What Causes Juvenile Scoliosis?

The cause of structural scoliosis in children is usually unknown (idiopathic). 

Idiopathic scoliosis is further classified as infantile, juvenile, or adolescent, depending on the age the scoliosis presented. 

• Infantile scoliosis – affects children between birth and age 3 (approximately 1% of all idiopathic scoliosis cases, with about 60% being boys)
• Juvenile scoliosis – affects children between ages 4-10 (about 10-15% of all idiopathic scoliosis cases)
• Adolescent scoliosis – affects children between ages 10 until the end of growth (adolescent scoliosis has the highest occurrence of the three categories, as it is most common during growth spurts or just before puberty starts)

While 85% of structural scoliosis cases are unknown, it can be the result of:

• Neuromuscular conditions such as cerebral palsy or muscular dystrophy (called myopathic scoliosis)
• Marfan syndrome
• Poliomyelitis
• Birth defects affecting the development of the vertebrae (called congenital scoliosis, and affects 1 in 10,000 babies)
• Back injury
• Infections, tumors, lesions, or metabolic disorders

While non-structural scoliosis is less common than structural scoliosis, factors that increase the likelihood of developing it include:

• Muscle spasms in the back that pull the spine in a sideways direction
• Leg length difference
• Inflammation on one side of the spine, possibly due to appendicitis or pneumonia

While boys and girls are equally likely to develop juvenile scoliosis, girls have a higher risk of developing more severe scoliosis. 

Genetics also seem to play a role as scoliosis tends to run in families.

What are the Signs and Symptoms of Juvenile Scoliosis?

Mild curves can develop without you or your child realizing it because they can appear gradually and usually don’t cause pain. 

You may first notice that your child’s clothes fit awkwardly or hang unevenly, or notice a slight curve in the spine while your child is in the bath or changing.

Symptoms to watch out for include:

• Difference in leg length (which can be observed when your child is standing)
• One shoulder looks higher than the other
• One shoulder blade looks more prominent than the other
• The waist looks flat on one side or is uneven

In more moderate to severe cases of juvenile scoliosis:

• The ribs look higher or stick out farther on one side as the spine begins to twist
• One hip is higher than the other, causing the hips to be out of alignment and changing the way your child walks
• The head does not look centered on the body
• There is reduced range of motion in the spine
• Trouble breathing and/or heart problems are possible if the rib cage twists and presses against the lungs and heart
• Back pain and inflammation may occur due to higher stress on the joints and discs in the spine

How is Juvenile Scoliosis Treated?

Treatment for juvenile scoliosis varies depending on the cause, severity, and likelihood of progression. 

About 90% of idiopathic juvenile scoliosis cases are mild, and a doctor will simply monitor the condition with checkups every 4 to 6 months until your child has reached full skeletal maturity, when the risk of the curve progressing is low. 

Severe cases of juvenile scoliosis continue to get worse as children grow and can be disabling. In these cases, if a brace does not stop the progression, surgery is usually required.

Treatment for juvenile scoliosis can include:

• Physiotherapy exercises to help keep the back strong and flexible
• Bracing to prevent the curve from worsening as your child grows. A back brace is most effective for children who are still growing and have a curve of 25-30°. It is no longer needed after the bones stop growing. Children can usually participate in most activities while wearing a brace. Bracing can avoid or at least postpone surgery until an older age. 
• Surgery – in severe cases where a brace has not helped, spinal fusion surgery is used to straighten the spine and prevent scoliosis from getting worse. Physiotherapy is an important part of rehabilitation.

Physiotherapy for Juvenile Scoliosis

Physiotherapy is a drug-free and non-surgical treatment that focuses on increasing strength, mobility, function, and quality of life. 

Depending on your child’s individual needs, physiotherapy for juvenile scoliosis can include:

• Stretching, strengthening, and range of motion exercises
• Functional retraining
• Bracing
• Orthotics to add support and absorb the shock from regular activities
• Patient education
• If there is pain, cross-disciplinary pain-relieving therapies such as: 
  • Heat and cold therapy
  • Manual therapy (joint and soft tissue mobilizations)
  • Massage therapy
  • Chiropractic

Are you seeking physiotherapy for juvenile scoliosis? Book an assessment today.

Can Juvenile Scoliosis Go Away on Its Own?

Scoliosis is often the result of a growth spurt and many cases resolve themselves without the need for bracing or surgery. 

It is important, however, to take your child to the doctor as soon as you notice any symptoms, or even a slight curve, to make sure there is no (more serious) underlying cause, and to ensure the curve does not worsen over time.

When your child’s bones have stopped growing after adolescence, the risk of the curve worsening is low.

However, since juvenile scoliosis affects children between the ages of 4 and 10 who are still growing, scoliosis is easier to treat when caught early if it is moderate or severe and therefore likely to progress. 

Larger curves and “S” shaped curves are more likely to worsen over time than smaller curves or “C” shaped curves. Curves in the middle of the back (thoracic spine) are more likely to worsen than curves in the upper (cervical) or lower (lumbar) back.

Can You Prevent Adult Degenerative Scoliosis?

Juvenile scoliosis is not something that can be prevented.

Adults who had scoliosis as children have an increased risk of chronic back pain when they are older. You may want to consult a physiotherapist for a custom preventative treatment plan to address your unique concerns. 

Some steps you can take to try to prevent or reduce your chance of developing back pain later in life include:

• Exercising regularly, including stretching exercises such as yoga or tai chi (at least 30 minutes every day)
• Eating a non-inflammatory diet (avoiding sugar, and processed and refined foods)
• Drinking enough water (8 glasses a day)
• Maintaining a healthy weight (which reduces stress on the facet joints in the spine)
• Practicing good posture
• Wearing orthotics and proper, supportive shoes
• Using an ergonomic chair if you work at a desk
• Moving around more – don’t sit in one position for long periods of time every day
• Lightening the load of your purse or bag, or at least alternating shoulders so you don’t favour one shoulder over the other

Book a Physiotherapist Consult for Juvenile Scoliosis Today

Concerned about symptoms of juvenile scoliosis? Book an assessment with a physiotherapist today.