Dear Doctors,
My daughters back seems to be a little uneven when she bends down, but she does not have any pain with this. Someone told me that this may be scoliosis, but she does not have any back pain. Is this possible? What should I look for and what are the dangers?

This is a very good question, and is the reason why scoliosis is often times overlooked by parents
and even some health care professionals. In children and teens, scoliosis generally has no symptoms and is not obvious until the curve of the spine becomes severe. It may first become noticeable to a parent who observes that the child’s clothes do not fit right or that hems hang unevenly. The child’s spine may look crooked or the ribs may stick out. Scoliosis is usually something that comes on gradually, but can progress rapidly throughout adolescence. The scoliotic curvature will usually cease when a person is at skeletal maturity, but may progress again in a persons latter years if for example he / she becomes osteoporetic. Scoliosis in the upper back needs to be monitored in adolescence closely to ensure that the heart and lungs are not “crowded out”.

In a child who has scoliosis:
One shoulder may appear higher than the other.
One hip may appear higher than the other.
The child’s head may not be centered over his or her body.
One shoulder blade may stick out more than the other.
The ribs are higher on one side when the child bends forward from the waist.
The waistline may be flat on one side.
Most of the time, scoliosis does not cause pain in children or teens. Pain with teen scoliosis
may indicate another problem, such as a bone or spinal tumor. If your child has pain associated
with scoliosis, it is very important that he or she see a doctor to determine the underlying cause.

Adults with scoliosis may or may not have back pain. In most cases where back pain is present, it
is hard to determine whether scoliosis is the cause. However, if scoliosis in an adult worsens and becomes severe, it can cause back pain and difficulty breathing.

In the case of your daughter, I suggest that she would have a Chiropractic-Orthopedic evaluation
to determine the extent and / or significance of your observations.

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