Scoliosis

Scoliosis in Children

What is scoliosis?

Scoliosis is an abnormal sideways curvature of the spine, which can also involve twisting or rotation of the spine. It can occur at any age but is commonly identified in children and young people, particularly around puberty and between the ages of 10 and 15.

Scoliosis varies from child to child. Some children have a mild curve that simply requires monitoring, while others may need physiotherapy, bracing or specialist treatment.

Types of scoliosis

Idiopathic scoliosis

Idiopathic scoliosis is scoliosis where there is no known cause. It is the most common type and is often diagnosed during puberty. Although it can run in families, it is not caused by anything a child or parent has done or not done.

Congenital scoliosis

Congenital scoliosis is present at birth and occurs when one or more vertebrae do not develop normally during pregnancy. It is often identified at a younger age.

Neuromuscular scoliosis

Neuromuscular scoliosis develops as a result of an underlying neurological or muscular condition, such as cerebral palsy, muscular dystrophy or spina bifida. Muscle weakness or imbalance can contribute to the development and progression of the spinal curve, particularly during periods of growth.

What are the signs of scoliosis?

Signs may include:

• Uneven shoulders or shoulder blades

• Uneven hips

• A visible curve in the spine

• The rib cage appearing more prominent on one side

• The head appearing off-centre in relation to the pelvis

• The body leaning to one side

• Changes in posture or the appearance of the back

Scoliosis does not always cause pain. If you notice changes in your child's posture or spinal alignment, it is worth seeking professional advice.

How is scoliosis diagnosed?

A healthcare professional will usually assess your child's posture, spinal alignment and movement. Imaging, such as an X-ray, MRI or CT scan, may be used where appropriate.

The size of the spinal curve is commonly measured using the Cobb angle. Your child's age, growth, the location and size of the curve, and whether it is changing will all influence management.

How can physiotherapy help scoliosis?

Physiotherapy can be an important part of managing scoliosis in children and young people. Treatment is individualised and focuses on helping your child maintain strength, movement and function.

Treatment may include:

• Strengthening exercises to support posture and physical function

• Stretching and mobility exercises to maintain movement

• Trunk and core exercises to improve stability and control

• Postural and movement training

• Scoliosis-specific exercises, where appropriate
• Hydrotherapy to work on strength, mobility and balance in water

• Advice and exercises to support your child at home

Physiotherapy does not necessarily straighten a structural spinal curve, but it can help children maintain physical function, manage symptoms and stay active.