Scoliosis in Children – Causes of Back Pain in Kids

by LMatthews on May 1, 2012

scoliosis and back pain in childrenScoliosis can cause back pain in children, infants, and adults and is a condition where the spinal curvature becomes abnormal leading, potentially, to breathing problems, pain, spinal stenosis, and abnormal posture. Many cases of scoliosis in children are mild and remain asymptomatic but other cases can become severe and debilitating.

Whilst scoliosis is not a common cause of back pain in kids, the back condition may require surgery, use of a scoliosis back brace, or other intervention to correct the abnormality. The underlying pathology of scoliosis in children can include spondylolysis, spondylolisthesis, Scheuermann kyphosis, disc herniation, or hydromyelia, although many cases of childhood scoliosis have no known cause and are referred to as idiopathic scoliosis.

Spinal Stenosis and Scoliosis Symptoms

Some spinal curvature is normal but scoliosis is a condition where the spine curves sideways rather than front to back, creating an ‘s’ or ‘c’ shape in the spine. Where the condition is identified early on as the cause of back pain in kids it can be successfully managed, treated, and prevented from becoming worse, in most cases. Longstanding spinal misalignment and scoliosis in adults may prove harder to correct and some symptoms may persist even after treatment. Pronounced abnormal spinal curvature can cause spinal stenosis with pinched nerves and further spinal degeneration creating symptoms that may become severe and permanent. Spinal curves of more than fifty degrees can cause significant problems as the lungs may become restricted, spinal structures are more liable to slip, herniate, and fracture, and spinal stenosis symptoms may be worse where a patient also develops degenerative disc disease or other back condition alongside scoliosis.

Causes of Scoliosis in Children

The cause of scoliosis is not identified in most cases although the condition often begins in childhood and tends to be more severe in girls than in boys. Catching the problem early can make a huge difference in prognosis with scoliosis as correction of the abnormal spinal curve is easier to effect as the child grows rather than later in life when the curve may be more significant. Scoliosis curvature of ten degrees or more occurs in an estimated 1.5-3%of the general population. Larger spinal curves or twenty degrees occur in 0.3-0.5% of people, and 0.2-0.3% of the population are thought to have scoliosis of thirty degrees or more.


Symptoms of Scoliosis in Children

Spotting scoliosis in children means being alert to abnormalities in posture, such as one shoulder being higher than the other or one hip appearing raised. Some parents notice that just one side of their child’s pants becomes worn and scuffed over time, indicating a possible discrepancy in leg-length due lumbar scoliosis and one hip being higher than the other. Some children with scoliosis have a shoulder blade that is more prominent than the other, or may appear to have a flat waistline on one side but not on the other.

In children with scoliosis it may also be that the child’s head appears to be off-center and that their ribs stick out or look higher on one side of the body, particularly when bending forwards. Symptoms of scoliosis in children may only present as mild postural issues but these can become more severe and pronounced as they grow and the spine continues to twist and curve abnormally. Adults with scoliosis may have trouble breathing and suffer from severe back pain.

Back Pain and Scoliosis in Childhood

Back pain in children can be caused by a variety of conditions, including scoliosis; a study by Ramirez, et al (1997), found a 23% incidence of back pain in children with idiopathic scoliosis and noted that the likelihood of back pain increased in those over fifteen years of age. Girls with scoliosis who had started their periods were also more likely to have symptoms of back pain, as were children with a history of injuries and who had more mature skeletal structures.

scoliosis in children back pain spinal stenosis

Curvature of more than 50 degrees is likely to cause breathing problems in those with scoliosis.

Scoliosis Correction for Children

Younger children and infants with scoliosis are considered most at risk of developing serious symptoms connected to the back condition. To check for scoliosis the doctor will assess the ribs and back to see if there are clear discrepancies. A chest or spine x-ray may then be necessary to measure the spinal curve if it is found to be abnormal. Children who are still growing may find that the spinal curvature worsens and their symptoms of scoliosis become more severe, including back pain, breathing difficulties, and even digestive issues if the postural defect is extreme. Some paediatricians believe in screening all children for scoliosis in order to catch it early and reduce its impact. Mild cases of scoliosis in children tend not to need correction or treatment as the spine may simply correct itself during growth or remain asymptomatic. Where scoliosis is diagnosed in a child they will likely need check-ups every four to six months to monitor development and some children may need to wear a scoliosis back brace to encourage proper alignment of the spine as they grow. In severe cases, if the brace does not work, children may need scoliosis surgery.

Coping with Scoliosis as a Family

Scoliosis can be a stressful condition for children as they may look and feel different to their friends and classmates and may have back pain, breathing problems, activity restrictions, and require regular visits to the doctor’s office or hospital. A back brace can also restrict activities and be uncomfortable, difficult to put on without help, and may make them feel conspicuous at school. It is important that the child understands why such interventions are necessary in order to help them cope with the condition in the best way possible. Siblings of those with scoliosis are also more likely to develop the condition themselves and so it is particularly important to monitor children’s growth in families where one or more members has the spine condition. Children with missing limbs or who are significantly shorter than their peers are also more likely to develop scoliosis, as are children who have incurred a previous spinal injury and whose vertebrae may already be out of alignment. However, in the review by Ramirez, et al, the incidence of back pain in children with scoliosis was not associated with gender, family history, or limb-length discrepancy.

Find out more about treatments for scoliosis, a spine condition that affects children and adults.

Reference


Ramirez N, Johnston CE, Browne RH., The prevalence of back pain in children who have idiopathic scoliosis. J Bone Joint Surg Am. 1997 Mar;79(3):364-8.

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