Diagnosis of Scoliosis

Because most children and teens do not have symptoms, doctors may diagnose scoliosis during a routine exam. Your child’s doctor may diagnose scoliosis by:

• Taking a medical history and family history, which may include asking about other medical problems that might be causing the curve in the spine. Some children are identified through school screening.
• Completing a physical examination to evaluate your child’s posture and look for asymmetry in the trunk or shoulders, or if one side of the rib cage is higher than the other when your child bends forward.
• Taking x-rays. This is the most common test that doctors use to diagnose the disorder. An x-ray can evaluate and measure the curve of the spine. This information helps the doctor determine the severity of the curve and possible treatments.

Treatment of Scoliosis

Doctors recommend treatment for scoliosis based on:

• The locations of the curve.
• If the curve is mild, moderate, or severe.
• If the curve causes symptoms.
• If your child or teen is still growing.

The goals of your child’s treatment may include to:

• Stop or slow the curve in the spine from progressing.
• Prevent or decrease pain.
• Prevent or manage any respiratory problems that may develop due to the curve.
• Help improve posture.
• Help improve quality of life.

Your child’s doctor may recommend the following treatments:

• Observation. If the curve is mild and your child’s skeleton is still growing, the doctor may recommend monitoring the spine. This may include visits with the doctor every few months.
• Bracing. If the curve is moderate and your child or teen is still growing, your doctor may recommend using a brace to keep the curve from getting any worse. The goal of wearing a brace is to slow or stop the curves in the spine from increasing. The type of brace depends on the severity of the curve. The brace is fitted to your child or teen and should be worn every day for the full number of hours recommended by the doctor. Research shows that braces work well if your child or teen is still growing and they are worn as directed. Once your child or teen is done growing, your doctor may determine that the brace is no longer needed.  
• Surgery. If your child or teen is still growing and the scoliosis continues to progress, your doctor may recommend surgery. The type of surgery depends on the location and severity of the curve. All surgeries have risks for complications. Talk to the surgeon about the risks and benefits of surgery. Types of procedures may include:
  • Spinal fusion, which joins two or more vertebrae of the spine together. This can help straighten the curve. The surgeon may use metal rods and screws to help keep the spine straight while the spine heals.
  • Insertion of an expandable rod, which a surgeon may recommend if your child or teen is still growing. This rod is lengthened by the surgeon at scheduled times as your child grows.
• Physical therapy. The doctor may recommend physical therapy to help strengthen muscles.  

Research shows that alternative therapies such as chiropractic treatment, nutritional supplements, and electric stimulation do not help manage scoliosis or keep the curve from getting worse.

Who Treats Scoliosis?

The following health care providers may treat scoliosis in children and teens:

• Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.
• Pediatricians, who diagnose and treat children.
• Physical therapists, who teach ways to build muscle strength.
• Primary care providers, such as a family physician.