Scoliosis In Children: What Causes It And How To Treat
sagari gongala 
Image: iStock
Jump to:
- Scoliosis: A bend in the spine?
- What causes scoliosis?
- How does a kid know he has scoliosis?
- Diagnosing scoliosis in children
- Does scoliosis require treatment?
Our spine is a critical part of our body. A vital portion of the central nervous system, the spine is straight and not curved but looks almost like the letter ‘S’ from a lateral (side) angle (1). But in some children, it looks curved when seen from the front or back.
That is because of a condition called scoliosis, which causes a sideways curve in the spine. Scoliosis is a common disorder among children aged between ten and 15. In most cases, scoliosis in children may not even require treatment (2). Here, MomJunction tells you more about the condition, its causes, symptoms, diagnosis and treatment options.
What Is Scoliosis?
When you see the spine from a rear angle, it should look vertically straight. Scoliosis gives the spine a sideways curve. So when viewed from a rear angle, the spinal cord seems curved or bent to a side, like the letter ‘S’ or ‘C’.
The spine may have a natural curvature, but if the curve is above 10 degrees, the child is diagnosed with scoliosis. The curves can grow over 30% in some rare cases (3).
Whether or not the spinal deformity needs treatment depends on the severity of the curve and how it affects the child. The severity of the condition could rely on what has caused it.
[ Read: Broken Tailbone In Children ]
What Causes Scoliosis In Children?
The American Academy of Orthopedic Surgeons and the Scoliosis Research Academy have categorized scoliosis into three types, depending on what causes it.
- Neuromuscular scoliosis: It happens due to a neurological condition such as cerebral palsy, muscular dystrophy, tumors of the spinal cord, paralytic conditions, spina bifida, and neurofibromatosis. Children with these conditions may have difficulty walking, because of which the spine might become curved.
- Congenital scoliosis: It is caused at the time of fetal development. This type of scoliosis occurs when there is a problem in the baby’s spine development in the womb. It is usually diagnosed when the child is around two years old. Sometimes, it goes undetected until the child turns eight or above.
- Idiopathic scoliosis: In this case, the cause of scoliosis is not known. Around 80% cases of scoliosis are idiopathic (4). This type of structural scoliosis is common in children and can occur even in healthy, normal kids. Idiopathic scoliosis is further categorized into three types:
- Infantile scoliosis occurs in children aged 0-3 years old. The curve usually is to the left and grows as the child grows. Infantile scoliosis is more common in boys than it is in girls.
- Juvenile scoliosis occurs in children aged between three and ten.
- Adolescent scoliosis occurs in children, especially girls, aged between ten and 18.
Scoliosis may also occur due to:
- an infection in the spine
- spinal injury
- a difference in the length of the legs
- tumor
- hereditary reasons
Regardless of the causes, scoliosis may remain undetected for a long time. However, early detection is important to provide the right treatment, if needed, for scoliosis in kids. Therefore, identify the symptoms of scoliosis in children.
[ Read: Muscular Dystrophy In Children ]
Signs And Symptoms Of Scoliosis In Kids
The symptoms may differ from one child to another based on what’s causing it and the severity of the curve. Common symptoms of scoliosis include:
- Uneven shoulders
- Difference in height between the shoulder blades and hip height or position
- When the child stands, it may look like he or she is leaning to a side
- The head is not centered with the rest of the body
Scoliosis rarely causes pain or any disability, which makes identifying it difficult unless you specifically look for the symptoms. Besides the symptoms, your child’s doctor may recommend a few tests and procedures to confirm the diagnosis. Learn more about this next.
Diagnosis Of Scoliosis: Tests And Procedures
A thorough physical examination, followed by family medical history, is the first thing a doctor would do to diagnose scoliosis. This is followed by an X-ray, which is the primary tool to check the structural changes in the spine. The X-ray checks the angle or the curvature of the spine and determines the severity.
In some cases, the doctors may also recommend:
- Magnetic response imaging or an MRI for a more detailed image of the spine and the angle of its curve.
- Computed tomography or CT scan may be used to get a better look at the bones, muscles, organs and the fat tissue surrounding it.
The tests and procedures help in the early detection of the condition, and treatment for it.
[ Read: Back Pain In Children ]
Treating Scoliosis In Children
Treatment options for scoliosis depend on the cause of the condition and its severity. Based on the diagnosis, the doctor may recommend (5):
- Observation for a while, if the curve is not severe and the child is still young and growing. The child will have to go for checkups once every couple of months, or as recommended by the doctor. Regular doctor visits would also include further diagnostic tests to determine the progression of the curve, which depends on the skeletal growth of the child. More often than not, the curve progression stops as the child reaches puberty.
- Braces when the angle of the curve is over 25° but the child’s skeletal growth is not yet complete. Braces may also be recommended for a growing child with a curve in the spine that is between 20° and 29° but is not progressive. The type of braces and the duration for which the child has to wear the brace would depend on the age of the child and the angle of the curve.
- Surgery, when the curve is more than 45° on the X-ray and braces are not helping. If surgery is needed, it may be best to get it done as soon as possible.
There may be other treatment options, but there is no scientific evidence that they help in preventing the progression or in correcting the angle.
Neglecting scoliosis and not treating it when needed can cause problems with the heart and lung in some children, in the long term. If you have the slightest of doubt that your child has scoliosis, consult your doctor as soon as possible.
Even after the treatment starts, frequent monitoring and proper care at home are essential to ensure the results are favorable.
[ Read: Knee Pain In Children ]
Home Care Tips For Scoliosis: Dos and Don’ts
Scoliosis itself may not be painful or disabling the child, but the treatment options may have some impact on the child’s life. In some case, the impact could be dramatic and make life challenging for the child.
Here are a few home care tips that you can try to help your child cope with scoliosis. These tips may not prevent the curve from progressing but can minimize the chances of aggravating and causing pain.
Do not:
- Text frequently using a mobile phone. When the child texts using a phone, he or she sits in a head-bent position that is not good for the spine.
- Swim competitively or participate in sports like football, which is a high-contact sport.
- Sleep on your stomach. Sleeping with a brace can be difficult, and one of the worst or most uncomfortable sleeping positions for kids with scoliosis is to lie on the stomach. This position requires you to turn your face to a side and sleep, which can twist the spine further.
- Sleep with the lights on, as that can hamper the melatonin levels in the body. Low melatonin is linked to early onset of puberty, which is associated with growth spurts that can progress scoliosis.
- Play on trampolines, as it can advance the curvature of the spine.
- Run long distances, jump or step as that can lead to spinal compression. Carrying heavy things on the side or the back can also lead to compression of the spine.
[ Read: Torticollis In Children ]
Dos:
Here are a few things that you should do.
- Get early intervention to improve the odds of preventing scoliosis progression.
- Use a quality mattress which is not too soft. Ideally, a firm or a medium-firm mattress is recommended for people with scoliosis.
- Move often as standing or sitting in the same position for a long time stresses the spine.
- Stretch often to reduce the pain and ease any discomfort. Good ways to stretch include bending in the direction of the curve, hanging from a bar for as long as possible and a static chest stretch.
Scoliosis management is specific to the child and depends on the age, the degree of curvature and the status of the skeletal growth. The best way to ensure that your child is getting the right care for his condition is to talk to your doctor, and prepare a personalized home care management plan.
Do you have any tips for scoliosis management in children? Share them in our comments section.
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