Scoliosis is a sideways curve of the spine, often with a twist of the vertebrae. Scoliosis in children is most often found between the ages of 10 and 15, when children are growing fast. In adults it is either left over from childhood or develops over the years from wear of the vertebrae. A related but different condition is kyphosis: an excessive forward curve of the upper back (a rounded or hunched back).
Symptoms
- One shoulder is higher than the other.
- One shoulder blade sticks out more, especially when bending forward.
- The waist isn’t symmetrical: on one side the arm hangs closer to the body.
- The body seems to lean slightly to one side.
- In adults: back pain and tiredness after standing or walking.
In children, scoliosis usually doesn’t hurt. That is why it is often a parent, a PE teacher or the GP at a routine check-up who notices it.
Why it happens
In most children the cause isn’t known. This is called idiopathic scoliosis, and it is more common in girls and runs in some families. A difference in leg length or poor posture can cause a slight tilt that isn’t true scoliosis. Less often the cause is a congenital change in the vertebrae or a neurological condition. In adults, scoliosis often comes from wear of the discs and joints (degenerative scoliosis). Scoliosis in children can increase while the child grows, so check-ups matter most in the years of fast growth.
A heavy backpack and poor sitting posture don’t cause scoliosis, but they add to tiredness and back pain.
How we treat it
Kaloyan starts by looking at your posture, doing a forward bend test and reviewing the X-rays. Bring all the X-rays you have, because comparing them over time shows whether the curve is growing. The X-ray is used to measure the angle of the curve (the Cobb angle), which shows its degree. For mild and moderate scoliosis, the treatment is corrective exercises: exercises that strengthen the muscles of the back and abdomen and teach correct posture and breathing. With children, Kaloyan works in front of a mirror and with games to keep it interesting.
There are usually 1–2 sessions every 2 weeks, and at home the child exercises for 20–30 minutes every day. The exercises don’t straighten the spine completely. They improve posture and strength, and with children Kaloyan monitors the curve together with the orthopaedic doctor while they grow. If the angle is larger, an orthopaedic doctor also needs to decide about a brace.
With adults who have scoliosis, Kaloyan works more on pain and back endurance. The exercises are for strength and mobility, and part of each session is about how to sit, stand and lift in daily life.
What you can do yourself
- Encourage your child to play sport. Movement is good, but it doesn’t replace the exercises.
- Carry the backpack on both shoulders.
- If your child wears a brace, they should wear it for as many hours as the orthopaedic doctor has advised. The exercises go together with the brace, not instead of it.
- During fast growth, check your child’s back with the bend test once every few months.
When to see a doctor first
If the scoliosis hasn’t been confirmed with an X-ray, Kaloyan will refer you to an orthopaedic doctor first. It is also a good idea to see a doctor when:
- the curve is clearly visible or grows over a few months;
- your child has severe back pain, especially at night;
- there is numbness or weakness in the legs, or problems with urinating;
- the scoliosis appeared together with other complaints, for example changes in the way your child walks.
