Scoliosis – Diagnosis and Treatment
Diagnosis
Doctors usually start by asking about symptoms, past health issues, and recent growth spurts. During the exam, they watch how the spine looks when the person stands or bends forward.
They check for uneven shoulders, hips, or ribs that stick out on one side. Sometimes, they do a neurological check to see if muscle strength, feeling, or reflexes seem off.
Scans and Pictures of the Spine
Imaging tests show the shape and size of the spinal curve.
- X-rays are the main tool. Doctors use them to see if the spine curves sideways and to measure how bad the curve is. People with scoliosis often need several X-rays over time, which adds up to a lot of radiation.
- Some lower-dose scanners can create a 3D image of the spine with less radiation. Not every medical center has these machines, though.
- Ultrasound can give another view of the spine, but it’s not as precise as X-rays for measuring the curve.
- MRI scans come into play if the doctor suspects another issue, like a spinal cord problem, could be causing the curve.
- CT scans and bone scans don’t get used much, but doctors might order them for tricky cases.
These tests help doctors figure out if the scoliosis is idiopathic, congenital, neuromuscular, or nonstructural. Results from these tests guide treatment for kids, teens, and adults.
Treatment
Supportive Bracing
Doctors often suggest a back brace for kids or teens with a moderate curve who are still growing. Wearing a brace doesn’t fix or reverse scoliosis, but it can help keep the curve from getting worse as the child grows.
Key facts about bracing:
- Braces are usually made from sturdy plastic and shaped to fit close to the body.
- You can wear them under clothing, wrapped around the ribcage, lower back, and hips, and they’re almost invisible.
- Most people need to wear the brace 13–16 hours a day. The more you wear it, the better it works.
Kids can usually keep up with sports and regular activities, even with the brace on. If they need to, they can take it off for short times, like for swimming or sports.
| Bracing Quick Facts | |
|---|---|
| Who | Growing children & teens with moderate scoliosis |
| Main purpose | Stops the curve from getting worse |
| Does it correct the curve | No, it just prevents it from advancing |
| Design | Plastic, lightweight, fits under clothes |
| When to stop | When bone growth is finished, usually around age 14 for girls and 16 for boys (but varies) |
Bracing works best when bones are still growing. Doctors often use hand X-rays to check how much growing is left.
Surgical Procedures
If scoliosis is severe or the curve keeps getting worse, the doctor might recommend surgery to straighten the spine and avoid future problems. Surgery aims to keep the spine as straight and stable as possible.
Main surgical choices:
- Spinal Fusion: Surgeons connect two or more vertebrae so they can’t move separately. They put small pieces of bone or similar material between the bones, then use metal rods, screws, or hooks to hold the spine straight while it heals. Over time, the bones fuse together.
- Growing/Expanding Rods: For young kids with fast-worsening scoliosis, doctors sometimes attach expandable rods to the spine. They can lengthen these rods as the child grows, either in the clinic or by surgery every few months.
- Vertebral Body Tethering: Surgeons put screws along the outside edge of the curve and thread a strong, flexible cord through them. Tightening the cord helps straighten the spine. As the child grows, the spine may straighten even more.
Possible complications:
- Infection
- Bleeding
- Nerve injury
These problems don’t happen often, but they’re still risks to keep in mind.
Doctors usually recommend surgery if:
- The curve is big or keeps getting worse
- Bracing didn’t stop the curve from growing
- The person has finished or nearly finished growing
Surgeons use metal rods or other hardware to keep the back steady while the bones heal. After surgery, people need regular checkups to track recovery and spine health.
Everyday Approaches for Spine Care
People with mild scoliosis, uneven shoulders, or back pain often feel better when they stay active. Daily movement supports spine health and can lower discomfort.
Most individuals don’t need to avoid lifting or sports. Non-surgical treatment might include therapy, stretching, and keeping a balanced lifestyle.
General Tips:
- Do regular, low-impact activities
- Try stretches to ease stiffness
- Pay attention to posture during daily tasks
Alternative medicine
Some people try other ways to manage scoliosis, like:
- Chiropractic adjustments
- Soft bracing
- Electrical muscle stimulation
- Vitamin or mineral supplements
These options probably won’t straighten the spine, but some individuals use them for comfort.
Finding Support and Managing Emotions
Having scoliosis as a teen can bring up all kinds of feelings—frustration, worry, or self-doubt. This stage of life is tough enough, so the right support really matters.
Teens might find it helpful to talk honestly with friends about how scoliosis affects them. Good friends can offer comfort and support.
Ways to find support:
- Join support groups for young people and families dealing with scoliosis
- Connect with others to share stories and advice
- Lean on close friends for everyday encouragement
Support groups can help families learn from others and pick up useful tips.
Getting Ready for the Visit
Bringing a written list to the appointment helps a lot. Include details about any symptoms your child has noticed, like pain or changes in posture.
Add info about past illnesses or injuries. If spine problems run in the family, jot that down too. Make a list of questions for the healthcare team. Being prepared makes the visit smoother.
Example of What to Bring:
| Item | Details |
|---|---|
| Symptom List | When symptoms started, how they have changed |
| Medical History | Past illnesses, surgeries, or treatments |
| Family History | Relatives with scoliosis or similar conditions |
| Questions for Provider | Things you want to learn or discuss |
What the Healthcare Provider May Ask
The doctor will sit down with you and your child to chat about the details. They might ask when you first noticed anything unusual, if your child feels pain, or if breathing seems harder lately.
You’ll probably hear questions about any quick growth spurts or changes, like when menstruation started. Sometimes they’ll want to know if anyone else in the family has had similar spine problems.
Giving honest answers really helps the team figure out the best plan for your child.
