Scoliosis and emotional issues

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Having scoliosis can be emotionally upsetting for young children and teenagers. Find out about some common issues they face, such as negative self-image and increased stress.

Key points

  • Scoliosis can affect your child's body image, but feelings of anxiety, fear, and withdrawal often improve with time.
  • Treatment can improve the appearance of your child’s back, rib cage, shoulders and hips.
  • While some studies showed that children with scoliosis are unhappy with their appearance or feel isolated or depressed, others found that many children were not bothered by scoliosis.

Sometimes, scoliosis can cause a child stress and negatively affect their body image. There are a number of ways to help them with the feelings brought on by the diagnosis.

Body image

Scoliosis can affect the shape of your child’s back, rib cage, shoulders, and hips. Sometimes these changes can affect how they feel about their body (body image) and themselves.

Negative body image doesn’t always relate to the size of the curve. Your child may have a relatively small curve and be concerned about their body image. They might refuse to wear bathing suits, tank tops, or tight-fitting clothing. On the other hand, your child may have a large curve and changes to their body shape without having problems with their body image.

The three main reasons your child might have surgery for scoliosis include:

  • Preventing further deformity
  • Preventing future health problems
  • Improving the appearance of your child’s back, rib cage, shoulders, and hips

It is very important that your child lets their surgeon know their feelings about how their body looks. The surgeon will discuss with your child if and how much surgery can help improve the appearance of the back, rib cage, shoulders, and hips.

Exercising regularly can help your child feel better about their body. Being in contact and talking with other children facing the same issues can also help your child feel less isolated. Talking with others about the challenges of clothing, sports, dating and other struggles can help your child cope better.

Other emotional issues

Being diagnosed with scoliosis can cause your child a lot of stress. When they were first diagnosed, they may have felt anxiety, fear, and withdrawal. These feelings tend to improve with time.

If your child has to wear a brace before surgery, they may face additional issues, such as:

  • Bullying and teasing by their peers
  • Feeling different from their friends
  • Confrontation with their parents about wearing their brace

If your child needs to be treated with surgery, they may have other concerns:

  • Fear of the surgery itself and the risks
  • Worry about missing school and falling behind
  • Concern about how they will look after the surgery
  • Concern about activities they will be able to do after surgery
  • Concern about pain after surgery

Other things that can cause difficulty with adjusting to the diagnosis include:

  • Denial: refusing to accept the diagnosis of scoliosis and its treatment
  • Ongoing family problems
  • Previous challenges with coping in other situations
  • History of being bullied and teased at school by peers
  • You and/or your child have a pre-existing mental health diagnosis such as anxiety, depression, eating disorder, etc.
  • Prolonged treatment

Teens who receive scoliosis treatment after 16 years of age tend to have more mental health problems than those treated at a younger age. If you or child have a pre-existing mental health diagnosis, sharing your concerns with your child’s health-care team will help the team identify available resources at the hospital to help with coping and readiness for surgery.

Not all children with scoliosis react in a negative way. One study found that 40% of teens were not bothered by being diagnosed with scoliosis, and half of the teens who had surgery said they felt more independent and mature. However, if you are worried or your child has shared concerns with you, make sure to let the surgical team know.

Coping with anxiety about surgery

It is normal for children to experience an increase in stress before surgery. Symptoms of stress include feeling tense, restless, nervous, worried, nauseous or irritable. Stress symptoms are sometimes experienced as anxiety or depression.

Just like any skill, learning to manage stress takes practice. Your child may find it helpful to start thinking about and practicing strategies for stress management before the surgery. These strategies can also be helpful to cope with pain experienced after surgery.

Helpful strategies to cope with stress include:

  • Focusing on breathing: Taking deep, slow breaths is a way to relax physically and emotionally. Try to breathe in through your nose, send your breath deep into your belly, and breathe out slowly through your mouth.
  • Listening to music, meditations, or audiobooks.
  • Getting adequate sleep: No screens 90 minutes before bed, limit caffeine intake, and keep a regular sleep schedule.
  • Using creative outlets such as art, journaling, music, or dancing.
  • Exercising regularly.
  • Speaking to people you trust about how you are feeling.
  • Spending time doing the things you enjoy.
  • Finding opportunities for laughter.

Knowing what to expect from surgery can help children feel more confident about what’s to come. Encourage your child to ask questions and express any concerns prior to surgery. Before surgery, it may be helpful for you and your child to review the reasons your child is having surgery. Make a list of the benefits identified by your child, your family, and your child’s health-care team.

Coping with hospitalization

For children

Being in hospital can be difficult for children, especially teenagers. Adolescence is a time when independence, peer relationships, body image and privacy become increasingly important. Scoliosis surgery and recovery can have an impact on each of these domains as teens depend on others to meet their personal needs, require time away from school, and experience a change to their physical appearance (scarring).

While in hospital, your child is encouraged to:

  • Practice stress management strategies when they are feeling overwhelmed, frustrated or in pain.
  • Talk about how they are feeling with family, friends, a social worker, or the health-care team.
  • Remind themselves that staying in hospital is temporary.
  • Bring comforting items from home.
  • Stay connected to friends and family.
  • Utilize distraction. The hospital has many fun spaces for families, and activities that can be provided in your child’s room. Your child can even have a teacher bring them schoolwork while in hospital.

For parents

Some parents express feeling helpless during their child’s hospitalization for scoliosis surgery. While it is difficult, you will not be able to take away all of your child’s suffering. Modeling effective stress management, being involved in care with the hospital team, and providing distraction and emotional support to your child are all helpful ways parents can help their child with recovery from surgery.

While your child is in hospital, you are encouraged to:

  • Be prepared for your child to behave or act differently than their normal selves after surgery, as they are coping with pain and influenced by medications.
  • Develop your own network of support. This may include friends, family members, or a social worker.
  • Practice self-care: taking breaks from your child’s bedside, walking outside, connecting with friends and family.

Helping your child cope at home

Understand that your child may need more support from you after surgery and may be feeling vulnerable. Sometimes, feelings of vulnerability come across as anger, hostility, and ambivalence. Your child may not spontaneously or openly talk about feelings of stress and anxiety. You may notice your child is feeling stressed through their behaviour.

Signs of stress in adolescents include:

  • Irritability
  • Changes in mood
  • Headaches
  • Stomachaches
  • Changes to sleep
  • Trouble concentrating
  • Difficulty at school
  • Increased crying

Identify how your child is feeling by listening to their concerns and inviting open conversation. Try to avoid distractions such as cellphones while checking in with your child. You can’t solve every problem, but you can acknowledge and understand what your child is going through.

Parents can also model positive ways to cope with stress. Remember to take care of yourself, ask for support, and manage demands.

As your child recovers, encourage a slow return to daily activities and re-engagement in school and friend groups. Reinforce what your teen is doing well and the progress they are making in their recovery. If you are concerned about your teen’s coping, reach out for social work or community mental health support.

Speaking to a social worker

Social workers are available to help patients and their families cope with the challenges that come up around surgery. Your child can ask to speak with a social worker before their surgery, or they can ask to meet with a social worker while in hospital. Social workers can support you and your child with difficult feelings, managing stress, advocating for the needs of your family, and connecting you with resources and supports in your local community.

Last updated: September 8th 2020