"Don't slouch!" "Stand up straight!"

Do your parents ever say things like that to you?

The human spine is designed to keep you standing straight and tall. But everyone's spine has natural curves. The most obvious one makes the lower back curve slightly inward.

In some people, however, the spine also curves sideways--a condition called scoliosis. On an X-ray image, the spine of someone with scoliosis is shaped more like an "S" or a "C" than a straight line.

Most cases of scoliosis are mild. But some people have severe curves. If the spine is very crooked, the person's ribs or hips may stick out more on one side than the other. Also, one shoulder may be lower than the other.

Of every 1,000 children, three to five develop spinal curves that are considered large enough to need treatment, reports the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health.

Often the exact cause of scoliosis isn't known, but scoliosis is definitely not the result of slouching! Sometimes the condition is diagnosed in kids under age 10. But the most common type, adolescent scoliosis, occurs after the age of 10. Girls are more likely than boys to develop adolescent scoliosis.

In most people with scoliosis, the curve in the spine is so small that it causes no problems. Even a pronounced scoliosis curve doesn't usually cause pain in children and teenagers--but it can lead to painful back problems in adulthood. That's why it's important to diagnose and treat scoliosis early.

You may have been checked for scoliosis already. Many public schools check students for the condition in fifth or sixth grade. And many pediatricians include a screening for scoliosis as part of a regular checkup.

Here's what happens during a physical examination for scoliosis: The doctor looks at the patient's back, chest, pelvis, legs and feet. He or she checks to see if the patient's shoulders are level, whether the head is centered and whether opposite sides of the body look level. The doctor also examines the back muscles while the patient is bending forward to see if one side of the rib cage is higher than the other. If differences are found, the doctor will usually send the patient to a spine specialist for further study.

When someone is diagnosed with scoliosis, the first thing the doctor will do is try to figure out how serious the curve of the spine is. In many cases, no treatment is needed, although the doctor will continue to monitor the spine as the body grows to make sure the scoliosis isn't getting worse. Other spinal curves may need to be treated with a special body brace. In rare cases, back surgery may be needed.

Body braces are prescribed for kids or teenagers with spinal curves that could lead to trouble later in life. These braces must be worn every day for the full number of hours prescribed by the doctor until the child stops growing. Luckily, most modern braces for scoliosis are light and can be worn under clothes. Kids who wear them can participate in all normal activities, including sports.

Wearing a brace for scoliosis is not like wearing the braces that your orthodontist puts on your teeth. Orthodontic braces correct crooked teeth, making them straighter. Scoliosis braces don't straighten the spine; they just keep spinal curves from getting worse as the body grows. Bracing is only used when someone's body is growing. When the skeleton is mature, around age 18 or so, the patient puts the brace away for good.

Tips for Parents

The American Academy of Orthopaedic Surgeons (AAOS) suggests that parents watch for these signs of scoliosis, beginning when a child is about 8 years old:

* Uneven shoulders.

* Prominent shoulder blade (one or both).

* Uneven waist.

* Elevated hips.

* Leaning to one side.

The AAOS says any one of these signs warrants an examination. For more information, contact the National Scoliosis Foundation, 5 Cabot Place, Stoughton, MA 02072; telephone 1-800-NSF-MYBACK (673-6922). This nonprofit organization provides pamphlets, a newsletter and other informational materials on childhood and adult scoliosis. The foundation also provides support group information and lists of physicians in each state who specialize in scoliosis.

For You to Do

It's very important for all people, including those with scoliosis, to exercise and remain physically fit. Your bones and muscles need to be used to keep them strong as you grow. Exercise also helps kids maintain a healthy weight. And it's good for your heart and lungs, too. To stay motivated, keep a record of your weekly exercise in a calendar book or on a chart you mount on your bulletin board. Write down what exercise you do, how long you do it and how it made you feel. After a month, look back and congratulate yourself on being a fit person, not a couch potato.