Overview
Scoliosis is a sideways curvature of the spine that commonly affects adolescents. The cause of most childhood scoliosis cases is unknown. Some cases may be hereditary, as the disorder can run in families, but the majority of children with scoliosis do not have a family history of the disease. Scoliosis can range from mild to severe, and in some instances, it can lead to complications such as breathing problems, back issues, and chronic pain. If you notice signs of scoliosis in your child, it's important to consult a healthcare provider.
Understanding the disease
Symptoms
The symptoms of scoliosis may include uneven shoulders, one shoulder blade appearing more prominent than the other, an uneven waist, one hip higher than the other, a prominence on one side of the back when bending forward, and a spine that rotates or twists in addition to curving side to side. These symptoms can cause the ribs or muscles on one side of the body to stick out farther than those on the other side.
Risk Factors
The risk factors for developing the most common type of scoliosis include age (signs and symptoms typically begin in adolescence), sex (girls have a higher risk of the curve worsening and requiring treatment), and family history (although scoliosis can run in families, most children with scoliosis don't have a family history of the disease).
Assessment and Diagnosis
Triage
You should see a doctor if scoliosis is suspected. Signs of scoliosis include uneven shoulders, one shoulder blade appearing more prominent than the other, an uneven waist, one hip higher than the other, and a prominence on one side of the back when bending forward. While mild cases may not require treatment, it is important to monitor the condition, especially if the curve is getting worse. If you notice signs of scoliosis in your child, consult your healthcare provider.
Diagnosis
To diagnose scoliosis, a healthcare provider will initially take a detailed medical history and ask questions about recent growth. During the physical exam, they may perform a neurological exam to check for muscle weakness, numbness, and reflexes. Imaging tests, such as plain X-rays, can confirm the diagnosis and show the seriousness of the spinal curvature. Repeated radiation exposure can be a concern, so healthcare providers might suggest a low-radiation imaging system or ultrasound. In some cases, magnetic resonance imaging (MRI) might be recommended to check for underlying conditions.
Management and Treatment
Complications
Potential complications of scoliosis include breathing problems due to the rib cage pressing against the lungs, chronic back pain as an adult, uneven hips and shoulders, prominent ribs, and a shift of the waist and trunk to the side. Scoliosis can also cause self-consciousness about appearance. In severe cases, it can reduce the amount of space within the chest, making it difficult for the lungs to function properly.
Treatment
Treatments for scoliosis depend on the severity and progression of the curvature. For mild cases, monitoring with X-rays is usually enough. In some cases, a brace may be recommended to prevent the curve from getting worse. If the curve is severe or worsening, surgery may be necessary. Bracing and surgery are more common in adolescents and young adults.
Preparing for medical consultation
To prepare for an appointment for scoliosis, you should:
- Gather information: Make a list that includes detailed descriptions of your child's signs and symptoms, if any are present. Also, provide information about medical problems your child has had in the past and any that run in the family.
- Prepare a list of questions: Compile a list of questions you want to ask the health care team during the appointment.
- Gather medical records: Bring any previous scans or X-rays (including images and reports) and other important medical records to the appointment.
- Be aware of pre-appointment restrictions: Ask about any restrictions or preparations that need to be made before the appointment.
- Bring a support person: Consider bringing a family member or friend to the appointment to help remember important details and provide support. Remember to be proactive in communicating with the health care team and providing them with all the necessary information. This will help ensure a comprehensive evaluation and appropriate treatment plan.