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Idiopathic Scoliosis: Symptoms, Causes & Treatments
What is Idiopathic Scoliosis?
Idiopathic scoliosis is a sideways (lateral) curvature of the spine that develops without a known cause—which is why it is described as “idiopathic”. It is the most common type of scoliosis and is thought to be the cause of most cases. Unlike scoliosis caused by neuromuscular conditions, congenital vertebral abnormalities or injuries, idiopathic scoliosis arises without an obvious trigger.
Seen from behind, a healthy spine usually forms a straight line. In idiopathic scoliosis the spine may curve into a single “C” shape or a double “S” shape. As the spine curves, it often rotates too, so the vertebrae and ribs on one side can become more prominent; this rotation is what creates visible asymmetry in the torso.
Types of Idiopathic Scoliosis
Idiopathic scoliosis is classified according to the age at which it first appears. The main types are:
- Infantile idiopathic scoliosis: Appears from birth to 3 years of age and is uncommon (under 1% of cases).
- Juvenile idiopathic scoliosis: Develops between about 4 and 10 years old and makes up a minority of cases (roughly 10–15%).
- Adolescent idiopathic scoliosis: The commonest type, usually first noticed during the adolescent growth spurt (roughly ages 10–18) and accounting for the largest share of idiopathic scoliosis cases.
Curves are also described by their location in the spine — thoracic (upper back), lumbar (lower back) or thoracolumbar (the area between thoracic and lumbar). Describing the curve’s shape and area helps clinicians decide on monitoring and treatment options.
At what age does scoliosis start?
Although idiopathic scoliosis can begin at any stage of life, it most commonly appears during periods of rapid growth. For children and adolescents, this is typically during the adolescent growth spurt. Girls often develop noticeable curves earlier than boys, coinciding with puberty and rapid height increase. Some children have milder curves that are present but not detected until later.
Adults may also have scoliosis — either because a curve diagnosed in childhood has persisted into adulthood or because a previously small, undetected curve progresses over time. Degenerative scoliosis in later life usually stems from age-related changes in the spinal bones and discs rather than being idiopathic in origin.
Idiopathic scoliosis in adults
Adults with idiopathic scoliosis typically fall into two groups: those whose childhood curves continue into adulthood and those whose curves were mild and unnoticed until they progressed. Adults may notice increased back pain, reduced flexibility, loss of height, or, in severe cases, breathing difficulties if the ribcage is affected. Digestive symptoms can occur rarely, due to compression of abdominal structures.
Management in adults differs from paediatric care because the spine is no longer growing and is less flexible; however, many conservative principles — such as physiotherapy, pain management and activity modification — still apply.
Causes of Idiopathic Scoliosis
By definition, the exact cause of idiopathic scoliosis is unknown. Nonetheless, research points to several factors that may increase susceptibility or influence how a curve develops and progresses.
Research suggests genetic factors play a significant role in idiopathic scoliosis development
Genetic Factors
There is good evidence of a genetic component to idiopathic scoliosis. Many families include more than one affected member, and twin studies show higher concordance in identical twins than in non-identical twins. Researchers have not found a single “scoliosis gene”; instead, multiple genes are likely to influence risk and how the spine develops during growth.
Hormonal Influences
Hormonal factors have been investigated because girls are more likely than boys to develop curves that need treatment. Abnormalities in signalling pathways — for example, those involving melatonin or growth-related hormones — have been studied, but firm conclusions are still lacking. These remain plausible contributing factors rather than proven causes.
Common Misconceptions
It is important to correct some widespread myths:
Idiopathic scoliosis is not directly caused by poor posture, carrying heavy backpacks, taking part in sports, or by a child’s diet. While these activities may influence symptoms or comfort, they do not cause the underlying spinal curve to develop. It is not a disease, or contagious.
Risk Factors
Although the root cause is unknown, clinicians monitor children more closely when risk factors are present:
- Family history: A parent or sibling with scoliosis increases the likelihood a child may develop a curve; this helps doctors decide how often to check height and spine alignment.
- Sex: Girls and boys get mild curves at similar rates, but girls have a substantially higher risk of curve progression that requires treatment.
- Age and growth: The risk of progression is highest during rapid growth phases, especially the adolescent growth spurt.
- Skeletal maturity: Children who are still growing (not yet skeletally mature) have a greater chance that a curve will worsen over time.
Healthcare teams look at the age, growth stage, and the presence of any family history, when assessing the likelihood of scoliosis. A practical step for parents is to inform their GP or paediatrician about any family history of scoliosis and how it may affect the follow-up plan.
Symptoms of Idiopathic Scoliosis
Idiopathic scoliosis often develops slowly and without pain, which can make early detection difficult. Parents, school nurses or teachers commonly spot the condition during routine checks when they notice physical asymmetry in a child.
Common Signs and Symptoms
Watch for these visible signs — they are the most frequent clues that a child may have scoliosis:
- Uneven shoulders (one shoulder sits higher than the other)
- One shoulder blade appearing more prominent
- Asymmetric waistline or uneven hips
- Rib prominence on one side when the child bends forward
- Clothes hanging unevenly or trousers fitting oddly
- The child seems to lean to one side
- An apparent difference in leg length (often due to the curve, not an actual limb length difference)
These signs are often most noticeable during periods of rapid growth in adolescence. A simple screening, the Adams forward bend test — where the child bends at the waist with arms hanging and knees straight — can reveal rib prominence and trunk asymmetry.
Does scoliosis cause headaches?
Idiopathic scoliosis does not directly cause headaches, but muscle imbalances and postural changes linked to a curved spine can lead to tension and pressure on the neck and shoulders that may, in some people, trigger tension-type headaches. In severe, rare cases of thoracic curves, breathing changes may be the cause of headaches, but this is rare.
If you experience headaches that are regular or intense, don’t hesitate to consult a doctor.
It is likely that the headache is not related to the spinal condition and may be caused by different factors.
Diagnosis of Idiopathic Scoliosis
Diagnosis usually follows a few straightforward steps carried out by a GP, physiotherapist or orthopaedic specialist:
- Physical examination: The doctor or specialist will look at the back while the child stands and bends forward, checking for asymmetry and rib prominence.
- Scoliometer measurement: A scoliometer measures trunk rotation and helps quantify the angle of prominence seen during the Adams test.
- X‑rays: If scoliosis is suspected, full‑spine standing X‑rays are used to confirm the diagnosis and measure the curve using the Cobb method.
- Further imaging: In selected cases, an MRI may be requested to exclude other rare causes of spinal curvature (for example, spinal cord abnormalities).
The Cobb angle, measured on a standing X‑ray, is the standard way to describe how large a curve is. Curves are commonly grouped as:
- Mild: Cobb angle less than 20°
- Moderate: Cobb angle 20–40°
- Severe: Cobb angle greater than about 40–50°
These categories guide treatment and monitoring. For example, a child with a mild curve may only need regular checks, while a growing child with a moderate curve may need bracing or specialist referral. If you notice any of the signs listed above in your child, make sure you speak to your GP — early assessment helps the clinical team decide whether your child may need further tests or referral to a specialist.
Treatments for Idiopathic Scoliosis
Treatment for idiopathic scoliosis depends on several factors: the child’s age, how much growth remains (skeletal maturity), the severity and pattern of the curve, and the assessed risk of progression. The main aims are to prevent the curve from getting worse, preserve function and, where possible, improve spinal alignment and quality of life.
Observation and monitoring
Many mild curves do not require immediate intervention. For children with small curves (commonly under 20–25 degrees) or for skeletally mature patients with stable curves, careful observation is often appropriate. This typically includes:
- Regular clinical reviews, often every 4–6 months while the child is growing
- Periodic standing X‑rays to check the Cobb angle and any change in the curve
- Recording height at each visit to detect growth spurts that increase risk of progression
Even when observation is chosen, maintaining core strength and general fitness through appropriate exercises supports the spine and overall well‑being.
Conservative management
Spinal bracing
Bracing is the principal non‑surgical option for growing children with moderate curves (typically around 20–40 degrees) and a significant risk of progression. The evidence shows that bracing can prevent many curves from worsening to the point where surgery may be needed—the effectiveness is closely linked to wearing time.
In the UK, commonly used brace types include:
- Gensingen brace: Custom-made from a 3D scan, designed for three‑dimensional correction and improved comfort.
- Boston brace: A rigid underarm brace that applies corrective pressure to the trunk.
- Charleston bending brace: Worn at night to over‑correct the curve while sleeping.
- Rigo‑Chêneau brace: A corrective, three‑dimensional orthosis targeting the spine and ribcage.
The bracing pathway usually involves assessment by an orthotist specialising in scoliosis, measurement or a 3D scan, fitting and adjustment, and regular follow‑up as the child grows. Most braces are prescribed to be worn for many hours per day (commonly 16–23 hours), although schedules vary by brace type and the individual treatment plan. Compliance is crucial — a brace only works if the child wears it for the recommended time, so comfort, discretion under clothing and practical support for the family are important considerations.
Physiotherapy and scoliosis‑specific exercise
Specialist physiotherapy is an important adjunct to bracing and an option for adults or children with mild curves. Programmes are tailored to the individual’s curve pattern and needs and may include:
- Schroth method: A scoliosis‑specific, three‑dimensional exercise approach using posture correction, muscle activation and rotational breathing.
- SEAS (Scientific Exercise Approach to Scoliosis): Exercises that develop active self‑correction and spinal stabilisation.
- Core strengthening: Targeted exercises to support the trunk and improve posture.
Enhance physiotherapy with StandSure Therapy Aid
Tools such as the StandSure Therapy Aid can help patients perform targeted rehabilitation exercises safely by providing stability and promoting correct alignment during sessions.
Physiotherapy is most effective when prescribed and supervised by a clinician trained in scoliosis‑specific approaches. For many growing children, physiotherapy works alongside bracing; for adults with mild to moderate curves, it may be a primary treatment to reduce pain and improve function.
Functional Electrical Stimulation (FES)
Functional Electrical Stimulation is an adjunctive technique that can activate muscles on the weaker side of the curve. In selected cases, FES has been used to complement exercises or bracing, though its availability and evidence base vary — discuss this option with your clinical team if it is offered.
Surgical management
Surgery is considered when curves are severe (commonly greater than 40–50 degrees) or when a moderate curve continues to progress despite good bracing. The principal surgical procedure is spinal fusion, though other growth‑friendly options exist for younger children.
Spinal fusion aims to correct and stabilise the curve by joining two or more vertebrae together using bone graft, rods, screws and other implants. This creates a solid bone mass to maintain the correction. For younger children who still need to grow, growth‑sparing procedures may be offered:
- Growing rods: Expandable rods attached above and below the curve that can be lengthened as the child grows.
- Vertebral body tethering (VBT): A less invasive option using a flexible cord to partially correct the curve while allowing continued spinal growth.
Deciding for surgery is a careful process involving discussion with an experienced spinal surgeon about expected benefits, risks and likely recovery. Typical considerations include the degree and pattern of the curve, symptoms (for example, pain or breathing difficulty), the child’s remaining growth and the family’s preferences.
What to expect and common complications
After spinal fusion, most children and adults experience pain that is controlled with medication and gradually reduce activity for several weeks to months. Possible complications — discussed in detail with your surgeon — can include infection, implant problems, nerve irritation, reduced spinal flexibility and, rarely, the need for further procedures. Your surgeon will explain the procedure, risks and the likely recovery timetable for your situation.
Can idiopathic scoliosis be cured?
There is no single treatment that “cures” idiopathic scoliosis in the sense of restoring a perfectly straight, naturally flexible spine without ongoing considerations. However:
- Bracing can often prevent significant progression in growing children and reduce the chance that surgery will be needed.
- Surgery (spinal fusion or growth‑friendly procedures) can greatly reduce the curve and stop progression, though fused segments are less flexible afterwards.
- Physiotherapy and exercise help maintain function, reduce pain and support overall spinal health.
The goal of treatment is to preserve function, prevent progression and keep the child active and engaged in normal activities where possible.
Exercises and home programme
Exercise programmes should be individualised. Examples used in specialist clinics include Schroth‑based routines, modified side planks and targeted core stability work. It is important that exercises are prescribed and supervised by a physiotherapist experienced in scoliosis — incorrect techniques may be ineffective or, in rare cases, harmful.
Make sure you discuss exercise goals and any equipment provision with your physiotherapist and/or orthotist so the home programme supports the clinical treatment plan.
Living with Idiopathic Scoliosis
Beyond medical treatment, there are several practical and emotional aspects to consider when living with idiopathic scoliosis.
Swimming is often recommended for people with scoliosis, as it strengthens core muscles without compressing the spine
Can you live a long life with scoliosis?
Yes — most people with idiopathic scoliosis can expect a normal lifespan. The condition rarely shortens life expectancy. Even those with larger curves usually lead long, productive lives, although they may need more intensive management or support in some cases.
Only in exceptionally severe, untreated cases might cause complications affecting the heart or lungs influence longevity. Modern screening and treatment makes such progression uncommon.
Physical activity and sports
Physical activity is generally encouraged. Staying active helps strengthen the muscles that support the spine and promotes overall health.
- Recommended activities: Swimming, walking, cycling and targeted core‑strengthening exercises are often beneficial.
- Activities to approach with caution: High‑impact sports or those involving extreme spinal rotation may need modification — discuss specifics with your doctor or physiotherapist.
- After surgery: Following spinal fusion, some contact sports or high‑impact activities may be restricted, depending on the procedure and surgeon advice.
Make sure you check with the treating clinician about which activities suit your child or yourself; personalised advice is important because recommendations depend on curve severity, treatment and recovery stage.
Emotional and social support
The psychological impact of scoliosis can be significant, particularly for children and adolescents. Worries about body image, wearing a brace or facing surgery can affect confidence and social life.
Finding peer support, counselling or talking to other families can help. Organisations such as the Scoliosis Association UK provide helplines and support groups that many find valuable.
For further support and research information in the UK, see the Scoliosis Support & Research Charity (SSRC), which offers information, local contacts and resources for families and individuals affected by scoliosis.
Parents and carers should be alert for signs of emotional distress and seek professional help if needed — talking therapies or peer groups can make a real difference.
Practical tips for daily living
Small practical changes can improve comfort and function in everyday life:
- Ergonomics: Use supportive seating, an ergonomic workstation at school or home, and a comfortable mattress that supports the natural curves of the spine.
- Backpack use: For children, use a two‑strap backpack, keep loads light and distribute weight evenly.
- Clothing and braces: Choose clothing that accommodates a brace comfortably and helps the child feel confident; modern braces are often discreet under clothes.
- Pain management: Simple measures such as heat or cold packs, gentle stretching, physiotherapy and relaxation techniques can help manage discomfort.
With appropriate care, support and adaptations, most people with idiopathic scoliosis lead active, fulfilling lives with minimal long‑term limitations.
Frequently Asked Questions About Idiopathic Scoliosis
Can idiopathic scoliosis be cured?
There is no single treatment that completely “cures” idiopathic scoliosis by restoring a naturally straight, fully flexible spine without ongoing consideration. That said, treatments can be very effective: bracing often prevents progression in growing children, and surgery can substantially straighten the spine and stop further worsening. The overall aim is to maintain function, reduce symptoms and keep the child active rather than to achieve perfect straightness.
When to see a doctor: if you notice persistent signs of a curve in your child, see your GP — they can advise whether a referral to a specialist is needed.
At what age does scoliosis start?
Idiopathic scoliosis most commonly appears during periods of rapid growth. For many children this is the adolescent growth spurt (roughly ages 10–15), though it can also be present in infancy (0–3 years) or in the juvenile years (4–10 years). Girls often show treatment‑requiring progression more frequently than boys.
When to see a doctor: if your child enters a growth spurt and you notice any asymmetry, make sure you discuss it with your GP or school nurse — early assessment helps determine whether monitoring or treatment may be required.
Can you live a long life with scoliosis?
The outlook for people with idiopathic scoliosis is quite good. The vast majority of individuals live a normal life, and even those with larger curves generally lead full and active lives. Only in very rare, untreated, extremely severe cases might cardiopulmonary complications affect longevity.
When to see a doctor: regular follow‑up with your specialist or GP is advisable if the curve is moderate or severe, or if symptoms such as breathlessness or increasing pain appear.
Idiopathic scoliosis vs scoliosis: what’s the difference?
“Scoliosis” is a general term used to describe any sideways curvature of the spine. However, “idiopathic scoliosis” is the most common and means that the reason for the curve is not known. Other types include congenital scoliosis. Where a person is born with abnormal vertebrae, neuromuscular scoliosis is linked to cerebral palsy, and degenerative scoliosis develops in adulthood due to wear and tear.
When you visit a doctor, and a spinal curve is suspected, your GP or specialist will be able to identify the type and decide whether you need ongoing monitoring, treatment or additional advice.
What are the types of idiopathic scoliosis?
Idiopathic scoliosis is usually classified by the age of onset:
- Infantile: birth to about 3 years
- Juvenile: roughly 4–10 years
- Adolescent: around 10–18 years — the most common group
Curves are also described by shape (single “C” or double “S”) and location (thoracic, lumbar or thoracolumbar). These details help clinicians judge likely progression and the most suitable treatment or monitoring plan.
When to see a doctor: if you are unsure which category your child falls into, the GP can arrange appropriate imaging and referral to a specialist team.
Support Resources and Charities
Living with scoliosis can be challenging, but several UK organisations offer information, peer support and practical guidance to help families and individuals navigate treatment and daily life.
Support groups provide valuable community connections for those affected by scoliosis
British Scoliosis Society
The British Scoliosis Society supports surgeons, healthcare professionals and researchers working to improve scoliosis care. Their site includes professional resources, research updates and a directory to help you find specialist services.
Scoliosis Association UK
The Scoliosis Association UK (SAUK) offers nationwide support for children and adults affected by scoliosis, including helplines, local support groups and educational materials. Their peer networks can be especially helpful when starting bracing treatment or considering surgery.
For additional support and research updates, see the Scoliosis Support & Research Charity (SSRC), which provides information, peer support and details of local services across the UK.
Joining these organisations can provide access to:
- Local support groups and online forums where you can connect with others facing similar challenges
- Up‑to‑date information on treatment options and research developments
- Guidance on finding specialist care and navigating the healthcare system
- Resources to help manage the emotional and social impacts of scoliosis for children and families
Contact your general practitioner or check the helplines and local support groups run by these charities to find assistance in your area, they’ll be able to guide you towards the right support when in need of advice.
Conclusion
Customised care and support can effectively control idiopathic scoliosis; early detection, while the patient is still growing, provides the best opportunity to stop the curve’s progression. We have a few different ways to manage scoliosis, including careful observation, bracing, physiotherapy, and, in severe cases, surgery. The good news is that new techniques are continually improving the outcome and quality of life for those living with it.
Living with scoliosis does not mean you are restricted; many people lead happy and active lives when they have the right treatment plan in place, which involves tailoring the care to meet the specific needs of the individual, whether they are a child or an adult. The decision to wear a brace, go for conservative treatment or have spinal fusion surgery is made jointly with the healthcare team, and they’ll break down the benefits, recovery times, and any potential complications so that you can make an informed decision with your family.
Support Your Scoliosis Management Journey
Physiotherapy plays a giant role in scoliosis treatments, and with the help of some practical equipment, we can amplify the effectiveness of exercises. StandSure Therapy Aid is one such aid that stabilises the body while patients do their rehabilitation exercises and helps them grow a stronger core.
Explore StandSure Therapy Aid Learn How It’s Used
Consult your orthotist, physiotherapist or surgeon to discuss whether this or other aids might fit your treatment plan.
If you notice persistent signs in your child, make sure you see your GP or a specialist for assessment — early action can change the course of the condition. For further information and peer support in the UK, visit the Scoliosis Support & Research Charity (SSRC).
Every scoliosis journey is different. Working closely with healthcare professionals experienced in scoliosis care will help ensure the most suitable treatment for your circumstances and the best possible long‑term outcome.
