Scoliosis: What It Is, How It's Monitored and Where Chiropractic Fits
Scoliosis: What It Is, How It's Monitored and Where Chiropractic Fits
Quick summary
- Scoliosis is a sideways curve of the spine of 10 degrees or more on an X-ray (the Cobb angle), usually with some rotation of the vertebrae.
- The most common type, adolescent idiopathic scoliosis, affects roughly 2 to 3 in every 100 young people. Most curves are small and need monitoring rather than treatment.
- For growing teenagers with larger curves, bracing has good evidence for reducing progression to the point where surgery is needed (Weinstein et al., 2013). Decisions about bracing and surgery belong with a scoliosis specialist.
- Chiropractic care does not straighten a scoliosis. Where we help is with associated back pain, stiffness and function, and with screening and referral for monitoring.
Parents often notice it first: one shoulder higher than the other, a hip that sticks out, or a rib hump when their child bends forward. Adults may be told about it after an X-ray for back pain. Either way, the word scoliosis raises a lot of questions. This guide gives an honest overview of what scoliosis is, how it is monitored and where chiropractic care fits.
What scoliosis is
Scoliosis is a three-dimensional change in the shape of the spine. It is defined as a sideways curve of at least 10 degrees measured on an X-ray, called the Cobb angle, usually with rotation of the vertebrae. Types include:
- Adolescent idiopathic scoliosis (AIS): the most common type, developing during growth with no single known cause.
- Degenerative (de novo) scoliosis: develops in adulthood as discs and joints change with age.
- Congenital and neuromuscular scoliosis: less common types linked to how the spine formed or to conditions affecting nerves and muscles.
Scoliosis is different from postural asymmetry. Uneven shoulders or a tilted pelvis can also come from habit, muscle imbalance or a leg length difference, without a structural curve.
Signs to look for
- One shoulder or shoulder blade higher or more prominent than the other.
- Uneven waist creases, or one hip appearing higher.
- A rib or lower back hump on one side when bending forward (the Adams forward bend test).
- The body leaning to one side.
If you notice these in a child or teenager, see your GP. Screening is particularly important during growth spurts, when curves are most likely to progress.
How scoliosis is monitored and treated
Management depends on the size of the curve, how much growing is left, and symptoms. International guidelines from the SOSORT group describe a stepped approach for growing children: observation for small curves, scoliosis-specific exercise in some cases, bracing for moderate curves, and surgery for severe or progressive ones (Negrini et al., 2018).
The BrAIST trial found that bracing in growing adolescents with moderate curves significantly reduced the progression of curves to the threshold for surgery, and that more hours of brace wear were linked to better results (Weinstein et al., 2013). Decisions about bracing and surgery are made with an orthopaedic or scoliosis specialist.
In adults, the focus is usually on managing pain and maintaining function. Many adults with scoliosis have little or no pain.
Where chiropractic care fits, honestly
Chiropractic care does not straighten or cure a scoliosis curve, and you should be wary of any provider who promises that. Here is what we can do:
- Screening and referral: we check for signs of scoliosis and refer to your GP and a specialist for X-ray monitoring when it is needed.
- Pain and stiffness: back pain is common in people with and without scoliosis. Manual therapy and exercise can help some people with associated back pain and stiffness.
- Strength and confidence: a tailored exercise program can help you stay strong and active. People with scoliosis can, and generally should, play sport and exercise.
- Working alongside your specialist: if you or your child is being monitored or braced, our care fits around that plan, not instead of it.
Noticed uneven shoulders or hips, or living with scoliosis and back pain?
We screen, refer for monitoring when needed, and help with pain, stiffness and staying active, alongside your specialist care.
Frequently Asked Questions
Can a chiropractor fix scoliosis?
No. Chiropractic care does not straighten or cure a scoliosis curve. It can help some people with associated back pain, stiffness and function, and a chiropractor can screen for scoliosis and refer for specialist monitoring.
How common is scoliosis?
Adolescent idiopathic scoliosis affects roughly 2 to 3 in every 100 young people. Most curves are small and need monitoring rather than treatment.
When is bracing needed for scoliosis?
Bracing is generally considered for growing adolescents with moderate curves that are at risk of progressing. The BrAIST trial showed bracing reduced progression to the threshold for surgery. A scoliosis specialist makes this decision.
Can people with scoliosis exercise and play sport?
Yes. Most people with scoliosis can and should stay active. Exercise helps maintain strength and fitness, and specific programs may be recommended by your care team.
References
- Negrini, S., Donzelli, S., Aulisa, A.G., et al. (2018). 2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis and Spinal Disorders, 13, 3. https://doi.org/10.1186/s13013-017-0145-8
- Weinstein, S.L., Dolan, L.A., Wright, J.G., & Dobbs, M.B. (2013). Effects of bracing in adolescents with idiopathic scoliosis. New England Journal of Medicine, 369(16), 1512–1521. https://doi.org/10.1056/NEJMoa1307337
This article is general information, not a diagnosis or a substitute for individual advice from your health professional.
