Scoliosis is very serious in children because all are facing growth, which means conditions can get worse quickly because growth triggers progression. Some children are more at risk for rapid-phase progression than others due to the stage of growth and development they are in; continue reading to learn more about the age groups most at risk.
Scoliosis can affect all ages but is most commonly diagnosed in children. While all types of scoliosis should be taken seriously, childhood scoliosis is particularly concerning because as a progression condition triggered by growth, children are the most at risk for continued/rapid progression.
In order to fully understand the seriousness of scoliosis in children, let’s talk about when the different age groups are diagnosed and the condition’s signs to watch for.
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When scoliosis is being diagnosed, part of the process involves further classifying conditions based on key patient/condition variables, one of which is patient age.
Conditions are classified to streamline the treatment process and to inform the crafting and customization of potentially-effective treatment plans.
Scoliosis involves the development of an unnatural sideways-bending spinal curve that also rotates, and this introduces a lot of uneven forces to the spine, its surrounding muscles, nerves, and the entire body.
Patient age is a particularly-important factor in terms of progression and pain, so before getting to the specific types of scoliosis classified by age, let’s first talk generally about these two important age-related variables.
Scoliosis is a progressive condition, meaning it has it in its very nature to worsen over time, and this means the size of the unnatural spinal curve is increasing, as are the condition’s uneven forces, and their effects.
In children, the main condition effect is postural deviation, which we’ll look more closely at within each age group’s individual section.
While we don’t always know what triggers the initial onset of scoliosis in children, we do fully understand what triggers it to get worse: growth and development.
Growth triggers the scoliosis to progress, and this means scoliosis isn’t a static condition; it’s always changing, particularly when the constant trigger of growth is occurring, so where a scoliosis is at the time of diagnosis doesn't mean that’s where it will stay.
Scoliosis ranges from mild to moderate and severe to very severe, and this is also the condition’s progressive line.
So scoliosis in children should be taken very seriously because we know if skeletal maturity hasn’t been reached, treatment has to effectively work towards counteracting the condition’s progressive nature, while facing the constant trigger of growth and development.
Now that we’ve addressed scoliosis progression in children, let’s talk about pain.
While there are never treatment guarantees, scoliosis that’s detected early and treated early in its progressive line is associated with treatment success; smaller scoliotic cruces are simpler to treat.
One of the biggest challenges behind early detection of childhood scoliosis is that its early signs are often too subtle for anyone, other than an expert, to recognize.
There was a time when mandatory scoliosis screening was conducted in schools across the United States, but that has since changed, shifting the onus of recognizing the condition’s early signs onto the shoulders of parents and patients themselves.
The main condition effect in children is postural deviation, and particularly when mild, these changes aren’t overt, and as scoliosis doesn’t become a compressive condition until skeletal maturity has been reached, childhood scoliosis isn’t commonly painful.
While we don’t want any child to suffer with pain, it does tell us something is wrong and is the most common symptom that leads to a diagnosis and treatment; pain is the main condition effect in adults.
In children, the constant lengthening motion of a growing spine counteracts the compressive force of the unnatural spinal curve, and it’s compression of the spine and its surroundings that causes the majority of condition-related pain.
So now let’s take a brief look at each type of childhood scoliosis, from youngest to oldest, and the signs that can accompany each.
Congenital scoliosis is a rare type affecting approximately 1 in 10,000, and congenital scoliosis is caused by a spinal malformation that occurs as the spine develops in utero.
Babies born with congenital scoliosis need to be monitored and assessed closely for signs of any other malformed systems and/or parts within the body, which is common.
Spinal malformations can include vertebral bodies being more triangular in shape, than rectangular, as they should be, and can also involve the failure of vertebral bodies to form into distinct and separate bones, instead becoming fused together.
The signs of scoliosis in babies can include a crooked spine that’s visible to the naked eye, along with postural asymmetries, and in atypical cases of scoliosis, such as congenital types, scoliotic curves can bend to the left, towards the heart, when it typical cases of idiopathic scoliosis, the curve always bends to the right, away from the heart.
Infantile scoliosis is diagnosed in infants between the ages of 6 months and 3 years old, and while some cases can resolve on their own and don’t progress with growth, many do, and there is no way of knowing which will improve on their own, and which will get worse with growth.
The signs of infantile scoliosis can include a crooked spine that’s visible to the naked eye and postural changes that can include uneven shoulders, shoulder blades, an uneven waistline, and arms and legs that appear to hang at different lengths.
Early-onset juvenile scoliosis is diagnosed between the ages of 3 and 10 years old; this is the age group I can make the biggest treatment impact with IF conditions are diagnosed early and treatment is started prior to the first significant adolescent growth spurt.
Signs of early-onset juvenile scoliosis are a crooked spine (sometimes visible to the naked eye depending on severity) and, again, postural changes that involve a disruption to the body’s overall symmetry.
Being proactive with treatment is key, particularly when it comes to working towards preventing progression because there are a number of benefits associated with early detection and intervention.
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis overall and is diagnosed between the ages of 10 and 18.
This age group is the most at risk for rapid-phase progression because of the stage of puberty adolescents are in, or are entering into, characterized by rapid and unpredictable growth spurts.
The earliest signs of adolescent idiopathic scoliosis are often uneven shoulders and hips, and additional postural changes can include:
Additional signs to watch for include changes to gait, coordination, and balance, and while seeing some postural asymmetries doesn’t necessarily guarantee a diagnosis of scoliosis, it does indicate the need for further testing, particularly considering the benefits of early detection.
When it comes to treating adolescent idiopathic scoliosis, the focus is on achieving a significant curvature reduction, and holding it there throughout growth.
You’ve likely noticed I keep coming back to the benefits of early detection, so what exactly are they?
Again, there are never treatment guarantees, but when detected and treated early, there are fewer limits to what can be achieved.
Scoliosis is simpler to treat while mild, when the unnatural spinal curve is smaller, and before the body has had ample time to adjust to its presence.
As scoliosis progresses, the spine gets increasingly rigid, and this makes it less responsive to treatment, and in addition, as the condition’s effects are increasing, they are becoming more established; it’s far more effective to proactively work towards preventing scoliosis progression and increasing effects, than it is to attempt to work towards reversing those effects once they’re established.
When it comes to addressing the postural changes associated with childhood scoliosis, here at the Scoliosis Reduction Center, patients benefit from a proactive conservative scoliosis treatment approach that addresses the condition’s underlying structural nature through condition-specific chiropractic care.
Physical therapy, corrective bracing, and rehabilitation are additional facets of treatment for many cases of childhood scoliosis, and what I want to be the most clear about is how awareness of the conditon’s early signs can lead to early detention and getting children on the path of potential treatment success.
