AT first glance, it may seem like a harmless habit. A child slouches at the dining table, leans slightly to one side or appears to have uneven shoulders. Many parents assume it is simply poor posture or the result of carrying a heavy school bag.
However, these subtle signs may sometimes point to a more serious condition known as scoliosis.
According to Dr Saw Lim Beng, Consultant Robotic and Spine Surgeon at Sunway Medical Centre, Sunway City (SMC), scoliosis is more than just a postural issue.
“Scoliosis is a three-dimensional spinal deformity where the spine bends and rotates, affecting the body’s overall balance,” he explained.
The condition often develops silently during childhood and adolescence. In many cases, there is little or no pain during the early stages, making it easy for parents to overlook.
Why timing matters
One of the most important aspects of scoliosis management is recognising it early, particularly before and during a child’s growth spurt.
Dr Saw said scoliosis often appears mild initially and may progress gradually. However, the period between the ages of 10 and 15 can be particularly critical.
“During this time, the spine can grow very quickly. A mild curve can sometimes worsen significantly as the child grows,” he noted.
This progression can occur faster than many families expect. A curve that previously required only observation may become more severe within a relatively short period, highlighting the importance of regular monitoring.
“Regular follow-up allows doctors to detect changes early and intervene when necessary, especially in growing children,” he added.
More than a physical condition
In its early stages, scoliosis may cause few noticeable symptoms. As the condition progresses, children may develop uneven shoulders or hips, prominent ribs, muscle fatigue and visible body asymmetry. However, the impact is not always physical.
“Some children become very self-conscious. They may try to hide their back with their hair or loose clothing, avoid social situations or feel different from their peers. This can affect their confidence and self-esteem,” stressed Dr Saw.
For teenagers, particularly girls, concerns about body image may influence social interactions, participation in activities and overall emotional well-being.
Debunking common misconceptions
One of the most persistent misconceptions is that scoliosis is caused by poor posture or carrying heavy school bags.
Dr Saw noted that between 80% and 90% of scoliosis cases are classified as idiopathic, meaning the exact cause remains unknown. While poor posture and heavy loads can contribute to back discomfort, they do not cause scoliosis.
“This misunderstanding often delays medical assessment because parents assume the problem will resolve once posture improves,” he stated.
The good news is that early detection often allows scoliosis to be managed without surgery.
Initial treatment may include regular monitoring, specialised physiotherapy exercises and bracing to prevent further progression of the spinal curve.
Advances in customised 3D braces and targeted physiotherapy programmes have expanded treatment options, helping many patients manage the condition effectively during their growth years.
Surgery is generally considered only when the spinal curve becomes more severe, typically above 45 degrees, or when there is significant progression despite other forms of treatment.
According to Dr Saw, modern surgical techniques have evolved considerably over the years.
“Advances in imaging, planning and surgical technology have improved the way spinal curvature conditions are managed,” he said.
At SMC, robotic-assisted systems may be used in selected cases to support surgical planning and decision-making as part of a multidisciplinary approach.
Nevertheless, Dr Saw stressed that surgery remains a last resort and is only considered when non-surgical options are no longer sufficient.
Don’t ignore the warning signs
One of the biggest challenges in scoliosis management is delayed diagnosis.
Many families hope the condition will improve on its own, only seeking specialist care when the spinal curve has already progressed significantly.
“Delaying treatment can allow the condition to worsen, making management more complex,” said Dr Saw.
Parents are encouraged to watch for warning signs such as uneven shoulders, clothes hanging unevenly, a body that leans to one side, prominent ribs when bending forward or an uneven pelvis during walking.
A simple forward-bend observation, known as Adam’s Forward Bend Test, may help identify possible signs of scoliosis, although a professional assessment is recommended if concerns arise.
In conjunction with Scoliosis Awareness Month, Dr Saw urged parents to look beyond posture and pay attention to changes in their child’s body alignment.
“Scoliosis is often beyond a child’s control, but timely assessment and appropriate treatment can make a significant difference to long-term outcomes,” he remarked. ‒ June 25, 2026
Main image: Sunway Medical Centre
