When your back “throws you a curve”: Scoliosis

I remember during my middle school days in New Jersey lining up once a year at the school nurse’s office, feeling awkward and nervous. Not only was the nurse checking our height and weight as she did every year in grade school, but now she was going to check our backs for some mysterious entity called “scoliosis.” Where I live now in Pennsylvania, many school nurses also screen students for scoliosis, a curve in the spine.

Although pediatricians check children’s spines for scoliosis throughout childhood, school based screens occur during pre-teen and teenage years. This timing is appropriate for school screens because most cases of idiopathic scoliosis, scoliosis with no known cause, occur during the rapid growth spurt of puberty. Eight times more common in girls than boys, scoliosis is painless and often detectable only to health care providers; minor curves are neither obvious nor disfiguring. Caught early, scoliosis can be ameliorated or corrected before adulthood when it can lead to back pain, difficulty breathing and disfigurement.

Unlike what some parents think, scoliosis does not cause “bad posture.” Likewise, “bad posture” does not cause scoliosis.

Depending on the degree of the curve, a child with idiopathic scoliosis might be re-examined every 4-6 months, might get an x-ray of her spine, or her health care provider might refer her to an orthopedic doctor, a specialist who cares for kids with scoliosis. Kids whose spinal curves are severe or are likely to get worse may need bracing until they stop growing. At that point the chances of the curve continuing to increase is low. Wearing a brace does not correct the curve; rather, it prevents any further curvature. Scoliosis braces are much more inconspicuous now than in the past, and can be hidden easily under clothing. Some children require surgery to correct a severe curve.