Scoliosis at puberty: why early detection and timely treatment matter

A fact: most scoliosis is detected in children going through puberty. In practice scoliosis can also appear when a child is small (congenital scoliosis), with limb-length differences, flat feet and so on.

Most parents only discover that their child has scoliosis by chance, or when they clearly see unusual changes in the child's body while growing: uneven shoulders, one shoulder blade sticking out, an unbalanced figure.

According to research and general assessment, the detection rate of scoliosis is highest at puberty, with 85% identified as scoliosis of unknown cause, known as adolescent idiopathic scoliosis (AIS). There is also a clear difference by sex: in girls scoliosis is found twice as often as in boys (a ratio of 2:1).

One very important thing parents need to know is that while the child is still growing and developing, the curve often increases very fast. So the earlier it is found and the earlier and better timed the intervention, the more likely it is to correct the spine to straight or to a safe range.

Epidemiology: a review in Nature Reviews Disease Primers (Cheng et al., 2015) reports that adolescent idiopathic scoliosis affects about 1–4% of children in early puberty and is more common in girls than boys.

In September 2026 the journal Frontiers in Pediatrics published a systematic review with network meta-analysis comparing non-surgical treatments for adolescent scoliosis, pooled from 13 studies with 709 patients. The methods compared were bracing, Schroth exercises (specific physiotherapy exercises to treat scoliosis without surgery), other specific scoliosis exercises, core-muscle training and traditional-medicine rehabilitation.

The results showed that bracing and physiotherapy exercise methods tended to control the short-term curve angle better than the other methods. In studies comparing them directly, bracing also gave better results than both Schroth exercises (physiotherapy) and traditional-medicine rehabilitation. The authors note that the evidence is sparse and highly heterogeneous.

Based on the current evidence, the approach to treatment is as follows:

The specific treatment decision is made by the specialist based on each child's age, skeletal maturity, curve pattern and risk of progression.

Clinical guidelines recommend that for moderate curves physiotherapy should accompany bracing, not replace it. Exercise helps the child build muscle strength, improve posture and take an active part in treatment. The brace corrects, reduces, holds and controls the curve while the spine is still growing.

The key to success in treating scoliosis at puberty is adherence and cooperation in following the instructions. A good brace works when it is worn, used correctly and for the prescribed time.

Research also records that wearing a corrective brace can cause psychological pressure, limit activity and affect the actual wear time. Parents can help their child by:

Advice: if you suspect your child has signs of scoliosis, take your child to a specialist as soon as possible. Intervening at the right time, while the child is still growing, is the best chance to control the curve and limit the risk of later surgery.