It was the annual school sports day, and the local park was buzzing with the laughter of children and the cheers of parents. I had just settled into a folding chair near the finish line, sipping on a cold bottle of water, when Sophie, one of the mothers in the neighborhood, sat down beside me. Her 13-year-old daughter, Grace, was warming up for the relay race, her lanky frame moving gracefully as she stretched by the track.
“She’s been working so hard for this,” Sophie said with a proud smile. “But, Dr. Priya, there’s something I’ve been meaning to ask you. Have you noticed how Grace’s shoulders don’t seem quite even when she stands? I’ve brushed it off as her slouching, but lately, it’s been bothering me.”
I glanced at Grace as she jogged past us. Sophie wasn’t wrong—one shoulder did appear slightly higher than the other, and her posture wasn’t symmetrical. As the race began and the children sprinted down the track, I made a mental note to speak with Sophie later. What she was describing sounded like scoliosis, and I knew how important early detection could be.
What Is Scoliosis?
Image courtesy NHS
Later that day, over coffee at the park café, I explained scoliosis to Sophie. “Scoliosis,” I began, “is a sideways curvature of the spine. It’s most commonly seen in children, especially during their growth spurts between the ages of 11 and 13.”
I drew a quick sketch on a napkin, showing how a normal spine looks straight when viewed from behind, while a spine with scoliosis curves into an ‘S’ or ‘C’ shape. “It’s usually painless, which is why it can go unnoticed. Parents often first spot it when they see their child’s clothes fitting unevenly or notice asymmetry in their shoulders or hips.”
How Common Is It?
Sophie looked worried, so I reassured her. “Scoliosis is more common than most people think. Around 2 to 3% of the population has it. In most cases, it’s mild, but about 1 in 1,000 people may develop a severe curve.”
“It’s also more common in girls than boys, especially during their teenage years,” I added. “For some, it’s simply a part of growing up and doesn’t require treatment. But for others, early intervention can make a world of difference.”
Symptoms and Subtle Signs
By this point, Sophie was taking mental notes, nodding as she listened. I told her the key signs to watch for:
- Uneven shoulders: One shoulder may appear higher than the other.
- Asymmetry in the waist or hips: One side may look more prominent.
- Clothes not fitting properly: A dress or shirt may hang unevenly.
- One shoulder blade sticking out: This is noticeable when the child bends forward.
- Difficulty breathing or back pain: Rare in mild cases but can occur with severe curvature.
The Emotional Impact
Sophie hesitated before asking, “Will this affect Grace’s self-confidence? She’s already so self-conscious about her body.”
I nodded, understanding her concern. “For many teens, scoliosis can feel like a social hurdle. They might worry about how they look or feel embarrassed about wearing a back brace. But with the right support from family, friends, and medical professionals, they can thrive.”
The Forward Bend Test: A Simple Screening Tool
I suggested Sophie book a check-up for Grace, but in the meantime, I explained how she could do a quick screening at home.
“Ask Grace to stand with her feet together and then bend forward as if she’s trying to touch her toes,” I said. “From behind, look for any unevenness in her rib cage or back. If one side appears higher than the other, that’s a potential sign of scoliosis.”
Diagnostic Tests and Measurements
If the forward bend test indicates scoliosis, a doctor will usually order an X-ray to confirm the diagnosis. “On the X-ray,” I explained, “we measure the curve of the spine using something called the Cobb angle. This tells us how severe the curvature is.”
- Mild scoliosis: Less than 20°—usually monitored.
- Moderate scoliosis: Between 20° and 40°—may require a brace.
- Severe scoliosis: Greater than 40°—might need surgical correction.
What Can Be Done?
The thought of treatment made Sophie visibly nervous. “Does this mean Grace will need surgery?” she asked.
“Not necessarily,” I reassured her. “Most cases of scoliosis are mild and don’t need any treatment beyond regular monitoring. If the curve progresses, we might recommend other interventions.”
Here’s a breakdown of treatment options:
Observation
- For curves less than 20°, regular check-ups are all that’s needed.
- Monitoring is important during growth spurts when curves can worsen.
Bracing
- Used for moderate curves (20°–40°).
- A back brace doesn’t straighten the spine but can prevent further progression.
- “The key,” I told Sophie, “is that the brace must be worn as prescribed, usually 16–23 hours a day.”
Surgery
- Reserved for severe cases (over 40°).
- “Surgery involves straightening the spine and securing it with rods and screws,” I explained. “It’s highly effective, but it’s only recommended when absolutely necessary.”
Living with Scoliosis: Grace’s Journey
A month later, Sophie brought Grace to my clinic. After a thorough exam and X-rays, we confirmed that Grace had a mild curve of about 15°. While it didn’t require treatment, I reassured both mother and daughter that we’d keep a close eye on it.
“Grace,” I said gently, “you’re strong, and this doesn’t define who you are. Keep doing the things you love—whether it’s running, swimming, or simply being yourself. We’ll make sure this doesn’t hold you back.”
Encouragement and Hope
As Sophie and Grace left my clinic that day, I couldn’t help but reflect on the power of early detection and support. Scoliosis, while daunting at first, is manageable with the right care and mindset. Parents like Sophie, who advocate for their children and seek help early, make all the difference.
Key Takeaways for Parents
- Know the signs: Uneven shoulders, asymmetrical hips, or a tilted rib cage may indicate scoliosis.
- Act early: Early detection through screening tests like the forward bend test can prevent complications.
- Support matters: Whether it’s wearing a brace or adjusting to life with scoliosis, emotional and social support is crucial for children.
FAQs on Scoliosis
1. Is scoliosis hereditary?
- Scoliosis can run in families, but not everyone with a family history will develop it.
2. Can scoliosis cause pain?
- Mild scoliosis usually doesn’t cause pain, but severe cases might lead to discomfort or breathing issues.
3. Will my child grow out of scoliosis?
- Some mild curves stabilize as a child grows, but others may progress, especially during growth spurts.
4. Can scoliosis be prevented?
- There’s no way to prevent scoliosis, but early detection helps manage it effectively.
5. Is exercise helpful for scoliosis?
- Activities like swimming, yoga, and pilates can improve posture and core strength but won’t cure scoliosis.
A Final Thought
As I watched Grace cross the finish line at the next sports day, her smile as radiant as ever, I felt a wave of pride. Sophie had taken action early, and Grace was thriving, scoliosis and all. Moments like these remind me why I do what I do—because every child deserves to stand tall, no matter the challenges they face.