Learning that your child has scoliosis can bring up a lot of questions.

What caused it? Will it get worse? Does my child need a brace? Will scoliosis cause pain? Can it be treated without surgery?

For many parents, the diagnosis is especially confusing because their child may look perfectly healthy and have no significant symptoms. Scoliosis is often discovered during a routine physical, school screening, sports examination, or simply because a parent notices that one shoulder or hip appears higher than the other.

The most common form of scoliosis in teenagers is called Adolescent Idiopathic Scoliosis, often abbreviated AIS.

At Barr Chiropractic and Scoliosis Center, we believe one of the most important first steps after a scoliosis diagnosis in Phoenix AZ  is education. Understanding what adolescent idiopathic scoliosis is—and what factors can influence its progression—can help families make more informed decisions about monitoring and treatment.

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What Is Adolescent Idiopathic Scoliosis in Phoenix AZ?

Adolescent idiopathic scoliosis is a three-dimensional spinal condition that typically develops or becomes noticeable during the adolescent growth years.

The word adolescent refers to the age group in which it occurs.

Idiopathic means that there is no single known cause.

And scoliosis describes an abnormal curvature of the spine that also commonly involves spinal rotation.

AIS generally appears in children and teenagers between approximately 10 years of age and skeletal maturity.

It is important to understand that scoliosis is more than simply a spine that curves sideways.

The spine may also rotate, and changes can occur in the rib cage, shoulders, waist and pelvis. This is why scoliosis is considered a three-dimensional condition rather than simply a sideways curve.

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What Causes Adolescent Idiopathic Scoliosis?

One of the first questions parents ask is:

“What caused this?”

With adolescent idiopathic scoliosis, there usually isn't one identifiable cause.

It is not generally considered to result simply from poor posture, carrying a heavy backpack, sleeping incorrectly, participating in sports or something a parent or child did wrong.

Researchers continue to study multiple possible contributing factors, including genetics, growth patterns, neurological factors, hormonal influences and biomechanics.

Family history may also play a role. Scoliosis can occur in multiple members of the same family, although having a parent or sibling with scoliosis does not mean that a child will necessarily develop it.

The important point for parents is that discovering scoliosis should shift the focus away from trying to determine who or what “caused” it and toward understanding the child's individual curve and risk of progression.

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What Does a Scoliosis Curve Look Like?

When viewed from behind, a healthy spine should generally appear relatively straight.

With scoliosis, the spine curves to the side and may take on a C-shaped or S-shaped appearance.

Curves can occur in different regions of the spine.

A thoracic curve primarily involves the upper or middle back.

A lumbar curve primarily involves the lower back.

A thoracolumbar curve occurs near the transition between the thoracic and lumbar spine.

Some patients have a single primary curve, while others have two significant curves.

The direction, location and magnitude of these curves can influence treatment recommendations.

This is one reason scoliosis care should be individualized rather than using the same treatment approach for every patient.

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How Is Scoliosis Measured?

Scoliosis is typically measured on an X-ray using something called the Cobb angle.

The Cobb angle gives doctors a standardized way to describe the magnitude of a spinal curve.

For example, a patient may have a 15-degree thoracic curve, while another may have a 32-degree thoracolumbar curve.

But the Cobb angle is only one part of the picture.

When evaluating an adolescent with scoliosis, we also want to consider factors such as:

 

• Age
• Skeletal maturity
• Amount of growth remaining
• Curve location
• Curve pattern
• Spinal rotation
• Previous progression
• Family history
• Overall posture and spinal balance

Two teenagers with the same Cobb angle may have very different risks of future progression.

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Why Growth Matters So Much

One of the most important considerations with adolescent idiopathic scoliosis is growth.

Scoliosis curves can progress during periods of rapid skeletal growth.

A younger child who has significant growth remaining may therefore require closer monitoring than an older teenager who is nearly skeletally mature.

This is why we don't want to look only at the current size of the curve.

We also want to ask:

How much growing does this child still have left to do?

A relatively small curve in a child with considerable growth remaining may deserve careful attention because there is still time for that curve to change.

Understanding growth and skeletal maturity can help doctors estimate progression risk and determine whether observation or conservative intervention may be appropriate.

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What Are the Signs of Adolescent Scoliosis?

Scoliosis can sometimes be difficult to notice, especially when the curve is relatively small.

Parents may begin to see subtle changes such as:

 

• One shoulder appearing higher than the other
• One shoulder blade appearing more prominent
• Uneven waistlines
• One hip appearing higher
• Clothing hanging unevenly
• The body appearing shifted to one side
• A rib prominence when bending forward
• An asymmetrical appearance of the back

One of the simplest screening methods is the forward-bending test.

When the child bends forward at the waist, rotation of the spine and rib cage may become more visible.

If you notice significant asymmetry, it may be worth having your child evaluated.

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Does Adolescent Idiopathic Scoliosis Cause Pain?

Many adolescents with scoliosis have little or no pain.

In fact, the absence of pain is one reason scoliosis can go unnoticed.

A teenager can have a measurable scoliosis curve and still participate in school, sports and normal activities without significant discomfort.

Some adolescents do report back discomfort, muscle fatigue or tightness, but pain alone does not determine the severity of scoliosis.

Likewise, the absence of pain does not necessarily mean that a curve should be ignored.

The primary concern during adolescence is often whether the curve is progressing while the child grows.

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Will My Child's Scoliosis Get Worse?

This is usually the question parents care about most.

Unfortunately, no one can look at a single X-ray and predict the future with absolute certainty.

Some curves remain stable.

Some progress slowly.

Others may progress more rapidly, particularly during periods of accelerated growth.

The likelihood of progression depends on multiple factors, especially the child's age, skeletal maturity, current curve magnitude and previous progression.

This is why follow-up is important.

If a doctor recommends observation, parents should understand when the child should be re-evaluated and whether additional imaging may be needed.

“Wait and see” should still involve a plan.

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What Are the Treatment Options for AIS?

Treatment recommendations for adolescent idiopathic scoliosis generally depend on the individual patient.

Options may include:

Observation and monitoring

For smaller, lower-risk curves, periodic examinations and imaging may be appropriate.

Scoliosis-specific exercise or rehabilitation

Exercises may be used to address posture, muscular control, mobility, breathing mechanics and movement patterns.

Bracing

For certain growing adolescents at risk for progression, scoliosis bracing may be recommended.

Other conservative scoliosis care

Some families choose to explore additional non-surgical approaches designed specifically for scoliosis.

Surgical evaluation

For severe or significantly progressive curves, consultation with a spinal surgeon may be appropriate.

These approaches are not necessarily mutually exclusive.

The appropriate strategy depends on the individual child.

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Our Conservative Approach to Adolescent Scoliosis

At Barr Chiropractic and Scoliosis Center, we have a special interest in conservative scoliosis care.

Our goal is not simply to look at the Cobb angle and apply the same protocol to every patient.

We evaluate the child's curve pattern, growth, skeletal maturity, spinal rotation, previous progression and overall clinical presentation.

When appropriate, our conservative program may combine several components, including:

Scolio-Trainer® treatment

Over-corrective nighttime-only scoliosis bracing

Scoliosis-specific exercises and rehabilitation

Periodic re-evaluation and imaging

Not every patient needs every component.

Treatment is based on the individual's needs and the characteristics of the scoliosis.

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The Scolio-Trainer®

The Scolio-Trainer® is a patented scoliosis treatment table developed specifically for conservative scoliosis care.

It was created around an important concept:

Scoliosis is a three-dimensional condition, so conservative treatment should consider more than a simple side-to-side spinal curve.

The Scolio-Trainer® allows us to position a patient according to his or her individual curve pattern while applying controlled corrective forces.

Depending upon the curve, treatment can incorporate lateral positioning and rotational components designed around the patient's specific scoliosis presentation.

The objective is to place the spine into a customized corrective or over-corrective position during treatment.

A typical Scolio-Trainer® session lasts approximately 30 minutes, although individual treatment plans vary.

It is important to understand that the Scolio-Trainer® does not guarantee correction of scoliosis. As with all conservative scoliosis treatment, outcomes vary from patient to patient.

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Over-Corrective Nighttime-Only Bracing

For certain growing adolescents, particularly those with curves that have a greater risk of progression, we may recommend combining Scolio-Trainer® treatment with an over-corrective nighttime scoliosis brace.

Nighttime braces are different from traditional full-time braces.

Instead of being worn throughout the school day, an over-corrective nighttime brace is generally worn while the child sleeps.

Certain nighttime brace designs use the lying-down position to place the spine into a corrective or over-corrective position.

For appropriately selected patients, this can provide an attractive option because the teenager can attend school, participate in sports and enjoy normal daytime activities without wearing the brace.

However, nighttime-only bracing is not appropriate for every scoliosis curve.

Curve size, location, flexibility, skeletal maturity and other factors need to be considered when determining the appropriate type of brace.

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Why Combine In-Office Treatment With Nighttime Bracing?

When indicated, we like the concept of combining treatment that occurs in the office with corrective positioning that continues at home while the patient sleeps.

During office visits, the Scolio-Trainer® allows us to work with the individual curve pattern using customized positioning and controlled forces.

At home, an over-corrective nighttime brace may provide additional hours of corrective positioning.

Scoliosis-specific exercises can also be incorporated to help the patient work on posture, movement and muscular control.

Together, these components create a more comprehensive conservative program.

Again, not every adolescent requires all three.

The treatment plan should fit the patient—not the other way around.

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Why Early Detection Is Important

One of the most important messages we can give parents is:

Don't panic about scoliosis, but don't ignore it either.

Early detection doesn't necessarily mean that treatment needs to begin immediately.

What it does provide is information.

If a curve is discovered while it is relatively small, parents and doctors can establish a baseline and monitor it carefully.

If the curve begins progressing, conservative treatment options can be discussed sooner rather than after substantial progression has already occurred.

This can be especially important when the child has significant growth remaining.

Earlier detection may provide families with more time and potentially more conservative options.

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What Parents Should Ask After a Scoliosis Diagnosis

If your child has been diagnosed with adolescent idiopathic scoliosis, don't be afraid to ask questions.

Some of the most important include:

What is my child's Cobb angle?

Where is the curve located?

Is there one curve or more than one?

How much skeletal growth remains?

Has the curve changed since the previous X-ray?

How frequently should we monitor it?

What is the risk of progression?

Would conservative treatment be appropriate now?

Is my child a candidate for nighttime-only bracing?

At what point would a surgical consultation be recommended?

Parents who understand these factors are better equipped to participate in decisions about their child's care.

 

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Don't Let the Diagnosis Overwhelm Your Teenager

There is another aspect of adolescent scoliosis that shouldn't be overlooked.

Teenagers are already navigating tremendous physical, emotional and social changes.

Learning that their spine is curved—or being told they may need treatment or a brace—can affect confidence and body image.

Try not to make scoliosis the center of your child's identity.

Encourage normal activities whenever medically appropriate.

Allow your teenager to participate in discussions about treatment.

Ask about his or her concerns.

And focus on what can be done rather than simply worrying about what might happen.

A scoliosis diagnosis is something to manage. It does not define who your child is.

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The Most Important Step Is Understanding the Curve

If your child has recently been diagnosed with adolescent idiopathic scoliosis, you don't need to make every decision immediately.

But you should understand the diagnosis.

Find out the Cobb angle.

Understand how much growth remains.

Determine whether the curve has been progressing.

Learn about the available options.

And make sure there is a plan for follow-up.

At Barr Chiropractic and Scoliosis Center, our goal is to help families understand their child's scoliosis and determine whether conservative treatment may be appropriate.

For selected patients, our program may combine the Scolio-Trainer®, scoliosis-specific exercises and an over-corrective nighttime-only brace to provide an individualized approach to conservative scoliosis care.

Every curve is different.

Every child is different.

And the best place to begin is with a thorough evaluation and a clear understanding of the options available.

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Schedule an Adolescent Scoliosis Evaluation

If your child has recently been diagnosed with scoliosis—or you've noticed uneven shoulders, hips, posture or rib prominence—we would be happy to evaluate them and discuss their options.

If possible, bring any recent scoliosis X-rays with you. Comparing current and previous imaging can provide valuable information about the curve and whether it has been changing.

Barr Chiropractic and Scoliosis Center

Dr. Stephen Barr