Posture Disorders, Kyphosis and Scoliosis
A sideways curve of the spine (scoliosis) or excessive rounding (kyphosis) can appear during growth. Early diagnosis allows bracing to prevent progression.
Seen from the front the spine is straight, and from the side it has gentle curves. Posture problems range from simple habitual slouching to structural curves of the spine. Spotting curves early, especially during the growth spurt, is very important for successful treatment.
Postural slouching
Long hours looking at screens, heavy school bags and an inactive lifestyle can lead to rounded shoulders in young people. This posture corrects when the child stands up straight, so it is not a structural problem. It improves with exercise, sport and better posture habits.
Scoliosis
Scoliosis is a sideways curve of the spine combined with rotation. The most common type is adolescent idiopathic scoliosis, which has no known cause and starts in adolescence. It progresses more often in girls. Congenital spinal anomalies and neuromuscular diseases can also cause scoliosis.
Signs
- Uneven shoulders or hips
- One shoulder blade more prominent than the other
- A hump on one side of the back when bending forward (rib hump)
- Different gaps between the arms and waist on each side
Kyphosis
Kyphosis is excessive forward rounding of the back. Scheuermann’s kyphosis, seen in adolescence, is caused by wedge-shaped vertebrae and does not fully correct when standing up straight. Back pain may accompany it.
Diagnosis
The child is examined from the front, back and side, and the forward bend test is done. A full-spine X-ray measures the degree of the curve (the Cobb angle) and assesses skeletal maturity. MRI is requested when needed. The amount of growth remaining determines the risk of progression.
Treatment
- Monitoring: Mild curves are checked with regular examinations and X-rays.
- Exercise and physiotherapy: Spine-specific exercise programmes support muscle balance and posture.
- Bracing: In growing children with moderate curves, a brace aims to prevent progression. Its effect depends on wearing it regularly for the recommended hours.
- Surgery: For severe curves, or curves that progress despite bracing, the spine is corrected and stabilised with screws and rods.
Posture at school and home
For children and teenagers who sit for hours every day, a good sitting position, a screen at eye level and a backpack carried on both straps and weighing no more than a small fraction of body weight all help posture. Taking breaks from sitting, moving during the day and playing sport regularly strengthen the back muscles. Swimming, pilates and sports that work the core are especially helpful.
How bracing works
A brace is custom-made from measurements and designed for the type of curve. To work, it must be worn for most of the day, for the recommended number of hours. During bracing, regular check-ups assess the fit and the course of the curve. The brace may be renewed as the child grows and is worn until growth is complete. Continuing sport and doing brace-specific exercises are recommended during this time.
Scoliosis surgery
Surgery is used for severe curves or scoliosis that progresses despite bracing. Screws are placed in the spine and connected with rods to correct the curve, and the vertebrae are fused. Nerve function is monitored during the operation with special methods. Patients usually get up soon after surgery and return to school and daily life within a few months.
Adolescence and follow-up
The risk of progression is highest during rapid growth: for girls, the years just before and after the first period, and for boys, mid-puberty. Regular check-ups during this time ensure progression is noticed in time.
Frequently asked questions
Do heavy school bags cause scoliosis?
Heavy bags can cause back pain and poor posture, but they do not cause structural scoliosis.
Can exercise cure scoliosis?
Exercise supports posture and muscle balance. On its own it is not enough for moderate and severe structural curves; a brace or surgery may be needed.
When should I have my child checked?
Especially during the growth years of about 10-14, an assessment is recommended if you notice uneven shoulders or hips or a hump on the back when bending forward.
Can a child with scoliosis play sport?
Yes. Sport is generally recommended for children with scoliosis. Children who wear a brace can take it off for sport and continue their activities.
Is scoliosis painful?
Adolescent idiopathic scoliosis is usually painless. Marked pain is assessed for another underlying cause.
Can sport be played after scoliosis surgery?
After recovery, many young people return to non-contact sports. Which sports are suitable depends on the extent of the surgery.
Can kyphosis be corrected with exercise?
Postural rounding improves with exercise and good posture habits. In Scheuermann's kyphosis, exercise reduces pain and supports posture; marked curves may need a brace.
Is scoliosis inherited?
Children with a family history of scoliosis are at higher risk and should be checked regularly during growth.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.