When a child starts slouching or one shoulder appears slightly higher than the other, many parents assume it’s caused by poor posture or a heavy school bag. But according to Dr Saw Lim Beng, Consultant Robotic and Spine Surgeon at Sunway Medical Centre, Sunway City, these subtle changes could sometimes be early signs of scoliosis.

“Scoliosis is not simply poor posture,” explains Dr Saw. “It is a condition where the spine curves and rotates, affecting the body’s overall alignment.”

The condition often develops quietly during childhood and adolescence, with many children experiencing little to no pain in its early stages. As a result, it can go unnoticed until the spinal curve becomes more obvious.

Why the Ages of 10 to 15 Matter Most

One of the biggest concerns with scoliosis is how quickly it can progress during a child’s growth spurt.

According to Dr Saw, mild spinal curves may remain relatively stable for years but can worsen rapidly between the ages of 10 and 15, when the body experiences significant growth.

“During this period, the spine can grow very quickly. A mild curve may sometimes progress during this phase of rapid growth,” he says.

Because of this, children diagnosed with scoliosis require regular monitoring to ensure early intervention if the condition begins to worsen.

More Than a Physical Condition

While scoliosis may not initially cause pain, more noticeable symptoms can appear as the curve progresses. These may include uneven shoulders or hips, muscle aches caused by imbalance, and visible asymmetry in the body.

However, the emotional impact can be just as significant.

“Some children become very self-conscious. They try to hide their back with loose clothing, avoid social situations or feel different from others. This can affect their confidence and self-esteem,” says Dr Saw.

For teenagers, particularly girls, concerns about body image may affect participation in social activities and overall well-being.

The Biggest Myth About Scoliosis

Many parents still believe poor posture or carrying a heavy school bag causes scoliosis.

However, Dr Saw notes that approximately 80 to 90 percent of scoliosis cases are classified as idiopathic, meaning there is no known cause.

“While posture and heavy loads can contribute to back discomfort, they do not cause scoliosis,” he explains.

This misunderstanding can sometimes delay proper medical assessment and treatment.

Early Detection Can Help Avoid Surgery

The good news is that not every child with scoliosis requires surgery.

“When detected early, many cases can be managed without surgery,” says Dr Saw.

Treatment options may include specialised braces, physiotherapy and regular monitoring to prevent further progression. Advances in customised 3D braces and targeted physiotherapy programmes have also improved treatment outcomes for many patients.

Surgery is typically only considered when the spinal curve becomes severe, usually exceeding 45 degrees, or when significant progression affects balance and function.

Even then, modern spinal surgery has evolved considerably with improved imaging, surgical planning and robotic-assisted technologies.

Signs Parents Should Watch For

As part of Scoliosis Awareness Month in June, Dr Saw encourages parents to pay closer attention to signs that may indicate a spinal problem.

These include:

• Uneven shoulders
• One hip appearing higher than the other
• Clothes hanging unevenly
• A visible lean to one side
• Prominent ribs when bending forward
• Uneven pelvic alignment when walking

A simple forward-bending observation, known as the Adam’s Forward Bend Test, may help identify potential spinal curvature. However, any concerns should be assessed by a healthcare professional.

“Scoliosis is often beyond a child’s control, but timely diagnosis and intervention can make a significant difference,” says Dr Saw.