Scoliosis is defined as curving of the spine from side to side. Most children with scoliosis develop this curvature during the rapid growth spurt that takes place at the onset of puberty. Rather than growing straight up and down, the spine grows with a curve to the side, either in one place, causing a “C” shape; or in two places, causing an “S” shape.

There is no specific cause for scoliosis in the majority of children. It does not result from bad posture, slouching, heavy book bags, or sleeping in the wrong position. However, the tendency to develop scoliosis does run strongly in families. Children with a family history of scoliosis should be watched particularly closely. Uncommonly, scoliosis can be the result of another problem such as a difference in leg lengths, cerebral palsy, or, very rarely, a tumor of the spine.

Scoliosis is relatively common, occurring in about three percent of adolescents. Of this group, only about 10 percent will be considered at risk for severe scoliosis and require any form of treatment. In other words, 90 percent of adolescents who develop scoliosis will never require any treatment for it. Scoliosis significant enough to require treatment is much more common in girls than in boys.

Scoliosis can continue to progress while a child grows, or it can develop and then stay stable. Once present, it rarely improves significantly. The younger the child, and the further he or she is from puberty when the scoliosis begins, the more likely the scoliosis is to progress further.

The most concerning curves are those that progress rapidly. Mild and moderate curves stop progressing once a child has stopped growing. Pediatricians can predict when children will stop growing based on where they are in puberty and by the appearance of the age of their bones on x-ray. Unlike mild and moderate curves, severe curves can continue to progress after growth has stopped. The goal of scoliosis screening and treatment is to prevent severe curves from forming. Only children determined to be at risk for severe curves are considered for treatment with a brace.

Most children with scoliosis do not have any associated pain or other symptoms. The scoliosis is usually diagnosed on physical exam, either at the pediatrician’s office or during a school screening. Since 1980, school screening for scoliosis has been mandated by the Commonwealth of Massachusetts for children in grades 5-9. Children who are identified as potentially having scoliosis are referred to their pediatricians for further assessment. Because school-screening programs do not want to miss anyone with a curve, it is very common for these programs to refer children who will be found by their pediatricians to be normal. At Hyde Park Pediatrics, all patients are checked for scoliosis at every well-child exam.

Contrary to what many believe, heavy backpacks do not cause scoliosis. However, they certainly do cause muscle aches and strains. The American Academy of Pediatrics recommends that backpacks weigh not more than 10-20 percent of a child’s weight. To avoid back and neck strains, your child should be instructed to choose a backpack with broad, padded straps and to wear the backpack over both shoulders. Backpacks on wheels are also a terrific option.

“Stand up straight” is great advice, but it will not prevent scoliosis. As your pediatricians, we will carefully examine your child’s back, watching for a developing side-to-side curve of the spine. If scoliosis is detected, we will monitor closely and refer to an orthopedic specialist if your child begins to develop a significant curve.