Scoliosis in a child is a three-dimensional curvature of the spine in which the vertebrae bend sideways and rotate at the same time. It is diagnosed by a doctor on the basis of an X-ray when the Cobb angle is at least 10°. Idiopathic scoliosis affects approx. 2–3% of children aged 10–16. Treatment, from observation through exercise to a brace, depends on the size of the curve and the child’s age.
This guide takes parents through the whole topic: from first checking the child’s back at home, through diagnosis by a doctor, to exercise, bracing and everyday habits. Each section gives a short answer and a link to a detailed article. Diagnosis and decisions about a brace or surgery are made by an orthopaedic doctor; the physiotherapist works with them in carrying out the therapy.
Decision map — where to start:
- You notice uneven shoulders, shoulder blades or waist → how to spot scoliosis in a child at home and a visit to the doctor.
- Your child has back pain, numbness or weakness in the legs → see a doctor first.
- You have an X-ray result with a Cobb angle and a recommendation to exercise → exercises for scoliosis in children.
- You are worried about the school bag and sitting at a desk → scoliosis, school bags and desks.
- Your child slouches, has flat feet or knock knees → postural defects in children.
In brief
- Scoliosis is diagnosed when the Cobb angle on an X-ray is ≥10°; idiopathic scoliosis affects approx. 2–3% of children aged 10–16.
- Approx. 80% of cases of scoliosis are idiopathic, i.e. without a known cause.
- The risk of the curve getting worse is greatest during rapid growth; once growth has finished, small curves rarely increase.
- A physiotherapy consultation at the clinic in Rydułtowy costs PLN 180; for children with scoliosis there are packages of 4, 8 or 12 visits (PLN 650 / 1150 / 1500).
- The clinic offers private visits only (not covered by NFZ, the Polish public health fund), Mon–Fri 7:00–20:00.
Contents
What is scoliosis in a child?
Scoliosis is a structural curvature of the spine in three planes: the spine bends sideways, the vertebrae rotate around their own axis and the natural curves seen from the side flatten. A curve with a Cobb angle of at least 10° on an X-ray is considered scoliosis. In most children the cause is unknown, and this is then called idiopathic scoliosis.
Because the vertebrae rotate, scoliosis shows not only as a sideways bend but also as an asymmetry of the trunk: one shoulder blade or one side of the ribs sticks out more, the waist creases are uneven, and the trunk is shifted relative to the pelvis. It is this rotation that causes the typical “rib hump” visible when bending forward.
Idiopathic scoliosis is most common in girls during puberty. Small curves occur about equally often in both sexes, but larger curves that need treatment are several times more common in girls. Genetic factors affect the development of idiopathic scoliosis – it is more common in families where someone has already had it.
How is scoliosis different from a postural defect?
A postural defect, also called scoliotic posture, is an asymmetry caused e.g. by habits, muscle tension or a difference in leg length; the vertebrae are not rotated, and the curve gets smaller or disappears when lying down and when bending forward. Scoliosis is a structural change with rotation of the vertebrae that cannot be straightened consciously. A medical examination and an X-ray settle the question.
The distinction matters in practice. Scoliotic posture usually requires removing the cause, e.g. correcting a leg-length difference as recommended by a doctor, and general activity. Structural scoliosis requires regular orthopaedic check-ups and often specific exercises, and sometimes a brace.
Other deviations from correct posture, such as a rounded back, flat feet or knock knees, are covered in our article postural defects in children.
What types of scoliosis occur in children?
Scoliosis is classified by cause and by the age at which it appears. The most common is idiopathic scoliosis, with no known cause. Less common are congenital scoliosis, resulting from malformed vertebrae, neuromuscular scoliosis, e.g. in cerebral palsy or muscular dystrophies, and scoliosis accompanying connective tissue disorders and genetic syndromes. Idiopathic scoliosis is further divided by age.
| Type | When it appears / what causes it | Notes |
|---|---|---|
| Infantile idiopathic | 0–3 years | rare; some curves resolve on their own |
| Juvenile idiopathic | 4–9 years | a lot of growth still ahead, needs close monitoring |
| Adolescent idiopathic | from age 10 until the end of growth | the most common form |
| Congenital | malformation of the vertebrae present from birth | managed by an orthopaedic doctor, often with additional tests |
| Neuromuscular | diseases of the nerves and muscles | treatment depends on the underlying disease |
The earlier scoliosis appears, the more growth the child still has ahead and the greater the risk of the curve getting worse, which is why scoliosis in a young child always needs assessment by a specialist.
How to spot scoliosis in a child at home?
At home you can notice worrying signs, but you cannot make a diagnosis. Look at your child’s back while they are in their underwear: are the shoulders and shoulder blades at the same height, are the waist creases symmetrical, is the head above the middle of the pelvis? When bending forward, i.e. in the Adams test, a bulge on one side of the back is a signal to see a doctor.
It is best to repeat this check every few months, especially during rapid growth. The absence of visible asymmetry does not rule out mild scoliosis, and visible asymmetry does not necessarily mean scoliosis – it may be caused e.g. by muscle tension.
Detailed step-by-step instructions, with a description of the Adams test and the most common mistakes parents make, can be found in our article how to spot scoliosis in a child at home. A spinal curve is also sometimes detected during routine health checks and school screening.
When should you take your child to a doctor first?
See a doctor urgently if the curve is accompanied by severe or night-time back pain, numbness, weakness in the legs, problems with walking, problems passing urine or stools, fever or shortness of breath, or if the curve is increasing quickly. A doctor’s assessment is also needed when scoliosis appears in a child under 10 years of age.
Idiopathic scoliosis is usually painless, so severe pain is a sign that the cause may be different, e.g. a change in the bone or in the spinal canal. Unusual curve shapes, e.g. a left-sided curve in the thoracic spine, are also a concern, as are skin changes over the spine: a tuft of hair, a dimple, discolouration or numerous light-brown patches on the skin. In such situations the doctor may order further tests, e.g. an MRI scan.
The first step is usually a GP or paediatrician, who refers the child to an orthopaedic doctor. Specialists the clinic works with are listed on the Recommended specialists page.
Who diagnoses scoliosis and decides on treatment?
Scoliosis is diagnosed by a doctor, most often an orthopaedic doctor, on the basis of an examination and a standing X-ray of the whole spine. On the X-ray they measure the Cobb angle and assess skeletal maturity, e.g. on the Risser scale. The doctor decides on the frequency of check-ups, a brace and possible surgery. The physiotherapist leads the exercises, assesses posture and function, and passes on observations from therapy to the doctor.
The Cobb angle is measured between the most tilted vertebrae at the ends of the curve. The measurement has a certain margin of error, usually a few degrees, so a small difference between two X-rays does not necessarily mean the curve has got worse.
A physiotherapist does not replace an orthopaedic doctor and does not order X-rays. They can, however, assess posture, mobility and muscle strength, measure trunk rotation with a scoliometer and notice changes between check-up visits. Good cooperation means that parents bring current X-rays and the doctor’s recommendations to therapy, and the doctor receives information about how the exercises are going.
What affects the risk of scoliosis getting worse?
The risk of scoliosis getting worse depends above all on how much growth the child still has ahead and on the size of the curve. Scoliosis can increase fastest during the pubertal growth spurt. The risk is higher in girls, in children before their first period or with a low level of skeletal maturity on the Risser scale, and in curves that are already larger at the start.
After growth has finished, curves below approx. 30° usually no longer increase, while curves above approx. 50° may slowly progress in adulthood too. That is why check-ups and treatment matter most in the years of intensive growth, and their aim is to stop the curve getting worse until the skeleton is mature.
How is scoliosis treated in children?
Treatment of scoliosis in children includes observation with regular check-ups, scoliosis-specific exercises, a corrective brace and, for large curves, surgery. The choice depends on the Cobb angle, age, skeletal maturity and the rate of change. The aim is to stop the curve getting worse, improve body shape and function, and avoid surgery. The treatment plan is decided by the doctor.
| Size of the curve (approximate, in a growing child) | Typical management |
|---|---|
| approx. 10–20° | observation, medical check-ups, often scoliosis-specific exercises |
| approx. 20–40° | specific exercises; the doctor considers a brace depending on age and rate of change |
| above approx. 45–50° | consultation about surgical treatment |
Approximate thresholds based on SOSORT and SRS guidelines. Treatment usually lasts until growth has finished, and exercise, bracing and check-ups complement each other. General information about the spine can be found in our back pain guide.
Which exercises help with scoliosis?
The best documented are physiotherapeutic scoliosis-specific exercises, known as PSSE. They include, among others, the Schroth method, SEAS, DoboMed and FITS. In these exercises the child learns three-dimensional self-correction, how to stabilise the corrected posture and how to build it into everyday activities. The exercises are chosen to suit the type of curve, so they should not come from random videos.
The SOSORT guidelines recommend such exercises as the first stage of treatment for smaller curves and as a complement to a brace for larger ones. The quality of the research is moderate: some randomised trials have shown less progression of the curve and improved quality of life, but further research is needed.
General physical activity, e.g. swimming or team sports, is good for fitness, but on its own it does not correct the curve. More about what works and what does not, plus a few safe general exercises with dosage, can be found in our article exercises for scoliosis in children.
When does a child need a brace?
The decision about a brace is made by the orthopaedic doctor. A brace is usually considered in a growing child when the curve exceeds approx. 20–25° or is increasing quickly. In the BrAIST study from 2013, wearing a brace clearly reduced the proportion of children whose curve progressed to the surgical threshold: a 72% success rate in the brace group compared with 48% in the observation group.
In the same study, effectiveness increased with the number of hours the brace was worn per day, which is why the doctor’s recommendations on wearing time are key. The brace is made by an orthotist on the doctor’s prescription, and its fit is checked at follow-up visits.
The physiotherapist helps the child while they are wearing a brace: teaches exercises to do with and without the brace, looks after mobility and muscle strength, and offers support if the child struggles to accept the brace. However, they do not change the doctor’s recommendations on wearing time.
Do school bags, desks and sport affect scoliosis?
A heavy school bag and sitting at a desk do not cause idiopathic scoliosis, although they can increase back fatigue and pain. Sport is not off limits: a child with scoliosis can usually take part in PE lessons and sports activities, and any restrictions are set by the doctor. However, sport alone does not replace specific exercises or a prescribed brace.
Many myths have grown up around scoliosis: that it comes from carrying a bag on one shoulder, sitting badly or a mattress that is too soft. Research does not confirm such links. What really matters for a child’s back is described in our article scoliosis, school bags and desks.
What does scoliosis therapy look like at the “W zdrowym ciele” clinic?
Therapy begins with a physiotherapy consultation for PLN 180, to which it is worth bringing a recent X-ray with a report and the orthopaedic doctor’s recommendations. The physiotherapist assesses posture, mobility and trunk rotation, and then proposes an exercise plan. The number and frequency of visits are set individually. For children with scoliosis, the clinic offers packages of 4, 8 or 12 visits.
The packages are a way of paying for regular therapy, not a recommendation of a specific number of visits. Parents decide whether a package makes sense after the consultation, once the therapy plan is known. You can also pay for individual services: a comprehensive visit costs PLN 180, a podoscope examination PLN 100 and exercises on a balance platform PLN 100.
| Visit package (scoliosis therapy for children) | Price | Validity |
|---|---|---|
| 4 visits | PLN 650 | 1 month |
| 8 visits | PLN 1150 | 2 months |
| 12 visits | PLN 1500 | 3 months |
Each package includes a physiotherapy consultation.
Prices valid from 08.2026. The clinic offers private visits only (not covered by NFZ), Monday to Friday, 7:00–20:00. The clinic follows a child protection policy, available on the child protection policy page.
Scoliosis treatmenttherapy for children with scoliosis in cooperation with an orthopaedic doctor: assessment, exercises, education for parentsconsultation PLN 180, comprehensive visit PLN 180, packages of 4 / 8 / 12 visits: PLN 650 / 1150 / 1500Good to know: bring all previous X-rays with reports to every visit to the orthopaedic doctor and the physiotherapist – comparing successive measurements is more important than a single result.
Summary
Scoliosis in a child is a three-dimensional curvature of the spine with a Cobb angle of at least 10°, diagnosed by a doctor on the basis of an X-ray. The period of rapid growth matters most: that is when regular check-ups, specific exercises and – if the doctor recommends it – a brace help stop the curve getting worse. At the clinic in Rydułtowy a consultation costs PLN 180, and visit packages are available for children with scoliosis.
Frequently asked questions
Does scoliosis hurt in children?
Idiopathic scoliosis in children is usually painless; some children only feel tired in the back after sitting or standing for a long time. Severe, night-time or worsening pain, especially with numbness or weakness in the legs, is not typical and needs urgent assessment by a doctor, as it may point to a different cause of the curve.
Is scoliosis hereditary?
Idiopathic scoliosis is more common in families where someone has already had it, which points to a role for genetic factors. This does not mean that the child of a parent with scoliosis will definitely develop it. If a parent or sibling has had scoliosis, it is worth regularly checking your child’s back during growth and telling the doctor about it.
How often are X-rays taken for scoliosis?
The frequency of X-rays is decided by the orthopaedic doctor, depending on the child’s age, the size of the curve and the rate of growth. During rapid growth check-ups are more frequent, and after growth has finished they are less frequent. The doctor weighs the benefit of a check-up against the radiation dose, so between X-rays a scoliometer measurement taken at the clinic is often helpful.
Can scoliosis go away?
Small curves, especially in babies, sometimes get smaller on their own. In teenagers the main aim of treatment is to stop the curve getting worse and to improve body shape, although some studies describe a small reduction in the Cobb angle after exercise or bracing. It is worth discussing realistic treatment goals with the orthopaedic doctor and the physiotherapist after the X-ray has been assessed.
What happens to scoliosis after growth has finished?
After growth has finished, curves below approx. 30° usually remain stable, while larger ones may slowly increase in adulthood too. That is why the doctor may recommend check-ups after puberty as well. Adults with scoliosis benefit from regular physical activity and, if they have symptoms, physiotherapy tailored to their needs.
Do I need a referral for scoliosis therapy?
For private therapy at the “W zdrowym ciele” clinic a referral is usually not required. However, it is advisable for the child to have been examined beforehand by an orthopaedic doctor and to have an X-ray with a report, because without it the size of the curve cannot be assessed. Bring all available X-rays and the doctor’s recommendations to the visit.
Is scoliosis therapy at the clinic covered by the NFZ?
No. The “W zdrowym ciele” clinic in Rydułtowy has no contract with the NFZ (the Polish public health fund) and offers private visits only. A physiotherapy consultation costs PLN 180, and packages are available for children with scoliosis: 4 visits for PLN 650, 8 visits for PLN 1150 and 12 visits for PLN 1500, valid for 1, 2 and 3 months respectively.
How should I prepare my child for the first visit?
For the first visit the child comes with a parent or legal guardian, who gives consent for the treatment. Bring X-rays with reports and the doctor’s recommendations. The child should wear comfortable clothing, e.g. shorts and a vest top, because the physiotherapist looks at the back, shoulder blades and pelvis.
Sources
- Negrini S. et al., 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth, Scoliosis and Spinal Disorders, 2018.
- Weinstein S.L. et al., Effects of bracing in adolescents with idiopathic scoliosis (BrAIST), New England Journal of Medicine, 2013.
- Scoliosis Research Society, Adolescent Idiopathic Scoliosis – patient information,.
- Weinstein S.L. et al., Adolescent idiopathic scoliosis, The Lancet, 2008.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish licence to practise as a physiotherapist). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
