Scoliosis is a sideways curvature of the spine that forms an S-shaped or C-shaped curve. It affects about 2% to 3% of the population and is usually detected in childhood or adolescence, when spinal bones are still developing. Mild scoliosis may cause no symptoms, while more severe curves can lead to pain, uneven body alignment, and breathing difficulties. Treatment varies depending on age, type of scoliosis, and curve severity.

Types of Scoliosis

Scoliosis is grouped into different types based on its cause, age of onset, and the location of the curve. Understanding your type of scoliosis helps guide treatment.

Idiopathic scoliosis
This is the most common form, representing about 80% of all cases. It has no known cause, though genetics may play a role since the condition tends to run in families. Idiopathic scoliosis appears mostly in children ages 10 and older. It is further divided into:

  • Infantile: age 3 or younger

  • Juvenile: ages 4–10

  • Adolescent: ages 11–18

Congenital scoliosis
Congenital scoliosis occurs when vertebrae fail to form or separate properly before birth. It affects about one in 10,000 newborns and may be accompanied by health issues such as kidney or heart abnormalities.

Neuromuscular scoliosis
Neuromuscular conditions such as muscular dystrophy and cerebral palsy impair the body's ability to support the spine, leading to scoliosis. This type progresses faster and often affects the entire spine.

Degenerative scoliosis
Seen mostly in adults over age 65, this type develops due to wear and tear of spinal discs and joints. Curves are usually mild, and symptoms gradually worsen with activity.

Scoliosis Symptoms

Symptoms depend on curve severity and location. Many children and teens have no obvious signs.

Typical symptoms include:

  • Uneven shoulders, ribs, or hips

  • One shoulder blade sticking out

  • A visible spinal curve

  • Leaning to one side when standing or sitting

  • Back pain or fatigue after long periods of sitting or standing

Severe curves may reduce lung capacity, making breathing more difficult.

What Causes Scoliosis?

Most scoliosis cases—especially idiopathic scoliosis—have no identifiable cause. Genetics may influence who develops it.

Other types have specific causes:

  • Congenital scoliosis results from abnormal spinal development before birth

  • Neuromuscular scoliosis develops due to conditions that affect muscle control

  • Degenerative scoliosis occurs from age-related spinal changes

  • Rarely, trauma, paralysis, or previous spinal surgeries can lead to adult scoliosis

Risk Factors

Factors that increase the risk of scoliosis include:

  • Family history

  • Onset during childhood or adolescence

  • Female sex, with higher risk of curve progression

  • Conditions such as Marfan syndrome or Ehlers-Danlos syndrome

  • Neurological conditions like spinal cord injury

How Scoliosis Is Diagnosed

Mild scoliosis may go unnoticed until detected during routine checkups. Diagnosis includes a physical exam, medical history review, and imaging tests.

Physical examination
Your provider checks posture, shoulder and hip alignment, and rib symmetry. You may bend forward so the curve becomes more visible. A scoliometer may be used to measure rotation.

Medical history
A review of your medical and family history helps identify possible causes or related conditions.

Imaging tests
If scoliosis is suspected, imaging confirms the diagnosis:

  • X-rays show the curve and measure the Cobb angle

  • CT scans give detailed images of the spinal canal

  • MRI shows vertebrae and spinal cord abnormalities

Children with congenital scoliosis may need ultrasound tests to check for heart or kidney issues.

Treatments for Scoliosis

Though scoliosis cannot be cured, treatments help slow curve progression, reduce symptoms, and improve quality of life.

Observation
Mild scoliosis may require only regular monitoring.

Bracing
Braces do not reverse scoliosis but help prevent curve progression, especially in growing children and teens.

Surgery
Surgery may be recommended for severe curves. Options include:

  • Spinal fusion

  • Osteotomy (removal and realignment of vertebrae)

  • VEPTR (expandable rods used in growing children)

Physical therapy
Physical therapy focuses on posture training, strengthening, flexibility, and scoliosis-specific exercises to improve spinal alignment and mobility.

How To Prevent Scoliosis

Since most scoliosis has no known cause, there is no proven way to prevent it. However, exercises designed for scoliosis and core strengthening can help slow curve progression. Bracing also prevents worsening in growing children.

Related Conditions

People with scoliosis may face additional health issues.

Anxiety and depression
Adolescents with scoliosis may experience emotional difficulties due to body image concerns or chronic pain.

Osteoporosis
Lower bone mineral density is common in scoliosis, raising the risk of fractures.

Gastroesophageal reflux disease (GERD)
Spinal curvature may weaken the lower esophageal sphincter, increasing the risk of acid reflux.

Headaches
Neck strain from spinal imbalance can cause tension headaches. Reduced cerebrospinal fluid flow may also contribute.

Living With Scoliosis

Most people with scoliosis can live active, healthy lives. Mild cases require monitoring and exercises. More severe cases may need bracing or surgery. Emotional support from family, friends, and support groups can help individuals adapt and maintain quality of life.