Scoliosis — an abnormal sideways curvature of the spine — is often seen as a condition that’s easily detected during a child’s routine checkup. But is your child’s scoliosis being missed at checkups? Many parents are surprised to learn that mild scoliosis can easily be missed, even during standard pediatric visits. In fact, if not properly screened and identified early, scoliosis can progress significantly, potentially leading to more invasive treatments later on.
Dr. Strauss explores why scoliosis is sometimes overlooked during checkups, how the screening process works, what signs parents should watch for, and why early intervention matters so much.
Understanding Scoliosis and Its Types
Scoliosis isn’t a one-size-fits-all diagnosis. There are three main types of scoliosis found in children:
- Infantile idiopathic scoliosis: From birth to age 3
- Juvenile idiopathic scoliosis: Ages 3 to 10
- Adolescent idiopathic scoliosis: Ages 10 to 18
The word idiopathic means the cause is unknown. Around 80% of all scoliosis cases in children are adolescent idiopathic scoliosis, and this is the form most school and pediatric screenings target.
During adolescence, the spine is particularly vulnerable due to rapid growth spurts — especially in girls, who typically enter puberty earlier than boys. This rapid growth, combined with underdeveloped postural control systems, is thought to be a leading reason why severe scoliosis is more common in girls, despite mild curves affecting both genders equally.
The Standard Pediatric Scoliosis Checkup
At a typical annual well-child visit — often scheduled near the end of the school year — pediatricians are expected to perform scoliosis screenings. The basic test includes the Adams forward bending test, where the child bends forward to touch their toes while the doctor observes the back for any asymmetry.
In a more thorough screening, the doctor may use a tool called a scoliometer. This small instrument measures the angle of trunk rotation and provides a more accurate assessment than observation alone. However, many pediatricians do not use it consistently. Some screenings are conducted quickly and may miss mild curves, particularly in the lower back, where signs can be subtler.
School Screenings: Mandated but Inconsistent
To catch scoliosis early, 37 U.S. states have mandated school screenings. These are often performed by nurses or gym teachers during specific school years, but the timing and thoroughness of these checks vary widely by state and school.
The goal is to identify scoliosis before the curvature progresses. Research shows that when scoliosis is detected early — especially when the curve is still small — non-invasive treatments like exercises can be highly effective. Children in this early stage often do not need bracing or surgery if managed properly.
However, because the school screenings rely heavily on visual cues and may not use tools like a scoliometer, milder or less obvious cases may be missed, allowing scoliosis to quietly worsen over time.
Why Early Detection Matters
Scoliosis is a progressive condition, meaning it tends to worsen as the child grows. A curve detected at age 10 or 11 can easily become more severe during puberty. The bigger the curve gets, the more aggressive the treatment must be — possibly involving bracing or even surgery.
This is why early detection and proactive treatment are so important. If a child is diagnosed with a small curve, many medical professionals still follow a “watch and wait” approach, advising parents to monitor the curve but take no action unless it grows. This strategy may delay intervention until it’s too late for conservative treatment.
Nowadays this philosophy is challenged. Instead of waiting, immediate, targeted exercises are recommended as soon as scoliosis is diagnosed, with the goal of preventing further curvature and avoiding the need for bracing altogether.
Red Flags Parents Should Look For
Because school and pediatric screenings aren’t foolproof, parents can play a crucial role in early scoliosis detection. Here are some visual signs to watch for in your child:
- Uneven shoulders – One shoulder appears higher than the other.
- Prominent shoulder blade – One shoulder blade sticks out more.
- Uneven waist – One side of the waist may look more curved or indented.
- Uneven hips – One hip juts out or appears higher.
- Arms hang unevenly – One hand may hang lower than the other due to torso rotation.
Additionally, when your child bends forward (as in the Adams forward bend test), observe if one side of the rib cage appears more raised than the other. This can be a strong indicator of scoliosis.
The Strauss Method: A Proactive Approach to Scoliosis
Unlike the conventional approach of waiting for curves to grow before initiating treatment, the Strauss Method emphasizes early, personalized interventions. Their process involves:
- Detailed physical screening, including the Adams test and scoliometer readings for both upper and lower back.
- Digital photography to detect asymmetries in posture.
- X-rays when necessary – the gold standard for confirming scoliosis and measuring the curve’s degree.
Even mild scoliosis can be spotted with this comprehensive screening. Once detected, the Strauss Method introduces custom scoliosis-specific exercise programs, which help correct postural distortions, strengthen the spine, and reduce the risk of progression.
Their philosophy is simple: Don’t wait for scoliosis to get worse. Start early and avoid the brace.
What Should You Do if You Suspect Scoliosis?
If your child exhibits any of the signs listed above — or if you’re simply not confident in the results of a routine pediatric checkup — consider the following steps:
- Request a second opinion or a more detailed scoliosis screening.
- Ask for a scoliometer test during your child’s well visit.
- Request a screening X-ray if you suspect a curvature, even if mild.
- Look into exercise-based scoliosis treatment centers if a curve is diagnosed.
The earlier a curve is spotted, the less invasive the treatment will need to be. Scoliosis doesn’t need to be a surgical diagnosis. With vigilance, early detection, and appropriate care, most children can avoid major interventions altogether.
Is Your Child’s Scoliosis Being Missed at Checkups? – Final Thoughts
Scoliosis screening should be a vital part of every child’s annual health check, but unfortunately, not all screenings are equal. The quick visual assessments often performed by pediatricians and school nurses may fail to detect mild or early-stage scoliosis — the very stage where intervention is most effective.
As a parent, staying informed and observant can make all the difference. Don’t rely solely on routine checkups. Take an active role in monitoring your child’s posture, ask informed questions at appointments, and advocate for comprehensive screening if something seems off.
When it comes to scoliosis, early action isn’t just beneficial — it’s essential.
Also read: Healing Scoliosis Through Passion, Persistence, and Innovation