Help! The school detected scoliosis in my child

School nurses provide a watchful eye on your child’s health. They look for common childhood issues such as hearing loss, vision problems and lice. But they also screen for scoliosis, an abnormal sideways curve in the spine. And if they detect scoliosis in your child — and you aren’t familiar with the condition — it could cause you some anxiety.

Before you assume your child will never stand straight again, you should know that adolescent idiopathic scoliosis is the most common type of scoliosis identified at school screenings. And the condition is often mild — less than 10% of kids who have it require treatment. But your child will need to be evaluated by a physician and possibly observed over time.

Here’s what else you should know about scoliosis:

What is adolescent idiopathic scoliosis?

Everyone’s spine naturally curves. But when that curve is extreme — making the spine look like the letter C or S — it’s called scoliosis. Adolescent idiopathic scoliosis (AIS) is a curve that develops in an otherwise healthy individual in a period of rapid growth during adolescence.

Scoliosis affects 2% to 3% of the population and tends to appear between the ages of 10 and 15. While AIS is detected in both genders equally, females are eight times more likely to have a curve that continues to get worse and eventually needs treatment.

What causes scoliosis?

There are several types of scoliosis, characterized by the underlying cause:

  • Congenital scoliosis, caused by a birth defect
  • Idiopathic scoliosis, which does not have a definite cause
  • Neuromuscular scoliosis, caused by a medical condition affecting the nerves and muscles

The most common type of scoliosis is idiopathic scoliosis. It can develop in infancy or childhood but is usually detected during adolescence. Experts don’t know what causes 80% to 85% of idiopathic scoliosis, but it tends to run in families. Approximately 30% of adolescents with idiopathic scoliosis have a family history of the disorder. And if you had scoliosis as a teen, your child has a one in three chance of developing it.

Scoliosis doesn’t happen because of physical activity (or lack of it), heavy backpacks, poor posture or different leg lengths. But the curve can appear quickly and seemingly out of nowhere as your child grows.

Common scoliosis symptoms

Often, it’s a pediatrician or school screening that first detects AIS. But once a child has a growth spurt (often during puberty), there may be some obvious signs of scoliosis, including:

  • Backache that may go down the legs
  • Difficulty breathing or sitting
  • Obvious curve in the spine
  • Prominent ribs on one side
  • Tilted or uneven shoulders
  • Uneven hips or waistline

Scoliosis screening in schools

The Scoliosis Research Society recommends screening for scoliosis between the ages of 10 and 14. Many, but not all, U.S. states require scoliosis screening in their schools. If your child's school does not offer screening or your child is attending school virtually, your child can be screened at their pediatrician's office. The Los Angeles Unified School District performs screening in grade seven for girls and grade eight for boys.

To screen for scoliosis, the school nurse (or your pediatrician) may assess your child in different ways, such as:

  • Adam’s forward bend test: As your child bends forward with feet together and arms hanging straight and loose, the nurse will observe the shape of the ribs to see if there is a difference between the two.
  • Standing test: Your child stands upright while the nurse looks at the hips and shoulders (to see if they are level) and the head (to see if it’s centered over the hips).

The school will inform parents and guardians if scoliosis screening results indicate that further attention is required.

What happens if the school screening detects scoliosis?

If your child’s scoliosis screening detects the possibility of scoliosis, the next step is an evaluation by your pediatrician. They will rule out other causes of spinal deformity, such as different-length limbs, unusual nerve issues and other physical problems.

Your pediatrician will likely request imaging of your child’s back. An X-ray can provide pictures of the spinal bones needed to measure the curve. A straight spine has a curve of 0 degrees. Any curve greater than 10 degrees is considered scoliosis. Curves greater than 25 degrees may require treatment.

If the curve is mild (less than 25 degrees), your pediatrician may monitor your child as they continue to grow to ensure the curve doesn’t progress.

Treatment for adolescent idiopathic scoliosis

Scoliosis treatment usually depends on the patient’s age, type of scoliosis and the degree of the curve. But there are three main treatment methods for treating idiopathic scoliosis in adolescents who are still growing:

  • Observation, for mild cases of AIS with a curve measuring less than 25 degrees
  • Bracing, for curves measuring between 25 degrees and 40 degrees
  • Surgery, to prevent curve progression and correct the curve when the measure is greater than 45 degrees

Most cases of AIS don’t cause serious problems — your child shouldn’t have back pain or need to restrict physical activity. But if the curve grows and worsens without being monitored, it can cause more severe issues with the lungs, heart or nerves.

If you suspect your child may have scoliosis, reach out to your child’s pediatrician.