Most children are ordered to “stand up straight” at some stage in their formative years. For a small percentage, however, this seemingly small parental nag is impossible to perform – they suffer from scoliosis, an apparently hereditary curvature of the spine which, if not detected and treated, can become worse and very painful in later years.

We all have natural curves in our spine, designed to round out our shoulders and indent our lower back slightly inward. A few unfortunates, however, have spines that also curve from side to side, and this problem cannot be corrected just by practising good posture and walking about with a book on your head!

An estimated two percent of the population develop these spinal sidewards S-shaped or C-shaped curves, which usually start becoming apparent in childhood, and more often in girls than in boys.

Scoliosis is usually preceded with the tag “idiopathic”, meaning the cause is unknown. It is however apparent that scoliosis runs in families – if someone in your family has the condition, you have a 20 percent chance of developing it. It is advisable to have your child’s spine checked if you or a relative has curvatures of the spine.

Generally infants and small children do not show any evidence of the problem – it only becomes visible or apparent in middle to late childhood – usually before puberty. It is associated with cerebral palsy and muscular dystrophy sufferers, but just as often affects healthy children.

Adults with scoliosis probably had the condition since childhood, even if it was not diagnosed and treated while they were still growing – it progresses and causes problems in later life, leading to deformity, severe pain and even trouble with breathing. Sometimes, though, adults do develop scoliosis because of the degeneration of disks in the spine, or perhaps because of osteoporosis (softening of the bone) in the elderly.

If you are destined to develop scoliosis, you can’t prevent it – but early detection and treatment can stop it getting worse.

When a child reaches about eight years of age parents should watch out for the warning signs: uneven shoulders; prominent shoulder blades; uneven waist; elevated hips; or leaning to one side. If you suspect a problem, take junior off to see the doctor, paediatrician or orthopaedic specialist.

Treatment depends entirely on how serious the curvature of the spine is – the specialist will also investigate the family history, what age the curvature began and where the curve is located. In children the problem is usually small, and the doctor will just want to “keep an eye on it”. If the curvature progresses, an orthopaedic brace can be prescribed to stop it becoming worse; the brace will not inhibit the child from taking part in any social or physical activities – it is usually worn for only a few hours a day. Once the skeleton of the child has matured he/she can be weaned off of the brace and usually the problem has been successfully corrected.

If a brace does not stop the condition developing further, or the curvature is more than 40 degrees when the patient is first seen, surgery may be necessary. Modern surgical techniques are very successful in correcting scoliosis.