What is Scoliosis?

Scoliosis is an abnormal sideways curve of the spine that can be in either one part of the spine or in multiple places. Scoliosis can cause minimal problems or it can be a source of significant pain and dysfunction. Identifying scoliosis early on is the best way to keep the problem from getting worse.
Types of Scoliosis

Technically, scoliosis is a curve in the spine that is at least ten degrees and is often an s-shape that is found in the thoracic and lumbar spine. Scoliosis is measured to determine the angle and if it’s less than ten degrees, it’s not technically scoliosis. A mild scoliosis is less than 20 degrees, moderate scoliosis is 23-40 degrees and severe scoliosis is greater than 50 degrees. A note on the curve: The normal curvature of the spine would be viewed from the side—the patient’s profile (if you had x-ray vision). With scoliosis, the twist in the spine occurs from left to right (or side to side) when looking at the patient’s back. In rare cases, it can be in the cervical spine, in the neck area, but it is most commonly found in the thoracic area (mid-back).

What causes scoliosis?

Idiopathic: About 80% of scoliosis cases are idiopathic, which is Latin for “we don’t know.” (So helpful, right?)

Congenital: Patients born with a bony defect like hemivertebra (half of a vertebra) or butterfly vertebra (misshapen vertebrae that takes the shape of a butterfly) can also contribute to scoliosis. Think Jenga blocks–if some of them are shaped strangely, the tower is going to tip.

Neuromuscular: Scoliosis is sometimes a result (or secondary) of diseases such as cerebral palsy, spina bifida, muscular dystrophy, and spinal cord disease or trauma.

Degenerative: In older patients, when the spinal column begins to degenerate, it can cause scoliosis—the most common type of scoliosis for this type of patient occurs in the lumbar (low back) spine.

Who is at risk for scoliosis?

Scoliosis affects 2-3% of the US population, which is about 6-9 million people. Because most scoliosis causes are idiopathic or unknown types, the potential for scoliosis can happen to anyone, but there are some groups more at risk.

Younger Ages: Typically, the most affected group that suffers from scoliosis are 10-15 year olds. Both males and females in this group are affected equally. 

Sex: However, females are 8x more likely to have a spinal curve that may require treatment.

Hereditary: In addition to this, if you have a family history of scoliosis, you are even more likely to have scoliosis.

Older Ages: If the condition is not addressed when the patient is young, scoliosis may worsen in patients 65 and older. If you are under 20, or your body is still developing and you may experience a growth spurt, monitoring is essential. Once a patient is generally over 20 or 21, your body isn’t likely to grow much more and the condition will generally stabilize. But when the patient grows older, over 65, degeneration of the bones can worsen your condition.

What are the signs and symptoms of scoliosis?

Patients will often experience a variety of symptoms including physical changes, pain, and fatigue. More specifically, look for these signs when you think you or a loved one is suffering from scoliosis:

  • Rib hump on one side
  • Uneven shoulders (one higher than the other)
  • Hunching over (thoracic kyphosis)
  • Shirts fit poorly because of the body’s asymmetry
  • Back pain
  • Muscle and joint aches due to uneven muscle tone and joints being worn down

In more significant scoliosis cases, the patient can become easily fatigued because the lungs and heart work harder when affected by the sideways curvature of the spine.

How do you diagnose scoliosis?

Early diagnosis is the best way to prevent scoliosis from progressing. To that end, make sure your child (especially from age 10-15) gets an Adam’s Test at school to screen for scoliosis. An x-ray is the best way to fully diagnose and monitor scoliosis, but in more complicated cases, a CT scan and/or an MRI may also be required to see the extent of the abnormal spinal curve.

If you need to do an Adam’s Test at home, you can have your child stand facing away from you, bend at the waist to touch their toes, and you can take two fingers and move down their spine to see if the path your fingers take down their spine is completely straight, or if it has a few curves. Smaller curves will be more difficult to detect, but larger ones will be clear. You can also keep an eye out for any unevenness of their ribs–if one side is higher, that may be a sign of scoliosis, as well. As soon as you suspect scoliosis, make a doctor appointment for treatment recommendations.

How do you treat scoliosis?

Pay attention: If your child has been diagnosed with scoliosis, it’s best to monitor their condition periodically, so you can evaluate whether the condition is worsening/progressing. The best way to monitor progression is with periodic x-rays to measure if the scoliosis curve is worsening.

Get stronger: Physical therapy may be helpful for strengthening weak muscles and helping with some stability to make up for the extra work other muscles are doing.

Chiropractic: Often, neck and shoulder pain is linked to scoliosis. Chiropractic care can be essential to support pain management and ease muscle tension, helping the affected areas of the body. Talk to your chiropractor about what methods of treatments may work with your condition, allowing your body to be at its most comfortable, and improving the range of motion that may have been impeded with scoliosis.

Brace yourself: If you can catch scoliosis early, bracing is an excellent, non-invasive way to help slow the progression of abnormal curvature. In addition to slowing progression, bracing can also be used as extra support in adults suffering from scoliosis. There are a variety of braces available; the brace used will depend on how advanced the patient’s scoliosis is. Take care to wear the brace as often as is recommended to prevent your condition from worsening. 

Scoliosis Patient
Weiss HR, CC BY 2.0, via Wikimedia Commons

Surgery: In severe cases of scoliosis, surgical correction may be required. Surgeries typically place Harrington Rods along the spinal curvature in order to straighten the spine. The rods are drilled to the spine and tightened in order to straighten the spine. Patients who elect this surgery generally have extreme curves (over 50 degrees) in their spine, and the rods will keep the spine from worsening and help mitigate the extra pressure being placed on the heart and the lungs.


Ultimately, we want patients with scoliosis to understand that the best outcomes result when scoliosis is caught early. Children 10-15 are the most likely to get it, and girls are more likely to worsen in their condition. Don’t delay in getting your child checked out so that you can take steps to manage it before it becomes a big issue.

At Element Chiropractic, we have an in-clinic x-ray to help diagnose scoliosis, and we’re experienced in co-managing scoliosis with any of your child’s other healthcare providers. While chiropractic care cannot fix scoliosis, we are able to help you be more comfortable through gentle adjustments and exercise recommendations to keep your body strong.