Spine & Chest

Scoliosis in Children and Adolescents: When to Worry

Name: Scoliosis in Children Milan: Degrees, Bracing and When Surgery Is Needed
Creator: Dott. Daniele Priano
Published: 2026-01-15

What's your child's scoliosis curve measurement? Learn about classification, when bracing is needed and surgical criteria. Milan scoliosis specialist.

Medically reviewed: April 2026·Dott. Daniele Priano

In short

Scoliosis is a three-dimensional deviation of the spine that may appear or progress during growth. Most curves are mild and do not require treatment; some evolve and deserve careful monitoring. The aim of the first visit is to decide whether observation alone, specific physiotherapy, or a brace evaluation is needed.

When an evaluation can be useful

Asymmetry of shoulders, scapulae or hips noted by you or the paediatrician
Visible rib hump when the child bends forward
Scoliosis already diagnosed, to reassess progression and skeletal maturity
Pre-adolescence and adolescence — phases of greatest growth

The aim of the visit is not always to start a treatment: often it is to understand whether the situation can be observed calmly or whether further investigation is needed.

Book a paediatric orthopaedic evaluation See how the paediatric orthopaedic visit works

Visits in Milan at Pini and CTO, subject to availability.

When not to wait

Onset of significant pain or night pain
Neurological symptoms (tingling, weakness)
Rapid progression visible within a few months

If you recognise one of these signs, contact your paediatrician or the emergency service.

Quick Answers

Can my child play sports with scoliosis?

Yes, in the vast majority of cases, sports are not only allowed but encouraged. Physical activity strengthens muscles and promotes correct posture. Symmetrical sports (swimming, athletics, volleyball) are preferred, but no sports are absolutely contraindicated. The important thing is that the activity is regular and enjoyable for the child.

Is the brace painful or limiting?

Modern braces are designed to be worn under clothing and allow most daily activities. Initial adjustment takes a few weeks. It is not painful if well-made and correctly worn. Compliance (adherence to treatment) is essential for effectiveness.

Does scoliosis always get worse?

No. Mild curves often remain stable or even improve. The risk of progression depends on curve magnitude, age, and remaining growth potential. Curves under 20° in patients at the end of growth rarely worsen.

See all 7 questions →

Classification by Age

Infantile Scoliosis(0-3 years)

Infantile scoliosis is rare, representing about 1% of cases. It can be resolving (self-correcting) or progressive. In males, the resolving form is more common, while progressive forms prevail in females. Careful monitoring is required given the long remaining growth period.

Prognosis: Many forms resolve spontaneously by age 3. Progressive forms benefit from early follow-up.

Juvenile Scoliosis(4-9 years)

Juvenile scoliosis represents 10-15% of idiopathic cases. It manifests before the pubertal growth spurt and has a higher risk of progression than the adolescent form. It affects females more frequently with a ratio of 2-4:1.

Prognosis: Higher risk of progression due to the long remaining growth period. Often requires a more structured pathway.

Adolescent Scoliosis (AIS)(10-18 years)

Adolescent idiopathic scoliosis (AIS) is the most common form, representing 80% of cases. It manifests during the pubertal growth spurt and predominantly affects females (7:1). Progression risk correlates with remaining growth potential and curve magnitude.

Prognosis: Progression depends on skeletal maturity and curve magnitude. Mild curves rarely progress after maturity.

Adolescent idiopathic scoliosis is a three-dimensional curvature of the spine associated with vertebral rotation. It typically develops between ages 10 and 16, with a strong female predominance in curves that require clinical attention.

Diagnosis starts with a careful clinical evaluation and, when indicated, targeted radiographic imaging. The risk of progression is estimated by considering curve magnitude, age, skeletal maturity, and pubertal stage.

During the visit we discuss the most appropriate path together: periodic monitoring for mild curves, specific exercises as supportive care, possible bracing in evolving forms in skeletally immature patients, surgical evaluation in selected cases. Sports are encouraged in most cases.

📐Not All Curves Require a Brace

A mild curve under 20° often requires only monitoring. I evaluate degrees, skeletal maturity, and progression potential to define the right path.

When to seek evaluation

Shoulder or pelvis asymmetry
Visible dorsal hump on forward bending
Visible spine curves from behind
Family history of scoliosis
Report from pediatrician or during school screening
Rapid growth during puberty

What is evaluated

Clinical and family history
Spine examination in standing and forward-bending position
Clinical assessment of trunk symmetry
Clinical assessment of skeletal maturity and pubertal stage
Radiographic imaging only when clinically indicated
Consideration of remaining growth potential

Treatment options

Periodic clinical monitoring for mild curves
Specific exercises as supportive care
Possible brace in evolving forms in skeletally immature patients
Surgical evaluation reserved for selected progressive cases

About Surgical Treatment

For scoliosis and spinal conditions, I focus exclusively on conservative management: observation, bracing, and specific physiotherapy. Cases requiring spinal surgery are referred to specialized vertebral surgeons with whom I collaborate.

Frequently Asked Questions

Can my child play sports with scoliosis?▼

Is the brace painful or limiting?▼

Does scoliosis always get worse?▼

Is scoliosis hereditary?▼

There is a genetic component: having a family member with scoliosis increases the risk of developing it. However, it is not a direct transmission and many children with family history do not develop significant scoliosis. Screening is still recommended in case of family history.

How long does brace treatment last?▼

The brace is generally worn until the end of skeletal growth, approximately until 16-18 years for females and 17-18 years for males. Daily wearing time (hours/day) is personalized based on the curve and growth phase.

Can orthotics correct scoliosis?▼

No, orthotics do not correct scoliosis. Scoliosis is a spinal deformity that cannot be influenced by foot supports. However, a leg length discrepancy can cause a compensatory spinal curve that mimics scoliosis. Learn more about Limb Length Discrepancy

Can scoliosis be caused by one leg being shorter?▼

Yes. Limb length discrepancy (difference in leg lengths) can cause pelvic tilt and a compensatory spinal curve that may be mistaken for true scoliosis. It is essential to distinguish between true (structural) scoliosis and postural curvature secondary to leg length difference, as treatments are very different.

Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.