Different from adult scoliosis due to how and when it develops, pediatric scoliosis manifests—as the name suggests—during childhood and before the body has finished growing, generally before the age of 18.

A musculoskeletal condition, scoliosis affects the spine and, specifically, the vertebrae that make up the sign. A normal spine appears—when view from a certain angle—as a straight line front-to-back, even though there are normal curves and bends present. But a spine afflicted with scoliosis will display an abnormal side-to-side curvature that may resemble the shape of a letter C or S.

There are several types of pediatric scoliosis, and each has a unique presentation as well as different treatment methods. The most commonly seen form of the condition, idiopathic scoliosis—meaning the origin of the disease is unknown or there is no clear cause—is found in some 80 percent of adolescent scoliosis sufferers. The idiopathic form of scoliosis can be further classified into three categories; when a child under the age of three is diagnosed with this disease, physicians label it as infantile idiopathic scoliosis; if a child develops idiopathic scoliosis after the age of three and before the age of 9, the condition is labeled as juvenile idiopathic scoliosis; and when a child between the ages of 10 and 18 presents with idiopathic scoliosis it’s categorized as the adolescent type.

Neuromuscular scoliosis manifests due to specific diseases that affect the spine and the functions of the nerves and muscles around it, such as spina bifida, cerebral palsy, muscular dystrophy and polio. With congenital scoliosis, the curvature of the spine occurs in the pre-natal stage and is the result of improper fetal development—either the bones of the spine don’t form completely and vertebrae are abnormally shaped or the spinal bones separate from one another during development.

Lastly, there are the structural and nonstructural classifications of pediatric scoliosis. When the abnormal curving of the spine is fixed, the cause usually originated from some form of neuromuscular, rheumatic or metabolic disease or is the result of a birth defect, injury or tumor and is known as structural scoliosis. Conversely, nonstructural scoliosis means the condition is the result of a muscle spasm or an inflammatory problem and is temporary in nature.

Pediatric scoliosis has been shown to have a genetic component and often more than one child within a family will develop an abnormal curving of the spine. And lastly, different forms and progressions of pediatric idiopathic scoliosis are more prevalent in males and females: for instance, the infantile type is more often seen in boys, but when a girl develops it the curves tend to be more drastic and require more treatment.

Pain is thankfully not a typical symptom of pediatric idiopathic scoliosis. But there are warning signs that can be visually observed, such as uneven hips or shoulders, a shoulder blade that juts outward more than its counterpart and an obvious curving of the spine to one side. Additionally, a child afflicted with the condition may experience fatigue in their back, especially after standing or sitting for long periods of time.