At the beach, in the bathroom mirror, or while trying on school clothes, scoliosis is often discovered in simple, everyday moments. A shoulder looks slightly uneven. One hip sits higher than the other. A shirt just doesn’t hang quite right.
“Parents often notice asymmetry first — uneven shoulders, a more prominent shoulder blade, or hips that don’t line up,” says Kyle Mitsunaga, M.D., pediatric orthopedic surgeon in Honolulu. “That’s usually what brings families in to get screened for scoliosis.”
Scoliosis is a condition in which the spine curves sideways, most often developing during the growth spurts of childhood or adolescence. While it can sound alarming, Dr. Mitsunaga stresses that the majority of cases are manageable, and many people with scoliosis live full, active lives without limitations. In observance of Scoliosis Awareness Month, learn what the signs mean, how scoliosis is diagnosed, and why most kids with scoliosis grow up to live full, active lives.
What exactly is scoliosis?
Not all curves are scoliosis. “Scoliosis is defined as a spinal curve measuring more than 10 degrees on an X-ray,” Dr. Mitsunaga explains. “Anything less than 10 degrees is considered spinal asymmetry, which is actually quite common. Not everyone is perfectly symmetrical.”
The most common form, accounting for about 80% of cases, is idiopathic scoliosis, meaning there is no known cause. “It’s not something kids did, and it’s not something parents did,” Dr. Mitsunaga says. While doctors believe there may be a genetic component, no specific gene has been identified yet.
How it’s diagnosed
Often, the first screening happens in a pediatrician’s office using a simple exam called the Adams forward bend test. Because scoliosis is a three-dimensional condition, bending forward can reveal spinal rotation that isn’t visible when standing upright.
“When kids bend forward, you can often see one side of the spine rotating more than the other. That’s what alerts us to take a closer look,” Dr. Mitsunaga says. If a screening tool called a scoliometer measures more than seven degrees of rotation, referral to a specialist for evaluation and X-rays is typically recommended.
Starting conservatively with treatment
For mild curves, treatment usually begins without surgery. “For mild scoliosis, we often start with Schroth-based physical therapy,” Dr. Mitsunaga says. This specialized form of physical therapy emphasizes posture, muscle balance, breathing, and body awareness.
Moderate curves, typically between 25 and 45 degrees, may require bracing, especially if the child is still growing. “Bracing works best when kids are still growing and when it’s worn consistently,” Dr. Mitsunaga notes. “In many cases, bracing can help prevent the need for surgery.”
Surgery is generally reserved for more severe curves. “We usually recommend surgery for curves over 50 degrees, because we know those curves will continue to worsen over time,” he says.
Advances give peace of mind
Scoliosis treatment has advanced significantly in recent years, including newer, less invasive surgical techniques that preserve more mobility. But one message remains constant.
“In kids, scoliosis is usually painless, which is why it can go unnoticed for years,” Dr. Mitsunaga says. And while the word “spine” can spark anxiety, outcomes are often very reassuring.
“Most people with scoliosis, treated or untreated, can live normal, active lives with normal careers and families,” he says. That includes athletes at the highest levels. “Scoliosis shouldn’t limit a child’s ability to participate in sports or everyday activities.”
Debunking common myths
Despite lingering misconceptions, everyday habits don’t cause scoliosis or make it worse. “Things like heavy backpacks, sleeping positions, or sports activities don’t affect scoliosis progression,” Dr. Mitsunaga says, noting that these concerns come up frequently in clinic visits.
The bottom line
Scoliosis Awareness Month is about education, not fear. Early recognition, appropriate monitoring, and today’s range of treatment options mean families have more clarity and more confidence than ever before.
As Dr. Mitsunaga emphasizes, scoliosis doesn’t define a child’s future. With the right care, it’s simply one part of the story — not the whole story.
Increase awareness
You don’t have to wait for a specific day, week, or month to learn about various health conditions! Check out these articles:
- anxiety awareness month
- cataract awareness month
- celiac disease awareness month
- children’s health month
- childhood obesity month part I and part II
- neonatal intensive care unit awareness month
