Many people who hear the term “scoliosis” think of a condition that develops in childhood or the teenage years. But there’s another form of scoliosis that’s present at birth: congenital scoliosis. This spinal condition develops due to abnormalities in the spine during fetal growth, creating a curvature that’s visible early in life. This type of scoliosis requires a different approach to treatment than the more common types seen in older children. Here, we will explain what congenital scoliosis is, the common approaches to treating it, and why waiting to act isn’t always the best option.
If you or your child has been diagnosed with congenital scoliosis, it can be helpful to know that there are options beyond simply waiting to see if the curve gets worse. Today, with modern approaches to physical therapy and scoliosis-specific exercises, it’s possible to take action to slow curve progression and improve spinal function—without invasive surgery.
Congenital scoliosis is a spinal deformity that is present at birth. It occurs when one or more vertebrae don’t form properly during fetal development. This can result in a curvature of the spine. Unlike adolescent idiopathic scoliosis, which tends to develop around puberty and is the most common form of scoliosis, congenital scoliosis is typically found early in life because the curve is present as the baby grows.
What Is Congenital Scoliosis?
This condition can vary widely in severity. Some children with congenital scoliosis might have a small, stable curve that doesn’t impact their daily lives, while others might have a more pronounced curve that worsens over time, affecting their mobility, posture, and even lung function. Physical signs can include an uneven shoulder height, a visible spinal curve, and asymmetry in the hips or ribs. In more severe cases, congenital scoliosis may impact growth and physical development.
Check out this video to learn more about congenital scoliosis caused by two hemivertebrae:
In the above video we discuss what congenital scoliosis is and with the help of one of our scoliosis patients, we show what it looks like in person as well as on x-ray.
The “Wait and See” Approach
Many families are told to “wait and see” if the curve gets worse after a diagnosis of congenital scoliosis. This is based on the fact that not every scoliosis curve worsens over time; some remain stable, and surgery or intervention may not be necessary. In the “wait and see” approach, doctors recommend regular monitoring with periodic x-rays and physical exams to assess any curve progression, particularly as the child grows.
However, while the “wait and see” approach is often recommended, it can feel discouraging for parents who want to take an active role in their child’s care. Many families may not realize that there are non-invasive, conservative treatments that can help manage congenital scoliosis and even prevent the curve from progressing.
Moving Beyond “Wait and See”
For many families, the idea of just waiting for the curve to worsen doesn’t feel like a complete solution. Luckily, conservative treatments offer a way to manage the curve early on, helping to improve posture, relieve discomfort, and slow progression in a way that can ultimately help a child avoid surgery. And there’s more good news: modern physical therapy has developed techniques specifically for treating scoliosis. These treatments are safe, non-invasive, research backed, and have shown great results for scoliosis patients of all ages.
Taking a proactive approach through scoliosis-specific physical therapy can be an empowering choice for families. With these therapies, children learn specific exercises designed to strengthen their spines, improve posture, and fight against progression of the scoliosis. And for many parents, this approach offers a sense of control, helping them support their child’s health more actively.
Conservative Treatment Options for Congenital Scoliosis
1. Physiotherapeutic Scoliosis Specific Exercise (PSSE)
One of the most effective options available today is physiotherapeutic scoliosis specific exercise (or PSSE), which tailors exercises to the individual curve of the spine. A leading approach within scoliosis therapy is the Schroth Method. This technique uses posture correction exercises, breathing techniques, and physical strengthening to improve spinal alignment and reduce pain. Schroth-trained physical therapists guide patients in exercises that strengthen the muscles surrounding the spine, support better balance, and encourage proper posture.
Studies have shown that the Schroth Method can be effective in reducing scoliosis progression when used consistently. It has even been shown to reduce the degree of curvature in some patients. By targeting the unique challenges of scoliosis curves, PSSE provides benefits that regular physical therapy can’t.
2. Core and Postural Strengthening
Building a strong core and improving posture are fundamental to managing scoliosis. The spine relies on surrounding muscles for support, and a strong core helps maintain spinal alignment and stability, which can reduce the risk of further curve progression. Stretching tight muscles—especially those in the chest, abdomen, and hip areas—can also help prevent the curve from becoming more pronounced by improving flexibility and mobility.
When practiced consistently, core and postural strengthening exercises support a healthy, stable spine that’s better able to resist the daily pressure of gravity on the spine. These exercises not only improve physical strength but also increase awareness of posture and movement, both of which are essential in managing scoliosis.
3. Breathing and Flexibility Exercises
Breathing exercises might seem unrelated to spine health, but they’re actually quite important for scoliosis patients, particularly those with curves in the upper spine that can affect lung capacity. The Schroth Method includes breathing exercises designed to improve rib mobility and lung function, which can be crucial for kids with scoliosis. Combined with flexibility exercises that stretch tight muscles and ligaments, these methods help scoliosis patients gain better control over their posture and reduce discomfort.
4. Manual Therapy
Because the spinal curve is related to changes in the bone shape in congenital scoliosis, this diagnosis often comes with tension and pain in the back where muscles and ligaments are shortened. Manual therapy techniques, such as ASTYM and massage, can be helpful to reduce tension in the collapsed areas of the trunk and improve mobility. This, in turn, can help improve function and reduce pain.
When Surgery Is Necessary
Despite the benefits of conservative treatment, surgery is sometimes necessary, particularly for severe cases or curves that progress quickly and start to interfere with organ function or the quality of life. Spinal fusion surgery is one option for stabilizing the curve and preventing further progression. In this procedure, metal rods are used to hold the spine in place while the bones fuse over time. Though effective, surgery is often a last resort due to its risks, recovery time, and potential impact on flexibility.
However, for families pursuing conservative treatments, surgery can often be postponed or even avoided altogether by actively managing scoliosis through PSSE and exercise.
The Benefits of a Proactive Approach to Congenital Scoliosis
Choosing a proactive approach can help prevent complications and give children a better quality of life. Conservative treatments provide an alternative path for families who want to take a more active role, addressing the condition head-on rather than waiting to see if it worsens.
By practicing scoliosis-specific exercises, children learn techniques they can use throughout their lives to manage their spine health. For parents, it’s a relief to know that they’re taking steps now to protect their child’s well-being. And for children, it fosters confidence in managing their condition and helps build lifelong habits that support a healthy spine.
Conclusion
A diagnosis of congenital scoliosis can be overwhelming, but it doesn’t mean that your only option is to wait and see. Conservative treatments like scoliosis-specific exercise, core strengthening, breathing exercises, and manual therapy can make a difference by slowing progression, relieving pain, and even reducing the need for surgery. If you’re interested in exploring these options, check out our scoliosis portal HERE.
Want to take a proactive approach?
Contact us today to learn more about how specialized treatment for congenital scoliosis can make a lasting difference.
David Butler, Physical Therapist
