Hearing the word scoliosis can be worrying, especially when it is about your child. Most cases are mild. Knowing what to look for, and when to act, makes the biggest difference.
What is scoliosis?
Scoliosis is a sideways curve of the spine, usually with some twisting of the vertebrae. Seen from behind on an X-ray, the spine looks more like a C or an S than a straight line. It is diagnosed when the curve measures more than 10 degrees, known as the Cobb angle.
Types of scoliosis
- Adolescent idiopathic scoliosis is the most common type. It appears between about age 10 and 18, has no single known cause and often runs in families. It affects roughly 2 to 3 in every 100 adolescents (Weinstein, Lancet 2008).
- Functional scoliosis is a curve without fixed rotation, linked to things like a pelvic tilt, a leg length difference or muscle spasm. It often changes when the underlying cause is addressed.
- Adult degenerative scoliosis develops later in life as discs and joints wear.
- Congenital and neuromuscular scoliosis come from how the spine formed before birth, or from conditions that affect nerves and muscles. These need care from a medical specialist.
Heavy school bags, sleeping on one side, sports and poor posture do not cause idiopathic scoliosis.
Signs to check at home
- One shoulder higher than the other
- One shoulder blade sticking out more
- An uneven waist or one hip higher
- Clothes hanging unevenly
- A rib hump on one side when bending forward, known as the Adams forward bend test
These are clues, not a diagnosis. A physical exam, and usually an X-ray, is needed to confirm scoliosis and measure the curve.
What the Cobb angle means
| Cobb angle | What it usually means |
| 10 to 19 degrees | Mild. Usually monitored, often with scoliosis-specific exercise. |
| 20 to 40 degrees | Moderate. In growing children, bracing may be considered alongside exercise. |
| Over 40 degrees | Severe. A referral to an orthopaedic spine specialist is advised to discuss options. |
Ranges follow the international SOSORT guidelines (Negrini, 2018). Your clinician will explain where your curve sits.
Does scoliosis get worse over time?
The risk of a curve progressing is highest during growth spurts, which is why early checks matter for children. After growth ends, long-term studies found that curves above about 30 degrees are more likely to keep progressing slowly through adulthood (Weinstein, JAMA 2003; Marty-Poumarat, Spine 2007).
Regular checks let you act early if a curve changes.
What research says about non-surgical care
- Scoliosis-specific exercise. In a randomised controlled trial, teenagers who added Schroth exercises to standard care had better Cobb angle outcomes than standard care alone (Schreiber, PLoS ONE 2016). The SOSORT guidelines recommend scoliosis-specific exercise as part of conservative care (Negrini, 2018).
- Bracing. In a large trial of growing teenagers with moderate curves, bracing lowered the number whose curve progressed to the point where surgery is usually discussed (Weinstein, NEJM 2013).
- Spinal mobilisation. A meta-analysis found spinal mobilisation techniques may help in managing adolescent idiopathic scoliosis, though the studies were small (Farooqui, 2018). Hands-on care is used for comfort and mobility alongside exercise, not in place of it.
- Adults. A review of non-surgical care for adult scoliosis found limited evidence overall, so care focuses on pain, function and staying active (Everett, Spine 2007).
How BP Chiro helps with scoliosis
Care starts with a full assessment: your history, posture, a forward bend test, and orthopedic and neurological exams. If you do not already have one, a full-spine X-ray may be needed to measure the Cobb angle.
- Scoliosis-specific exercises based on the Schroth method, fitted to your curve pattern
- Spinal flexion-distraction, a gentle intermittent traction, for comfort and mobility
- Chiropractic care and soft tissue work for back pain and stiffness
- Bracing advice, and referral to a spine specialist when the curve needs it
- Regular re-checks so changes are caught early
The aim is to stay ahead of progression, ease discomfort and keep you moving. Results vary from person to person.
When to see a doctor promptly
See a medical doctor without delay if back pain comes with numbness or weakness in the legs, loss of bladder or bowel control, fever or unexplained weight loss, or if a curve appears in a young child or changes quickly.
Book a scoliosis check
BP Chiro has clinics in Johor Bahru, Kluang, Seri Kembangan, Kepong and Penang. Every first visit starts with a full spinal assessment.
References
- Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet. 2008;371(9623):1527-1537.
- Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.
- Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289(5):559-567.
- Marty-Poumarat C, Scattin L, Marpeau M, Garreau de Loubresse C, Aegerter P. Natural history of progressive adult scoliosis. Spine. 2007;32(11):1227-1234.
- Schreiber S, Parent EC, Khodayari Moez E, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better Cobb angle outcomes in adolescents with idiopathic scoliosis: an assessor and statistician blinded randomized controlled trial. PLoS ONE. 2016;11(12):e0168746.
- Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med. 2013;369(16):1512-1521.
- Farooqui SI, Siddiqui PQR, Ansari B, Farhad A. Effects of spinal mobilization techniques in the management of adolescent idiopathic scoliosis: a meta-analysis. Int J Health Sci (Qassim). 2018;12(6):44-49.
- Everett CR, Patel RK. A systematic literature review of nonsurgical treatment in adult scoliosis. Spine. 2007;32(19 Suppl):S130-S134.