Frequently Asked Questions

1. What is scoliosis?
2. What are the symptoms of scoliosis?
3. How is scoliosis diagnosed?
4. What causes scoliosis?
5. Will scoliosis prevent my child from playing sports or doing certain activities?
6. Are there any exercises that will prevent scoliosis from getting worse?
7. What is the long-term outlook for a child with scoliosis?

1. What is scoliosis

The Scoliosis Research Society defines scoliosis as a curvature of the spine measuring 10 degrees or greater on X-ray. Scoliosis is diagnosed by a measurement placed upon the spine X-ray called a Cobb angle. The Cobb angle measures the side-to-side curve of a spinal curve on a spine X-ray. The diagnosis of scoliosis is made based upon physical exam and x-rays of the spine. Always consult your child's primary care provider or orthopedic specialist for a diagnosis. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 3 to 5 out of every 1,000 children develop spinal curves that are considered large enough to require treatment.

2. What are the symptoms of scoliosis?

While curvature is seen on an X-ray, rotation or twist is noted on physical exam when the individual bends forward (Adam's forward bend test). Back pain or leg is not commonly associated with scoliosis. A child experiencing these types of symptoms requires further medical evaluation.

The following are the most common symptoms of scoliosis. However, each child may experience symptoms differently. Symptoms may include:

• Difference in shoulder height
• When bending forward, the sides back appear of the different in height
• The head is not centered with the rest of the body
• Difference in shoulder blade height or position
• Difference in hip height or position
• Waist asymmetry

3. How is scoliosis diagnosed?

In addition to a complete medical history and physical examination, x-rays, a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film, is the primary diagnostic tool for scoliosis. In establishing a diagnosis of scoliosis, the physician measures the degree of spinal curvature on the x-ray.

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4. What causes scoliosis?

In most (80 to 85 percent) cases, the cause of scoliosis is unknown. Scoliosis is a type of spinal deformity. It is not related to or caused by poor posture, sleeping position, sports, or heavy back packs. We do not know the cause of scoliosis. There are many studies looking at genetics, hormones, endocrine & environmental factors to try to determine the cause of idiopathic scoliosis and why some curves get bigger. We believe growth is what can make a curve get bigger.

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5. Will scoliosis prevent my child from playing sports or doing certain activities?

No. However, kids with scoliosis need to do exercises that keep their back and leg muscles flexible. Sports and exercises that require using both sides of the body are especially important to keep the whole body strong. Sports or activities like volleyball, gymnastics, ballet and tennis use one side of the body more than the other. If your child is involved in one of these sports, our physical therapists can help find the best exercises and stretches to help strengthen both sides of his or her spine.

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6. Are there any exercises that will prevent scoliosis from getting worse?

While physical therapy, manipulation or electric stimulation have not been shown to keep scoliosis size from getting bigger, our physical therapists at Children's use special exercises to help manage the condition. These exercises are based on your child's individual curve and activities, whether he or she has pain, and current strength and flexibility. Physical therapy may be a part of your child's scoliosis treatment plan because it can improve pain, breathing, posture, balance, movement and overall quality of life.

Every child's needs and goals are different. Our highly trained physical therapists have found that patients have the best results when we use a variety of treatment methods to manage scoliosis. We use elements of a research-based method called the Scientific Exercise Approach to Scoliosis, as well as other physical therapy methods, to develop a very individualized and practical approach to care. Our goal is to make sure patients develop a greater awareness of their posture and provide them with the tools to maintain improved posture. We do that through:

• Flexibility training
• Balance and coordination activities
• Retraining breathing and posture
• Strengthening and conditioning exercises
• Therapy and massage techniques

Physical therapists work very closely with your child's team of orthopedic specialists to ensure your child's curve is closely monitored and care best meets your child's specific needs. We have a very conservative approach to care.

We'll work with you and your child so you understand treatment goals. Treatment goals may include sitting with better posture, participation in sports and recreational activities, or simply feeling better about the way he or she looks.

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7. What is the long-term outlook for a child with scoliosis?

The management of scoliosis is individualized for each child depending on his/her age, amount of curvature, and amount of time remaining for skeletal growth. Most curves do not progress. Most curves will not increase a child's risk of problems including back pain, arthritis or heart/lung problems. However growth can make curves get bigger. And, while children are growing scoliosis will require frequent examinations by your child's physician to monitor the curve as your child grows and develops. Early detection is important. If left untreated, severe scoliosis can cause problems. In general there are not sports or activity restrictions for children with scoliosis.

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