school age on one side

Overview

Scoliosis is a condition where the spine (backbone) curves to one side instead of running straight down the middle of the back. It can look like the letter 'C' or 'S' when viewed from behind. In school-age children, the most common type is 'idiopathic,' meaning the cause is unknown. It is not caused by carrying heavy school bags or poor posture.

Yes, scoliosis is fairly common. About 2 to 3 out of every 100 children develop some degree of scoliosis. Most curves are mild and do not need active treatment.

It affects both boys and girls, but girls are more likely to have curves that worsen and need treatment. It is most often found in children between 10 and 15 years old, though it can also appear in younger children.

Symptoms

Common symptoms

• One shoulder is higher than the other
• One shoulder blade sticks out more than the other
• One hip looks higher or more prominent
• The head is not centered over the pelvis
• The child leans to one side when standing
• Clothes, such as trousers or skirts, fit unevenly

Causes

Main causes

• In most cases, the cause is unknown (idiopathic scoliosis)
• Some children are born with a spinal abnormality (congenital scoliosis)
• Scoliosis can be linked to other conditions, such as cerebral palsy or muscular dystrophy

Risk factors

• Family history of scoliosis
• Being female
• Age at growth spurt (typically 10–15 years old)
• Certain genetic or neurological conditions

When to see a doctor

See a doctor urgently if:

• If you notice a sudden change in your child's posture or a noticeable curve in the spine
• If your child complains of back pain that limits daily activities
• If your child has any signs of nerve problems, such as leg numbness or weakness

Book a routine appointment if:

• During regular check-ups, the doctor may check for spinal curvature
• If you have concerns about uneven shoulders or hips, ask your doctor to assess
• School nursing or national screening programmes may refer your child for evaluation

Diagnosis

A doctor will first ask questions and observe your child from behind while they stand with their arms at their sides. The doctor may also ask your child to bend forward with hands touching their toes, which makes a spinal curve easier to see.

Tests that may be done

• Physical examination (looks at curve, posture, and balance)
• Forward bend test (Adam's test) to show rib or back prominence
• X-ray of the spine to measure the exact angle of the curve
• MRI (magnetic resonance imaging) if there are signs of nerve problems or an unusual curve pattern

What to expect at your appointment

The doctor will measure the curve using the 'Cobb angle' on an X-ray. Mild curves are typically under 20 degrees. Moderate curves are 20–40 degrees. Severe curves are over 40 degrees. Your doctor will explain what the measurements mean and how often your child needs follow-up.

Treatment

Treatment for childhood scoliosis depends on the size of the curve, the child's age, and whether the curve is likely to progress (get worse). The goal is to prevent the curve from worsening and to keep the spine as straight as possible while the child is still growing.

Self-care at home

• Encourage regular physical activity and sports to keep back muscles strong
• Maintain good posture during sitting and screen use (but note that posture does not cause or fix scoliosis)
• Ensure a balanced diet with enough calcium and vitamin D for healthy bones
• Use a supportive chair and backpack that is not overloaded

Medical treatments

For mild curves, doctors usually recommend regular observation with repeat X-rays every 4 to 12 months, depending on age. For moderate curves in growing children, a back brace may be worn to help stop the curve from progressing. Braces do not make the curve straight, but they can slow or halt worsening. Physiotherapy may help improve posture and strength. In some cases, a doctor may discuss other non-surgical options.

When is surgery considered?

Surgery is only considered for severe curves (usually over 45–50 degrees) or for curves that keep getting worse despite bracing. The most common procedure is spinal fusion, where metal rods and screws are attached to the spine to hold it straight while the bones heal together. Surgery is a big decision, and your child's specialist will discuss all risks and benefits with you.

Living with this condition

Most children with scoliosis can take part in all normal activities, including sports, dance, and gym. If your child wears a brace, they may need time to adjust, but it should not stop them from playing, except for contact sports where a brace may be removed if advised. Check with the doctor about brace use during sports.

Lifestyle tips

• Stay active: swimming, biking, and walking are great options
• If wearing a brace, be consistent with wearing times as prescribed
• Follow up with the medical team at scheduled appointments
• Encourage open conversations about any worries or discomfort

Diet and exercise

A healthy diet rich in calcium (milk, yogurt, leafy greens) and vitamin D (sunlight, fortified foods, oily fish) supports growing bones. Regular exercise strengthens back and core muscles, which helps overall posture and wellbeing. The child should not be restricted from exercise unless the doctor says otherwise.

Mental health and emotional wellbeing

Seeing a curved spine or wearing a brace can affect a child's self-image and confidence, especially around friends. It is normal to feel anxious or self-conscious. Reassure your child that many people live with scoliosis and that they are not alone. Talk to a school counsellor, psychologist, or your doctor if emotional stress becomes a concern.

Prevention

Most childhood scoliosis cannot be prevented, especially the common 'idiopathic' type. However, early detection is very important. Regular check-ups and school screening can catch a curve early, which makes treatment simpler and more effective.

Screening programmes

Many schools and health programmes offer scoliosis screening. If your child is not screened, your doctor can check at routine visits. You can also ask for a screening at any time if you notice changes.

Complications

If left untreated

• A mild curve may slowly worsen as the child grows
• A severe curve can cause visible deformity and imbalance
• Very severe curves may reduce space for the lungs and affect breathing
• Back pain may develop in adulthood

Long-term outlook

With early detection and appropriate monitoring, most children with scoliosis lead completely normal, active lives. Even when bracing or surgery is needed, the long-term results are generally very good. Your medical team will support you every step of the way, and many people with scoliosis go on to pursue any career or hobby they choose.

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