How is scoliosis different in adolescents?

Adolescent scoliosis often becomes noticeable during a growth spurt. One shoulder, waist or hip may sit higher than the other, or the ribs may look more prominent when the child bends forward. Some teenagers have no pain. A clinician examines posture, movement and the nervous system and may use standing spine imaging to understand the curve and how much growth remains.

The curve’s size, location, pattern and change over time guide management. A curve found in a younger child or an adolescent with substantial growth ahead may need closer follow-up than one found near the end of growth. Most cases are not caused by carrying a schoolbag or by ordinary exercise.

Keep scheduled reviews so changes can be identified during growth. Encourage ordinary activity when the treating team agrees; movement supports fitness and confidence. Physiotherapy may focus on posture, trunk control, breathing mechanics and comfort. If a brace is recommended, the care team explains its purpose, fit and wearing routine. Surgery is considered only for selected curves after specialist assessment.

Arrange an assessment for a new uneven shoulder or waist, a visible rib prominence, persistent back pain, or a curve that appears to be changing. Seek urgent care for weakness, numbness, difficulty walking, loss of bladder or bowel control, fever with severe back pain, or breathing difficulty.

Ask how much growth remains, where the curve is located, whether monitoring or a brace is appropriate, and which activities are suitable. Clarify which symptoms should trigger an earlier review and how the team will track posture, comfort and function.