Scoliosis in Children and Teens: Symptoms, Treatment & Therapy Support

Authored by: The DrSensory Editorial Team

Reviewed by: 🛡️ DrSensory Clinical Review Board – Doctor of Therapy Rehab Division

Last updated: June 2025

All medical content on this page has been reviewed and approved by licensed Doctors of Physical Therapy (DPTs) on the DrSensory Clinical Review Board. Our reviewers follow strict editorial standards and ensure alignment with current APTA guidelines, evidence-based practice, and orthopedic rehabilitation protocols.

Scoliosis in Children and Teens – Symptoms, Causes & Therapy-Based Treatment

What Is Scoliosis?

Scoliosis is a medical condition where the spine curves sideways in an “S” or “C” shape. While mild scoliosis often causes no symptoms, moderate to severe curves can impact posture, balance, and even lung function.

Scoliosis most commonly appears between ages 10–15, during periods of rapid growth. However, it can also occur in younger children or even in infancy.

Types of Scoliosis

Idiopathic Scoliosis

Most common; unknown cause; typically appears during adolescence

Congenital Scoliosis

Caused by abnormal spinal development before birth

Neuromuscular Scoliosis

Linked to conditions like cerebral palsy or muscular dystrophy

Degenerative Scoliosis

Typically occurs in adults due to aging of the spine

 

Signs and Symptoms of Scoliosis

  • Uneven shoulders or hips
  • One shoulder blade more prominent than the other
  • Ribs sticking out more on one side when bending forward
  • Clothing fits unevenly
  • Back pain or fatigue (especially in teens)

⚠️ Note: Scoliosis is often painless in children. A trained provider or therapist may be the first to spot it during a school screening or exam.

How Is Scoliosis Diagnosed?

Diagnosis typically involves:

  • Physical exam (e.g., Adam’s Forward Bend Test)
  • X-rays to measure the spinal curve (Cobb angle)
  • Functional movement assessments by physical or occupational therapists

If the curve measures more than 10 degrees, scoliosis is diagnosed.

Scoliosis Treatment Options

Treatment depends on the age, curve severity, and risk of progression.

Monitoring (Mild Cases)

For mild curves under 20°, doctors may suggest observation and regular check-ups every 6 months.

Bracing (Moderate Cases)

Bracing is used to prevent progression, especially during growth spurts.

  • Types: Boston brace, Wilmington brace, nighttime-only braces
  • Typically worn 12–20 hours per day
  • Bracing does not reverse scoliosis, but it slows curve progression

Surgery (Severe Cases)

Surgery is considered when the curve exceeds 45–50° and interferes with function.

  • Common procedure: Spinal fusion
  • Usually recommended when bracing has not worked

How Therapy Can Help Children and Teens with Scoliosis

Even when surgery or bracing is not required, therapy is essential for managing symptoms and improving posture, strength, and function.

Physical Therapy (PT) for Scoliosis

  • Postural alignment training
  • Core strengthening to support the spine
  • Breathing exercises to enhance lung function
  • Schroth method: evidence-based scoliosis-specific exercise program
  • Gait training and balance work

Occupational Therapy (OT) for Scoliosis

  • Functional adaptations for daily tasks (e.g., dressing, carrying school bags)
  • Ergonomic education (backpacks, seating)
  • Pain and fatigue management strategies
  • Psychosocial support for body image and self-esteem

Speech-Language Therapy (SLP) – When Applicable

  • For neuromuscular scoliosis, SLPs may support breathing and swallowing if upper body posture interferes with oral motor skills

Advanced Diagnostic Methods for Scoliosis

Emerging Technologies in Scoliosis Detection

Recent advancements in technology have introduced non-invasive methods for early scoliosis detection, which can be particularly beneficial for pediatric populations.

  • Video-Based Gait Analysis: Studies have shown that gait patterns can serve as biomarkers for scoliosis classification. Utilizing deep learning models like ScoNet-MT, clinicians can assess gait through video recordings, offering a non-invasive alternative to traditional methods.
  • Deep Neural Networks for X-Ray Analysis: Artificial intelligence models are being developed to analyze spinal X-rays more efficiently, potentially reducing human error and providing quicker assessments

Scoliosis in Adults: Management and Treatment

Understanding Adult Scoliosis

While scoliosis is often associated with children and adolescents, it can persist into adulthood or develop later in life.

  • Degenerative Scoliosis: This type occurs due to age-related changes in the spine, leading to curvature. It may present with symptoms like back pain and postural imbalance.
  • Management Strategies: Treatment may include physical therapy focused on strengthening and flexibility, pain management, and in some cases, surgical intervention.

Psychosocial Impact of Scoliosis

Emotional and Social Considerations

The physical appearance changes associated with scoliosis can impact a child’s self-esteem and social interactions.

  • Body Image Concerns: Adolescents may experience self-consciousness about their appearance due to visible spinal curvature.
  • Social Implications: There may be challenges in participating in physical activities or sports, leading to feelings of isolation.
  • Support Strategies: Engaging with support groups, counseling, and involving family in the treatment process can help address these concerns.

Scoliosis and Physical Activity

Exercise Considerations for Individuals with Scoliosis

Maintaining an active lifestyle is crucial for overall health, but certain exercises may be more beneficial for those with scoliosis.

  • Recommended Activities: Low-impact exercises such as swimming, walking, and specific scoliosis-focused routines can help strengthen muscles supporting the spine.
  • Activities to Avoid: High-impact sports or exercises that involve heavy lifting may exacerbate symptoms and should be approached with caution.

Scoliosis Surgery: What to Expect

Surgical Intervention for Severe Scoliosis

In cases where scoliosis progresses to severe levels, surgical intervention may be necessary.

  • Types of Surgery: Procedures like spinal fusion aim to correct the curvature and prevent further progression.
  • Recovery Process: Post-operative care includes physical therapy, pain management, and gradual return to normal activities.
  • Long-Term Outlook: With appropriate treatment and rehabilitation, individuals can lead active and fulfilling lives post-surgery.

Frequently Asked Questions (FAQ)

Is scoliosis painful?

Mild scoliosis usually causes no pain, especially in children. However, moderate or severe curves can cause back pain, muscle fatigue, or nerve irritation, especially in adolescents or adults.

Can physical therapy fix scoliosis?

Physical therapy doesn’t “cure” scoliosis, but it helps improve posture, muscular balance, mobility, and breathing capacity. Techniques like the Schroth method have been shown to reduce symptoms and improve function.

What degree of scoliosis needs a brace?

Bracing is typically recommended for curves between 20° and 40° in children who are still growing. Your orthopedist and PT will determine the best plan based on age and risk factors.

Can scoliosis be prevented?

Scoliosis, especially idiopathic, cannot be prevented because its exact cause is unknown. However, early detection and therapy can prevent worsening and support healthy growth.

Does scoliosis affect breathing?

Yes — large spinal curves in the thoracic spine can reduce lung expansion. Breathing-focused physical therapy and early treatment can help improve respiratory function.

When is scoliosis surgery necessary?

Surgery is typically considered when:

  • The curve is 45–50° or greater
  • The curve continues to worsen with growth
  • The child experiences pain, breathing issues, or postural instability

This page provides general educational content and is not a substitute for professional medical advice. Always consult a licensed provider for diagnosis and treatment.

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