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Overview

What Is Scoliosis?

Scoliosis is a condition in which the spine curves sideways and may also rotate. This scoliosis spinal curvature can make the shoulders, waist, or hips look uneven. It most often develops during childhood or adolescence, but adults can also develop or experience scoliosis. The exact meaning of scoliosis can vary because it may be related to growth, another condition, or age-related changes.

Symptoms

Scoliosis Symptoms

  • Uneven shoulders
  • One hip higher than the other
  • An uneven waistline
  • One shoulder blade that appears more prominent
  • Leaning to one side when standing
  • Back pain, especially in some adults with scoliosis
  • Shortness of breath with a severe spinal curve

Causes

What Causes Scoliosis?

Idiopathic scoliosis

Idiopathic scoliosis has no single identified cause and commonly begins during adolescence. Genetic factors may play a role, but scoliosis is not usually inherited in a simple, predictable pattern. This means having a family member with scoliosis may increase risk without making the condition certain; it is not generally considered a straightforward hereditary or genetic disease.

  • Congenital scoliosis: The spine develops abnormally before birth because of differences in the formation of the vertebrae.
  • Neuromuscular scoliosis: Conditions affecting muscles or nerves, such as cerebral palsy or muscular dystrophy, can prevent the spine from being supported normally.
  • Degenerative or adult-onset scoliosis: Wear of the spinal joints and discs can produce or worsen a curve later in life.
  • Functional scoliosis: A temporary or flexible curve may result from another problem, such as unequal leg length, muscle spasm, or pain.
  • Thoracic scoliosis: The main curve is in the chest or upper-back region of the spine.
  • Lumbar scoliosis: The main curve is in the lower-back region.
  • Thoracolumbar scoliosis: The curve extends across the junction between the thoracic and lumbar spine.

Risk Factors

Scoliosis Risk Factors

  • Being in a period of rapid growth, especially during adolescence
  • Having a family history of scoliosis
  • Being female, which is associated with a higher risk of curve progression in some adolescent cases
  • Having congenital differences in the spine
  • Having a neuromuscular condition that affects muscle control or strength
  • Older age with spinal disc and joint degeneration

Complications

Scoliosis Complications

  • Chronic or recurring back pain
  • Worsening spinal deformity as the curve progresses
  • Reduced mobility or difficulty with some activities
  • Breathing difficulty when a severe curve limits chest expansion
  • Self-image concerns or emotional distress

WHAT TO KNOW

Complications are not inevitable

Possible complications depend on the curve’s size and location, the person’s age, whether it progresses, and the underlying cause. Many people with mild scoliosis do not develop serious complications.

Diagnosis

How Scoliosis Is Diagnosed

A clinician usually begins with a medical history and physical examination. They may assess posture, shoulder and hip symmetry, the shape of the waist, and whether the trunk shifts to one side. During a forward-bend test, the clinician looks for a rib or back prominence caused by rotation of the spine. Neurologic checks and questions about pain, weakness, numbness, and changes in function help identify related problems.

Imaging and curve measurement

AssessmentWhat it evaluatesWhen it may be used
Physical examinationPosture, shoulder and hip balance, forward-bend changes, pain, strength, sensation, and reflexesAt the first assessment and during follow-up visits
Standing spinal X-rayThe location and shape of the curve and its severity, often using an angle measurementTo confirm scoliosis, establish a baseline, and monitor progression
MRI or other additional testsThe spinal cord, nerves, discs, bones, or another possible cause of symptomsWhen there is unusual pain, neurologic finding, rapid progression, or concern about an underlying condition

Treatment & Management

Scoliosis Treatment and Management

MONITORING

Mild or stable curves may be managed with periodic examinations and, when appropriate, imaging. Follow-up is especially important during growth because the curve can change more quickly.

ACTIVE TREATMENT

Bracing, physical therapy, pain management, or surgery may be considered when a curve is progressing, causes significant symptoms, or is severe. The choice depends on age, growth remaining, curve pattern, and overall health.

Nonsurgical care and bracing

Physical therapy and targeted exercise may support strength, movement, posture, and symptom control, but they do not necessarily straighten a structural curve. Pain relief may be part of care when scoliosis causes back pain. A brace is mainly used during growth to help limit progression in selected curves; it does not permanently correct every curve. Treatment goals may be to prevent progression, reduce symptoms, or improve function rather than completely straighten the spine.

Spinal fusion and other specialist surgical procedures may be considered for selected severe or progressive curves or for significant symptoms. In adults, scoliosis treatment is individualized according to pain, balance, spinal degeneration, functional limitations, and neurologic findings. Surgery is a major decision that requires discussion of expected benefits, risks, and recovery.

Outlook and Prognosis

Outlook and Prognosis for Scoliosis

The outlook varies with the cause, curve size and location, age when it began, skeletal maturity, symptoms, and whether the curve progresses. Many people with scoliosis remain active and function well, while others need ongoing care for pain, imbalance, or degeneration.

  • Mild scoliosis often remains stable, particularly after growth has finished.
  • Curves may progress more during periods of rapid growth.
  • Adults may develop back pain, stiffness, or degenerative changes related to the curve.
  • Regular follow-up can identify progression early and help guide scoliosis treatment.

When Should You See a Doctor

When Should You See a Doctor for Scoliosis?

  • A newly noticed uneven shoulder, hip, waist, or back shape
  • Persistent or worsening back pain
  • A known spinal curve that appears to be changing
  • Leg weakness or numbness
  • New bowel or bladder changes
  • Breathing difficulty, especially with a known severe curve

SEEK PROMPT CARE

Know when symptoms need urgent attention

Sudden severe pain, new neurologic symptoms, loss of bladder or bowel control, or significant breathing difficulty require urgent medical evaluation rather than routine follow-up.

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