Scoliosis

A sideways curve of the spine. Common, often mild, and in some groups it needs watching closely.

What it is

Scoliosis is a sideways curvature of the spine, usually with a degree of rotation. Around 3 to 4 children in every thousand need treatment for it.

Most cases in adolescents are idiopathic, meaning no cause is found. It appears during the growth spurt and can progress quickly while growth continues, then stabilise.

Neuromuscular scoliosis is different and matters more in care settings. In cerebral palsy, muscular dystrophy, Rett syndrome and spinal muscular atrophy, muscle imbalance pulls the spine sideways, curves progress further and faster, and they keep progressing after growth stops.

Signs you might notice

Uneven shoulders or hips. One shoulder blade sticking out more than the other.

A rib hump when bending forward, which is the standard screening test.

Clothes hanging unevenly. A waist that looks asymmetrical.

In neuromuscular scoliosis: leaning to one side in a wheelchair, sliding, needing more support to stay upright.

Back pain is not typical in adolescent scoliosis, and pain with a curve should be investigated rather than assumed.

How it can affect day-to-day life

Severe curves compromise breathing. That is the reason neuromuscular scoliosis is monitored so closely: the effect on lung function is what limits life, not the appearance of the back.

Bracing works in adolescents, and it is worn for many hours a day during exactly the years appearance matters most. Adherence is genuinely hard and needs support rather than nagging.

Seating and posture management is the daily work in neuromuscular scoliosis, and it is often the first thing to slip when equipment ages or staff change.

Supporting someone well

Get seating and postural management right and reviewed. Wheelchair and sleep positioning are what slows neuromuscular curves, and equipment that no longer fits is actively harmful.

Take bracing seriously and support it socially, not just clinically. A teenager wearing a brace needs practical help with clothing and a school that understands.

Do not restrict activity unnecessarily. Children with scoliosis can and should be active.

Watch breathing in progressive curves, and ask for lung function monitoring where relevant.

Refer early if a curve is progressing. Surgery has better outcomes when it is planned rather than urgent.

Where to get help

A GP can refer to orthopaedics or a specialist scoliosis service.

Scoliosis Association UK provide support, and their information on bracing is written by people who have worn one.

For neuromuscular scoliosis, ask for a posture management assessment as well as orthopaedic review.