Scoliosis

What is scoliosis?

Scoliosis is a sideways curvature of the spine — but it's more than that. It's actually a three-dimensional condition where the spine curves and rotates at the same time, often producing the visible asymmetry that families notice.

There are several types. The most common in young people is adolescent idiopathic scoliosis, which appears during the growth spurt without a clear cause. Other forms can be present from birth or relate to other underlying conditions.

The severity varies enormously. Some curves never need active treatment and have minimal impact on life; others progress and need careful management. The right approach depends on the type, size, location and how much growth remains.

What does it feel like?

Scoliosis is often picked up because of how the body looks rather than how it feels — particularly in mild to moderate cases. Common observations include:

• One shoulder higher than the other

• One side of the back more prominent when bending forward

• An uneven waistline or one hip higher

• Clothes that hang differently on one side

• In some cases, back pain or stiffness — though pain isn't the main feature in adolescent idiopathic scoliosis

Significant pain, neurological symptoms or rapid changes are not typical of garden-variety scoliosis and warrant prompt assessment to look for other causes.

How is it diagnosed?

Examination — including a forward bend test — usually identifies the asymmetry. The size and pattern of the curve are then established with imaging.

Standing X-rays are the standard for measuring the curve and tracking change over time. MRI is used in specific situations, such as when there are atypical features or when surgery is being considered.

Assessment also considers how much growth remains, because this is one of the most important factors in predicting how a curve might behave. The pattern of progression — or stability — over time guides the management plan.

What are the treatment options?

Smaller curves are often simply monitored, with the goal of catching any progression early. Larger curves in growing children may benefit from bracing, which can prevent worsening — though it doesn't generally reverse a curve. Significant curves, particularly those that progress despite bracing, may need surgery.

Each scoliosis is different, and the right approach reflects the specifics — size, type, age, growth potential and the wider clinical picture. Nev will work through this with you and your child at your consultation, so any decision is well-informed and built around what matters to your family.

When should you get it checked?

Seek a specialist assessment if:

• You've noticed asymmetry in your child's back, shoulders or waist

• A school screening or GP has flagged a possible curve

• There's a family history of scoliosis and you want a check

• Your child has back pain that isn't behaving like ordinary musculoskeletal pain

• You've been told there's a curve but want a clear plan and second opinion

Early identification gives the most options. Whether or not active treatment is needed, a clear assessment puts families in control of what comes next.