The Advantages of Early Screening and Identification of Scoliosis.
Scoliosis is a three-dimensional curve of the spine that can develop during childhood or adolescence. It affects around 2–3% of young people, yet in many cases it is not identified until the curve has already progressed. This is because early scoliosis rarely causes pain and changes in posture may be subtle, but unfortunately, by the time a curve becomes obvious, treatment options may be limited.
The good news is that scoliosis can be detected early through simple screening. Early identification allows families to act quickly, greatly improving outcomes and often preventing the need for surgery.
At clinics in Richmond and South Yarra, Melbourne, we provide early scoliosis screening that gives children and parents peace of mind and ensure the right steps are taken at the right time to ensure optimal future outcomes.
Why Does Early Scoliosis Screening Matters?
Scoliosis often progresses most rapidly during growth spurts. For girls, this is usually between ages 10–12, and for boys around 12–14. During these years, spinal curves can worsen quickly, sometimes by several degrees within months. If left undetected, scoliosis can progress beyond 40–50°, making surgery the most likely treatment option.
What does the current medical evidence say?
The BrAIST Trial (NEJM, 2013): This landmark study confirmed that bracing significantly reduces the risk of scoliosis progression, but only when started early in growing patients. Bracing is least effective when a curve is large or when skeletal growth is nearly complete. Early assessment and management would play a key role in this instance.
SOSORT Guidelines (2016): International recommendations emphasise that scoliosis-specific physiotherapy exercises and bracing work best when introduced in the early stages.
RACGP (2020): The Royal Australian College of General Practitioners highlights that most children with mild scoliosis can be monitored, but those at risk of progression must be identified promptly to prevent complications.
Common Questions we get asked:
Q: At what age should children be screened for scoliosis?
A: Girls should be screened between ages 10–12 and boys between 12–13, coinciding with growth spurts. These are the highest-risk years for curve progression.
Q: Is scoliosis painful?
A: Most cases of idiopathic scoliosis are painless. Pain, particularly at night or with neurological symptoms, may indicate another condition and should be reviewed promptly.
How Families Mistakenly Delay Early Assessment
During the adoloscent years, the subtle signs of scoliosis are often dismissed as poor posture or even growing pains in young children. By the time scoliosis is noticeable without screening, valuable treatment opportunities may have been lost.
Early screening by trained clinicians ensures:
Treatment begins while the child is still growing.
Bracing, physiotherapy, and monitoring are effective early interventions.
Surgery can often be avoided altogether.
Common Questions we get asked:
Q: Can exercises fix scoliosis?
A: Exercises such as the Schroth Method improve posture, lung function, and brace tolerance but do not replace bracing or surgery in moderate-to-severe curves.
Q: What happens if scoliosis is detected?
A: Management depends on the Cobb angle and growth stage. Options include observation, physiotherapy, bracing, or referral to a spinal surgeon.
How Does Scoliosis Screening Work?
At our clinics in Richmond and South Yarra, scoliosis screening is safe, quick, and non-invasive. Our physiotherapists use evidence-based methods to detect scoliosis early:
Postural Observation:
The clinician checks for uneven shoulders, a shifted waistline, or one hip sitting higher than the other. These subtle asymmetries may indicate a spinal curve.Adams Forward Bend Test:
The patient bends forward with arms hanging down. The clinician observes for a rib hump or muscle bulge, which occurs due to spinal rotation. This is one of the most reliable first-line clinical tests.Scoliometer (Angle of Trunk Rotation, ATR)
A small device is placed on the back while the patient is bent forward. If the reading is 7° or greater, the patient is referred for X-rays to measure the Cobb angle.Radiographic Confirmation
Standing PA and lateral X-rays measure the Cobb angle. A curve of ≥10° confirms scoliosis. Lower readings indicate postural asymmetry rather than scoliosis.
This process is painless, safe, and provides clear next steps for families to initiate effective management.
Common Questions we get asked:
Q: What happens if scoliosis is detected?
A: Management depends on the Cobb angle and growth stage. Options include observation, physiotherapy, bracing, or referral to a spinal surgeon.
Q: Why not just wait and see?
A: Scoliosis can progress quickly during growth spurts. By the time the curve is visible, treatment opportunities may be limited. Early screening provides a safer, proactive approach.
Q: How common is scoliosis?
A: It affects about 2–3% of children and adolescents. Girls are more likely than boys to develop curves that require treatment.
The Benefits of Early Identification:
1. More Effective Bracing
Bracing prevents scoliosis from worsening, although it is most effective when the spine is still growing. Early identification of a scoliotic curve ensures bracing is introduced at the right time, typically for curves between 20–40° in skeletally immature patients.
It is interesting to note that The BrAIST trial showed that children who wore a brace for more than 18 hours per day reduced their risk of needing surgery by up to 70%.
2. Enhanced Physiotherapy Support
Physiotherapy plays a key role in management of scoliosis with abundance of high-quality research in favour of Scoliosis-specific physiotherapy programs, such as the Schroth Method or SEAS (Scientific Exercise Approach to Scoliosis).
The Schroth Method is currently the most effective and research backed protocol to manage early-stage scoliosis.
The program typical aims to:
Improve posture awareness and spinal alignment.
Enhance lung function and breathing mechanics.
Help patients adapt to brace wear.
Support strength and flexibility to maintain quality of life.
3. Reduced Need for Surgery
Surgery is typically recommended when curves exceed 45–50°. By identifying scoliosis early, most patients can be treated with bracing and physiotherapy, greatly reducing the likelihood of surgery.
4. Psychological and Social Benefits
Adolescence is a sensitive time for body image and self-esteem. Detecting scoliosis early allows for timely, discreet treatment, reducing anxiety and social challenges associated with visible spinal curves.
5. Education and Reassurance for Families
Not every child with uneven posture has scoliosis. Early screening provides reassurance for families when no issues are detected, and ensures appropriate steps are taken when scoliosis is confirmed. Families also gain valuable education about posture, ergonomics, and healthy spine development.
When Should you Consider Scoliosis Screening?
Parents should consider a scoliosis screening consult if they notice:
Uneven shoulders or hips.
A rib hump or muscle bulge when their child bends forward.
Clothing that hangs unevenly.
A child who is in the middle of a growth spurt.
Even if scoliosis is not found, the reassurance provided is valuable for both the parents and the child. If scoliosis is detected, our physiotherapist are well equipped to initiate early intervention—whether that includes simple monitoring, physiotherapist supervised rehabilitation, bracing, or referral to a spinal specialist.
At Sports Health Physio Richmond and South Yarra, our team provides:
Comprehensive scoliosis screening consults.
Physiotherapy programs to support brace wear and posture.
Referral pathways to spinal specialists when required.
Key Takeaways:
Early screening and identification of scoliosis provide children and families with the best possible chance of avoiding surgery and maintaining healthy, active lives. Screening is simple, painless, and highly effective at identifying scoliosis before it becomes severe.
At Sports Health Physio Richmond and South Yarra, we are committed to helping families detect scoliosis early and providing evidence-based management pathways. Whether it is reassurance or early treatment, scoliosis screening ensures no opportunity for better outcomes is missed.