Scoliosis in Children and Adolescents

Since opening FLOW Physiotherapy Fremantle less than 6 months ago, the clinic has assessed and treated over 15 cases of scoliosis (spinal curvature) in children and young adults. Scoliosis is defined as lateral curve of the spine > 10degrees with an associated vertebral rotation.¹ Most of these clients came from the local suburbs of Beaconsfield, White Gum Valley, North Fremantle and Coogee. Most of these cases fitted the classification of Adolescent idiopathic Scoliosis.^{2, 3}

Is there an epidemic of spinal curvature in the Fremantle area? No. These numbers just reflect the focus of Flow Physiotherapy being spinal back pain and normal muscular development. In this catchment area, there are an estimated 8000 school-aged children and adolescents.

In the normal population, the statistics indicate that about 3% of will demonstrate a scoliosis which may require intervention of some sort.⁴ Using that statistic, we would expect around 240 individuals from Coogee through Spearwood, Hamilton Hill to Fremantle and North Fremantle may require assessment.

Scoliosis usually doesn’t cause significant problems, but a very small percentage of curves continue to progress and may require intervention.⁵ That intervention grades up from simple exercises and stretches (given by your physiotherapist) to spinal surgery.

It is recognised that early intervention measures such as exercises and bracing can prevent surgery⁶ but evidence-based medicine studies to test this point are scarce.

Suffice to say that FLOW Physiotherapy Fremantle supports the early identification of scoliosis using clinical assessment methods. Simple conservative treatments are available at FLOW. All are easily taught to carry out in the home. X-Rays and spinal surgery are necessary only in extreme cases of scoliosis and FLOW does not encourage unnecessary exposure to radiation.

• FLOW Physiotherapists can assess scoliosis using quick non-painful tests.
• Simple Exercises and stretches can be given.
• X-Rays can be ordered by FLOW Physiotherapists to assist measurement of curves, but are not usually needed and not routinely recommended.
• Braces can be considered in treatment and fitted as required.

1. Burton MS. Diagnosis and treatment of adolescent idiopathic scoliosis. Pediatr Ann 2013; 42: 224-228.
2. Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician 2014; 89: 193-198.
3. Picelli A, Negrini S, Zenorini A, Iosa M, Paolucci S, Smania N. Do adolescents with idiopathic scoliosis have body schema disorders? A cross-sectional study. J Back Musculoskelet Rehabil 2016; 29: 89-96.
4. Honeyman C. Raising awareness of scoliosis among children’s nurses. Nurs Child Young People 2014; 26: 30-37; quiz 38.
5. Weinstein SL, Dolan LA. The Evidence Base for the Prognosis and Treatment of Adolescent Idiopathic Scoliosis: The 2015 Orthopaedic Research and Education Foundation Clinical Research Award. J Bone Joint Surg Am 2015; 97: 1899-1903.
6. Shakil H, Iqbal ZA, Al-Ghadir AH. Scoliosis: review of types of curves, etiological theories and conservative treatment. J Back Musculoskelet Rehabil 2014; 27: 111-115.