Scoliosis is a condition where your spine curves sideways, often forming a C- or S-shape when viewed from behind. While mild cases may go unnoticed, more noticeable curves can lead to uneven shoulders, back pain, or posture changes. It most commonly develops during adolescence, though it can affect people of any age. Scoliosis treatment depends on the severity and age of onset, and may include observation, bracing, physiotherapy, or in some cases, surgery to correct or stabilise the curve.
What is scoliosis?
Scoliosis is a condition where your spine curves side-to-side, forming a C or S shape instead of remaining straight. While your spine naturally has forward and backward curves, scoliosis causes an abnormal lateral curvature that can affect your posture and movement.
The condition is most commonly diagnosed in children and adolescents, though it can also develop in adults due to degenerative changes in the spine. In many cases, scoliosis is mild and doesn’t cause symptoms, but more severe cases can lead to uneven shoulders, back pain, and difficulty breathing.
Scoliosis of the spine requires regular monitoring, especially in growing children, to track progression. Treatment options include bracing, which helps prevent worsening, and surgery, which may be necessary for severe cases to correct spinal alignment.
Types of scoliosis
Scoliosis can be classified into different types based on its cause and when it develops:
Idiopathic scoliosis
The most common type, with no known cause. It often appears in adolescence and may have a genetic link. Idiopathic scoliosis is further categorised by age:
- Infantile (0–3 years)
- Juvenile (4–10 years)
- Adolescent (11–18 years)
- Adult (18+ years, after skeletal maturity)
Congenital scoliosis
Present at birth due to abnormal spinal development in the womb. It may worsen as a child grows.
Neuromuscular scoliosis
Caused by underlying conditions like cerebral palsy, muscular dystrophy, or spina bifida, affecting muscle balance and spinal alignment.
Degenerative (adult-onset) scoliosis
Develops later in life due to age-related changes, such as disk degeneration or osteoporosis.
Types of scoliosis curvatures
Scoliosis can also be classified by the location and direction of your spinal curve:
- Thoracic scoliosis - affects the upper back (between your neck and rib cage) and is the most common form of idiopathic scoliosis.
- Lumbar scoliosis - occurs in your lower back and is often linked to age-related degeneration.
- Thoracolumbar scoliosis - spans your mid-to-lower spine and is common
- in adolescents, accounting for around 40% of idiopathic cases.
- Combined scoliosis - involves two curves, typically one in your upper and one in your lower spine, creating an S-shape. This double curve is less common.
- Dextroscoliosis - curves to the right and is the most frequent pattern in adolescent idiopathic scoliosis.
- Levoscoliosis - curves to the left and may be associated with underlying conditions like neuromuscular disorders or spinal abnormalities.
Symptoms of scoliosis - how to tell that you have scoliosis
Scoliosis symptoms vary depending on severity. It can develop gradually and early signs may be subtle. Here are key indicators to watch for:
- Uneven shoulders - one shoulder may appear higher than the other.
- Head misalignment - your head may not be centred with your body.
- Uneven hips - one hip may sit higher or protrude more.
- Asymmetrical shoulder blades - one shoulder blade may be more prominent.
- Uneven waist - your waistline may appear tilted or imbalanced.
- Rib prominence - one side of your rib cage may push forward.
- Back asymmetry when bending - your back may look uneven when bending forward.
- Postural changes - a noticeable curve in your spine affecting stance.
- Back pain - more common in adults but can occur in severe cases.
Most scoliosis cases are mild and don’t cause symptoms, but severe cases can lead to pain, posture issues, and breathing difficulties. If you notice any of these signs, it’s advisable to consult a healthcare provider for an evaluation.
How is scoliosis diagnosed?
Wondering how to know if you have scoliosis? A healthcare provider will typically diagnose scoliosis through physical exams, medical history reviews, and imaging tests. Early detection is crucial for effective treatment.
Physical examination and medical history
A doctor will conduct a detailed physical exam, checking for uneven shoulders, hips, or ribs, spinal curvature when bending forward, and muscle weakness, numbness, or reflex abnormalities.
They will also ask about family history of scoliosis, symptoms such as back pain or posture changes, and any bowel, bladder, or motor issues, which may indicate nerve involvement.
Imaging tests
If scoliosis is suspected, imaging tests help confirm the diagnosis and assess severity:
- X-rays - the primary tool for measuring spinal curvature.
- MRI scans - used if an underlying spinal cord issue is suspected.
- CT scans - provide detailed images of bones and soft tissues.
- Hand X-rays - sometimes used to determine skeletal maturity in growing children.
Regular follow-up X-rays may be needed to monitor progression, especially in children.
What age is scoliosis typically diagnosed?
Scoliosis is most commonly diagnosed during adolescence, typically between ages 10 and 15, when rapid growth can make spinal curvature more noticeable.
However, scoliosis can also be diagnosed in adults, often due to age-related degeneration or previously undetected mild scoliosis that worsens over time. In these cases, scoliosis symptoms may appear later in life, leading to a late diagnosis.
How is scoliosis measured?
Healthcare professionals assess scoliosis severity by measuring the **degree of spinal curvature**. This is done using:
- Scoliometer - a handheld device placed on the back to estimate the curve.
- X-rays - provide a precise measurement using the Cobb angle, which determines the degree of spinal curvature.
Severity Classification
Less than 10 degrees - no scoliosis diagnosis.
10 to 24 degrees - mild scoliosis.
25 to 39 degrees - moderate scoliosis.
40+ degrees - severe scoliosis.
The Cobb angle is measured similarly to angles in geometry, helping doctors determine treatment needs.
What causes scoliosis?
The cause of scoliosis depends on its type, but common factors include:
- Idiopathic scoliosis - the most common type, with no known cause, though it may have a genetic link.
- Congenital scoliosis - results from vertebrae malformation during embryonic development.
- Neuromuscular scoliosis - caused by underlying conditions like cerebral palsy, muscular dystrophy, or spina bifida, affecting muscle control.
- Spinal cord conditions - abnormalities in your spinal cord can contribute to scoliosis.
- Injury or surgery - trauma to your spine or early childhood surgeries on your chest wall may lead to curvature.
Risk factors for scoliosis
Certain factors may increase the likelihood of developing scoliosis:
- Family history - scoliosis can run in families, though not all cases are genetic.
- Age - most cases develop in children over 10 or during adolescence.
- Sex - while scoliosis affects all genders, females are more likely to experience curve progression requiring treatment.
- Underlying conditions - neuromuscular disorders like cerebral palsy, muscular dystrophy, or spina bifida can contribute to scoliosis.
- Spinal abnormalities at birth - congenital scoliosis results from vertebrae malformations during foetal development.
- Injury or surgery - trauma to your spine or early childhood chest surgeries may lead to curvature.
Complications of scoliosis
While mild scoliosis often doesn’t cause issues, severe cases can lead to complications, including:
- Breathing difficulties - a severe spinal curve can press against the lungs, making it harder to breathe.
- Chronic back pain - untreated scoliosis may lead to persistent discomfort, especially in adulthood.
- Postural changes - uneven shoulders, hips, or ribs can affect balance and appearance.
- Nerve damage - severe curvature may compress nerves, causing pain or weakness.
- Arthritis - increased spinal stress can contribute to early-onset arthritis.
- Spinal fluid leakage - in extreme cases, scoliosis may impact spinal fluid circulation.
- Organ dysfunction - severe spinal deformities can affect heart and lung function.
If scoliosis symptoms worsen or cause breathing issues, seek medical attention promptly.
How to relieve scoliosis at home
Managing scoliosis pain at home involves a combination of movement, posture awareness, and lifestyle adjustments.
Engaging in low-impact exercises such as swimming, yoga, and stretching can help strengthen core muscles and support spinal health. Maintaining proper posture while sitting and standing reduces strain on the spine, while heat therapy, massage, and over-the-counter pain relievers can provide relief from discomfort. A firm mattress and appropriate pillow support can improve spinal alignment during sleep, and a diet rich in calcium and vitamin D supports overall bone health.
While these strategies can help manage symptoms, it’s important to consult a healthcare provider for personalised guidance.
Scoliosis treatment
Scoliosis treatment depends on the severity of the spinal curve and the age of the patient. Mild cases may only require monitoring, while more pronounced curves can be managed with bracing, physiotherapy, or surgery. Advances in medical technology have made minimally invasive procedures more effective, helping patients maintain mobility and spinal health.
Braces
Children diagnosed with moderate scoliosis may need to wear a brace to prevent the spinal curve from worsening. While bracing doesn’t reverse scoliosis, it can help stabilise your spine during growth.
The most common brace is made of plastic, fitting under the arms and around the rib cage, lower
back, and hips. It’s discreet and can be worn under clothing. Braces are typically worn for 13 to 18
hours a day, with effectiveness increasing the longer they’re worn. Children can participate in most
activities, removing the brace for sports or physical exercise if needed. Some braces are designed
for nighttime use, depending on the type of scoliosis.
Bracing is most effective while a child is still growing. Growth typically stops around age 14 for
females and age 16 for males, though this varies.
Conservative scoliosis treatment
For patients with mild scoliosis, nonsurgical options focus on monitoring, pain relief, and strengthening exercises to maintain spinal health, mobility and comfort and prevent progression.
- Regular check-ups - healthcare providers track scoliosis progression through routine exams and imaging. Monitoring ensures early intervention if the curve worsens.
- Pain management - over-the-counter pain relievers help manage discomfort.
- Alternative therapies - like chiropractic care, acupuncture, and massage may provide relief.
- Exercise and core strengthening - targeted exercises strengthen muscles supporting the spine, stretching routines improve flexibility and posture, and low-impact activities like swimming and yoga enhance spinal stability.
Physiotherapy
Physiotherapy is often recommended for scoliosis patients to reduce pain, improve posture, and enhance mobility. A physiotherapist may tailor exercises to strengthen muscles supporting the spine and alleviate discomfort.
Common physiotherapy approaches include:
- Posture correction - helps maintain spinal alignment and reduce strain.
- Low-impact exercises - activities like swimming and yoga improve flexibility and core strength.
- Daily stretching - reduces stiffness and enhances mobility.
- Physical activity guidance - ensures safe movement and prevents further spinal stress.
Scoliosis surgery
Spinal surgery may be necessary for severe scoliosis or cases that don’t respond to nonsurgical treatments. The goal is to stabilise the spine, restore balance, and relieve pressure on nerves.
Types of scoliosis surgery include:
- Spinal fusion - the most common procedure, where vertebrae are fused together using bone grafts and metal implants to prevent further curvature. Recovery typically takes 3 to 6 months.
- Vertebral body tethering (VBT) – a minimally invasive technique where screws and a flexible cord are placed along the spinal curve. Tightening the cord gradually straightens the spine as the child grows.
- Expandable rods - used for young children with progressive scoliosis. Surgeons place growing rods along the spine, which are adjusted every few months to accommodate growth. Some rods expand automatically, while others require magnetic adjustments.
Potential Complications
- Infection - post-surgical infections may require antibiotics or additional procedures.
- Nerve damage - rare, but possible, affecting movement or sensation.
- Continued curvature - your spine may keep curving above or below the fusion site.
- Limited flexibility - fusion surgery reduces spinal mobility in the treated area.
Scoliosis surgery recovery time
Recovery from a scoliosis operation varies based on the type of procedure, age, and overall health. Here’s a general timeline:
First few weeks - hospital stay of 3 to 7 days for monitoring and pain management. Limited movement. Gradual walking with assistance.
6 to 12 weeks - increasing activity where light exercise and daily movements resume. Regular check-ups ensure proper healing.
3 to 12 months - full recovery. Most patients return to normal activities within 6 months. Strength building through physiotherapy to help maintain spinal stability.
Scoliosis at Ramsay Health Care
Ramsay Health Care UK offers comprehensive scoliosis services, including diagnostics, physiotherapy, and surgical treatment. Their expert teams provide personalised care plans with access to spinal fusion, vertebral body tethering (VBT), and expandable rod procedures for children and adults. With shorter wait times, fixed-price packages, and dedicated aftercare, Ramsay ensures a smooth and supportive treatment journey from diagnosis to recovery.
