathic means cause unknown.  The cause of more than 80% of scoliosis cases is unknown.  Scoliosis appears to involve a genetic tendency and many families have more than one family member diagnosed with scoliosis.

Other Causes of Scoliosis:

  • Congenital scoliosis. These types of scoliosis involve the vertebra of the spine and their development prior to birth.  Part of one vertebra (or more) does not form completely, or the vertebrae do not separate properly.
  • Neuromuscular scoliosis. Any conditions that affect the nerves and muscles can lead to scoliosis.  Conditions such as cerebral palsy, spinal bifida, muscular dystrophy, and spinal cord injuries can cause scoliosis.
  • Genetic conditions. Genetic conditions such as Marfan syndrome, Ehlers-Danlos syndrome, and Down syndrome may case scoliosis.
  • Injuries, infections, or degeneration of the spine can also cause scoliosis.

Risk Factors for Adolescent Idiopathic Scoliosis

Risk factors for developing adolescent idiopathic scoliosis include age, sex, and family history.  Signs of scoliosis generally begin in adolescents.  In childhood, idiopathic scoliosis occurs in both girls and boys.  As children enter adolescence, girls are five to eight times more likely to have their curves increase in size and require treatment.  Scoliosis appears to involve a genetic tendency and many families have more than one family member diagnosed with scoliosis.

Adolescent Idiopathic Scoliosis Risk Factors
Adolescent Idiopathic Scoliosis

Symptoms of Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis usually does not cause pain, neurological dysfunction such as weakness or numbness in the legs, or respiratory problems (shortness of breath).

Adolescent Idiopathic Scoliosis Diagnosis

The Scoliosis Research Society (SRS) deems the forward-bend Adams test with the use of a scoliometer (an instrument that measures rotation) as an effective screen for scoliosis.  The American Academy of Orthopedic Surgeons, SRS, Pediatric Orthopedic Society of North America, and American Academy of Pediatrics all believe that screening examinations for scoliosis should be part of the medical home preventive services visit for females at age 10 and 12 years, and for males, once, at age 13 or 14 years.  This means that pediatric primary care physicians should screen children at these ages.

Scoliosis in children is sometimes discovered by parents, coaches and teammates, as well as other movement teachers such as dance teachers.  Go to your doctor if you notice signs of scoliosis in your child. Mild curves can develop without you or your child knowing it because they appear gradually and usually don’t cause pain.

Plain X-rays can confirm the diagnosis of scoliosis and reveal the degree of the curvature. Repeated radiation exposure may become a concern because some people need multiple X-rays over a lifetime to monitor curve progression.  Certain imaging systems, such as the EOS imaging, use lower doses of radiation to create a 3D model of the spine

Treatment for Adolescent Idiopathic Scoliosis

Treatment for scoliosis depends upon the severity of the curve and skeletal maturity at the time of diagnosis.  When scoliosis is detected, the treatment goal is to stop the progression of the curve.  In the last ten years, researchers published a boom of evidence on the efficacy of conservative treatment for scoliosis in adolescents.   These treatments are most effective for individuals with smaller curves who haven’t reached skeletal maturity, which necessitates early detection.  We now have research that supports bracing and the amount of time spent in a  brace [1], the type of brace used [2], physiotherapy scoliosis-specific exercises [3] (mostly widely available in the US is Schroth Therapy [4]), as well as the need to monitor these adolescents for vitamin D deficiency [5].

Doctors may recommend spinal fusion surgery for select patients.

Working with Wellness In Motion

Working with adolescents who have scoliosis is one of the things we do best at Wellness In Motion through Pilates, yoga, and strength training.  First and foremost, we help your teen understand their individual scoliosis curve pattern and some things about scoliosis in general.  We love to educate!  Understanding the individual’s curve pattern is the foundation for working on postural alignment and knowing how to adjust out of the scoliosis pattern.

We also focus on increasing core muscle strength and postural training. Increasing core muscle strength helps stabilize the spine.  Postural training helps resist gravity and compression.  This work assists in breaking the asymmetric loading pattern.

And finally, we love to work on functional strength and brainstorm lifestyle ideas.

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