Parents have long been encouraged to examine their children at home for possible signs of scoliosis. The child should bend from the waist, with arms hanging free. Parents then examine the bare back for symptoms. These include a shoulder blade that sticks out more than the other and of course any obvious curving of the spine. Other symptoms include shoulders that are not even, a waist that is uneven, or if one hip seems higher. One side of the rib cage may also appear more prominent than the other.

There is normally not any pain involved, since the curvature occurs very gradually. Therefore, neither the child nor parent may suspect scoliosis unless it is caught in a screening by either the parent or the physician. Most doctors routinely check for the condition at all physical exams. If a parent notices any suspicious signs, the physician should be specifically requested to examine the child for scoliosis.

If the spine twists, it can put pressure on the heart and lungs. This can not only impair breathing but also make it more difficult for the heart to function properly. Heart damage as well as an increased risk of pneumonia can also result. As more years pass, back pain and arthritis may become common.

When scoliosis is suspected, a physician may order an X-ray to confirm his diagnosis and to ascertain how severe the curvature has become. Additional X-rays may be performed every 4-6 months to monitor the condition until the child is past puberty. If there is reason to suspect an underlying cause, the physician may also order an MRI, which stands for magnetic resonance imaging, or a CT scan. Bone scans may also be required.

Although it is seldom necessary, braces can be used to halt the curvature. This will not reverse the process. When braces are required, they are normally made of plastic and molded to fit the body for comfort. Whenever possible, an underarm brace is used. This type of brace cannot be used for curvature that occurs in the upper back, but is the most common for moderate cases. It fits underneath the arms and wraps around the ribs, lower spine, and upper hips. It is not particularly noticeable under clothes. When these types of braces will not work, a body brace with a collar for a chin rest and head rest may be used. These are bulkier and less comfortable and are normally used only when necessary.

Braces should be worn as many hours a day as possible for maximum effectiveness. They are seldom the cause for restricted activities. Braces can be removed for sports, bathing, or other activities. Braces are usually worn until the bones are through growing, typically one to two years after the onset of puberty.

In severe cases, curvature may worsen over time, and surgery may be recommended to reduce the curvature and prevent it from worsening. The procedure used is typically a surgery called spinal fusion. This joins at least two vertebrae together. Metal screws, wires, or rods may be used to straighten the spine and keep it immobile while it heals.

Many chiropractors will not attempt to treat children with scoliosis, since manipulation is not an effective treatment and can in fact cause damage. Physical therapy also is ineffective, although exercise that improves the overall health of the child is desirable even though it will not cure or retard the spinal curvature.

Treatment options have to be made on a case by case basis. There are certain factors the physician will consider when deciding on which treatment to employ and when it should begin. How severe the curve is, whether it is C shaped or S shaped, and where it is located are all important issues. The greater the curvature, the more likely it is to worsen; the S shaped or double curves are also more likely to worsen. Curves in the lower or upper spine are less likely to worsen than those in the middle. The age and gender of the child will also be considered. The curvature is more likely to worsen in girls than boys, and there is seldom progression of the curvature once the bones have finished growing.

Occasionally an adult will develop scoliosis as a result of either injury or a degenerative condition such as arthritis. Adults are more likely to experience back pain as a symptom than are children. Physical therapy and massage can neither straighten the spine nor prevent further curvature, but may be beneficial for pain relief.

Since early detection and, if necessary, intervention are beneficial in preventing further curvature, many schools now routinely screen students for scoliosis. Most people with this condition will require no treatment, and will lead a life without restriction.