Patient education: Scoliosis (The Basics)

What is scoliosis? — 

This is a condition that makes the spine (backbone) curve sideways, like the letter "S" or "C." Often, the spine also twists so the back is not flat. If the spine twists, 1 side of the back sticks out more than the other (picture 1).

Scoliosis usually starts as the spine is growing during childhood or the teen years. It can be caused by a problem a person is born with, a disease, or an injury. It might also run in families. But in many cases, doctors do not know what causes scoliosis.

What are the symptoms of scoliosis? — 

It usually does not cause symptoms. A doctor or nurse might find it during a child's routine checkup. Or the school nurse might notice it during a scoliosis check at school.

You or your child or teen might also notice:

●A shoulder, shoulder blade, hip, or breast that is higher than the other

●A shoulder blade that sticks out farther than the other

●A skin fold on 1 side of the waist

When symptoms do occur, they can include:

●Back pain

●Trouble breathing – If the spine curves a lot, the lungs might not have room to work correctly. This can cause breathing problems. Scoliosis this severe usually starts when a child is younger than 10. The scoliosis is usually obvious before breathing problems happen.

Should my child see a doctor or nurse? — 

It depends on your child's symptoms. See a doctor or nurse right away if your child limps, does not want to walk, or has 1 leg that feels weak. Make an appointment to see the doctor or nurse if:

●Everyday activities make your child's back hurt.

●Your child has severe back pain, or back pain that gets worse over time.

Is there a test for scoliosis? — 

Yes, there are several. They include:

●Forward bend test – This shows if the spine is twisted so 1 side of the back is higher than the other. The doctor or nurse can also measure how much the spine is twisted.

●X-ray of the spine – This can show how much the spine curves from side to side. Other kinds of X-rays can show if the scoliosis is likely to get worse as the child grows. An X-ray can also help the doctor tell if another problem in the body is causing the scoliosis.

Depending on the situation, the doctor might also order an MRI. This is an imaging test that creates pictures of the inside of the body. The pictures show more detail than an X-ray.

Your child's doctor or nurse will do an exam and ask questions. Along with tests, this should tell the doctor or nurse if your child has scoliosis and what is causing it.

How is scoliosis treated? — 

Treatment is different for each person. Mild scoliosis does not need to be treated. But severe scoliosis can cause breathing problems and heart problems, and needs to be treated.

Your child's doctor will talk with you about the different treatment options. They depend on whether the scoliosis is likely to get worse or not. They include:

●No treatment – If a child is finished growing and their spine does not curve a lot, treatment is usually not needed.

●Watchful waiting – If a child is not finished growing but the scoliosis is not severe, the doctor might suggest watching for changes. The child might need to see a specialist if the doctor or nurse cannot tell exactly how much the spine curves or if the scoliosis starts getting worse.

●Bracing – A child might need a brace to help straighten their spine if:

•They still have a lot of growing to do, and

•The scoliosis gets worse in 6 months or less

●Surgery – If the spine curves a lot, the doctor might recommend surgery even if a child is done growing. This is because severe scoliosis usually gets worse with time. The surgery joins vertebrae (bones in the spine) together to help them line up correctly. This can keep the curve from getting worse.

Can scoliosis cause problems during pregnancy? — 

Scoliosis does not usually cause problems with pregnancy and giving birth.

Can my child live a normal life? — 

Probably. Most people with scoliosis do not have long-lasting problems. Some people have back pain, but it is usually not serious.

Severe scoliosis that is not treated can damage the heart and lungs. If scoliosis is caused by a serious medical condition, that condition can cause problems, too. Your doctor or nurse will watch for problems and treat them if they happen.

More on this topic

Patient education: Upper back pain (The Basics)
Patient education: Do I need an X-ray (or other test) for low back pain? (The Basics)
Patient education: Anterior cervical spinal fusion (The Basics)
Patient education: Posterior cervical spinal fusion (The Basics)
Patient education: Thoracic or lumbar spinal fusion (The Basics)

Patient education: Back pain in children and adolescents (Beyond the Basics)