Adolescent scoliosis usually comes to the fore during a growth spurt when bone growth outstrips the soft-tissue elongation. In the more developed countries of today - with better screening in schools, better diet and heightened medical-awareness - spinal scoliosis in children rarely deteriorates to the grotesque degree of say Quasimodo.

However, mild cases of a slightly crooked spine in children are extremely common and can cause a range of symptoms from different spinal levels: leg pain, mid-back pain, shoulder/arm pain, neck stiffness and headaches. Sadly, children suffering pain from multiple spinal levels are often dismissed as malingerers. 

The Cobb angle is used to measure if the curvature is increasing.

A definitive diagnosis can only be made when the lateral spinal curvature angle known as the Cobb angle, exceeds 10° (see graphic). If an unsuspecting child with back pain is plain unlucky, what starts as a transient, correctable, hint-of-a-crooked-spine may quickly become much more severe, with the spinal curvature becoming more pronounced, literally by the month, if not the week.

Though certainly a concern, this is not a time to panic! Straightening and strengthening exercises can help prevent the scoliotic curves from worsening. This and spinal mobilisation of adolescent scoliosis makes a huge difference to its progression. The treatment of scoliosis is discussed in the video below. 

You can download Sarah's scoliosis video where she explains what happens to the spine both generally and locally – and most importantly, some spinal exercises that are truly liberating - including using the BackBlock.  

Back pain in children is uncommon, so any obstinate symptoms in any part of the spine should be investigated, especially if parents see their child's spine looking crooked. Although it's easy to worry (especially if the parent themselves suffers from back pain) it is also important to know there's lots of things to be done before ever seriously contemplating surgery. 

If a scoliosis diagnosis is made, the child should be re-evaluated every few months to see if their spine is progressing. After skeletal maturity only curves with a Cobb angle of more than 30° need be monitored for progression.

What Are the Causes of Adolescent Scoliosis?

The causes of spinal scoliosis are not fully understood. It may be the result of inequality of muscle strength either side of the body (and spine) in turn the result of low level birth trauma (cerebral palsy). The more marked the inequality of muscle power, the earlier the scoliosis comes to light. Leg length difference can also cause spinal scoliosis. 

Disc metabolism slows on the concave side, so it doesn't grow normally with the rest of the spine.

Scoliosis suddenly worsens during the growth spurt because compression on the concave side of the curve inhibits growth of the disc, whereas on the convex side the tensile stretching (traction) is growth-enhancing. This can cause marked increase in spinal curvature within weeks. You may like to read here in depth more about 'What Every Radiologist Should Know' on scoliosis. 

High activity levels with children are the best way of keeping adolescent scoliosis under control. There's no doubt yoga is the best with its ability to stretch and strengthen all parts of the body evenly. You can read about Yoga and Back Pain here. Handstands, and by extension walking on the hands, are the ultimate strengthening activity for childhood and adolescent scoliosis. 

Using the BackBlock in side-lying is supremely effective for lessening the curve of a thoracic scoliosis, with the block positioned cross-ways under the point of maximum convexity of the curve. To deal with the curve the other way in the lumbar area the BackBlock is positioned under the hip, in the flat area midway between the crest of the iliac bone and the prominent outer bone of the hip. Sarah's video above shows how to use the BackBlock for scoliosis.