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Scoliosis

Scoliosis is a sideways curve of the spine. It is most often found in children and teens, but it can also begin in infancy or develop in adults as the spine wears. Many curves are small and only need watching; larger curves may call for a brace or surgery, and adults are treated mainly for pain. Know the warning signs that need urgent care.

Know the warning signs. Most scoliosis is not an emergency, but some changes are.

  • Call 911 (999 in the UK) right away if back pain comes with pain, tingling, weakness or numbness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowel control, such as trouble peeing or leaking urine or stool. The NHS lists these as reasons to call an ambulance rather than drive yourself (NHS).
  • Call 911 for severe trouble breathing — gasping, unable to get words out, a tight or heavy chest, or lips or skin turning very pale, blue or grey (NHS). A very large curve can cause heart and lung problems (AAOS OrthoInfo), so MBHA suggests mentioning any new or worsening breathlessness to the care team promptly.
  • See a doctor promptly for new weakness or numbness in an arm or a leg, or severe back pain with weakness or numbness (AAOS OrthoInfo). For back pain that starts suddenly or is getting worse quickly, or comes with feeling hot, cold, shivery or unwell, the NHS advises asking for an urgent appointment (NHS).
  • A curve that seems to be changing quickly. In a child who is still growing, a curve can worsen rapidly during a growth spurt (AAOS OrthoInfo). MBHA suggests calling the child’s doctor or spine specialist and asking to be seen sooner rather than waiting for the next scheduled check. Most scoliosis surgeons agree emergency surgery is rarely needed (AAOS OrthoInfo), but a fast change still needs to be looked at.

What is scoliosis?

Scoliosis is a sideways curve of the spine. Instead of a straight line down the middle of the back, the spine looks more like the letter “C” or “S,” and the bones also twist (AAOS OrthoInfo). It can affect people of any age, from babies to adults, but most often starts in children aged 10 to 15 (NHS). Signs include leaning to one side, uneven shoulders, one shoulder or hip sticking out, ribs sticking out on one side and clothes not fitting well (NHS). Mild scoliosis generally does not cause pain, problems with movement or difficulty breathing, and may only be noticed at a school screening or checkup (MedlinePlus, MedlinePlus Genetics).

The most common kind, adolescent idiopathic scoliosis, affects an estimated 2 to 3 percent of children in the U.S. (MedlinePlus Genetics). “Idiopathic” means the cause is unknown, true in around 8 in 10 cases (NHS). Mild curves are about equally common in girls and boys, but severe, worsening curves are more common in girls (MedlinePlus Genetics). About 30% of people with adolescent idiopathic scoliosis have a family history of it (AAOS OrthoInfo). It is not caused by bad posture, exercise or diet (NHS), and heavy backpacks and sports do not cause it (AAOS OrthoInfo). Most people with scoliosis live normal lives and can do most activities, including exercise and sports (NHS); adolescent idiopathic scoliosis is not life threatening, and most curves do not cause serious problems (AAOS OrthoInfo).

Types of scoliosis

Screening and diagnosis

Small curves often go unnoticed until a growth spurt, and many cases are first spotted at a school screening or regular pediatric checkup (AAOS OrthoInfo). The standard screening test is the Adams forward bend test: the child bends forward with knees straight and arms hanging while the examiner looks from behind for a difference in the ribs on each side, and also checks that the hips and shoulders are level and looks for leg-length differences and nerve findings (AAOS OrthoInfo). An X-ray shows where the curve is and measures how big it is; the doctor may then refer the child to a pediatric orthopaedic or spinal deformity surgeon (AAOS OrthoInfo).

Should every child be screened? Experts disagree. The Scoliosis Research Society recommends screening girls at 10 and 12 and boys once at 13 or 14, but AAOS notes that “a great deal of controversy exists” about the benefits of school screening (AAOS OrthoInfo). The U.S. Preventive Services Task Force looked at the evidence in 2018 and concluded it was insufficient to weigh the benefits and harms of screening children aged 10 to 18; later literature scans in 2025 found no new evidence to justify an update (USPSTF). It found that screening tests detect scoliosis accurately when used in combination, but that false positives can lead to worry, chest radiation and unnecessary treatment. More than half of U.S. states require or recommend school screening, and AAOS, the Scoliosis Research Society and the American Academy of Pediatrics support screening by well-trained staff, while the UK does not recommend it (USPSTF).

Because scoliosis runs in families, AAOS suggests checking siblings and the children of parents with scoliosis at yearly physicals, especially between ages 10 and 15. Look at your child’s back in a bathing suit; if one shoulder looks higher or one side of the rib cage sticks out more, call the pediatrician (AAOS OrthoInfo).

When to see a doctor: the NHS advises seeing a doctor if you think you or your child has scoliosis; it is unlikely that anything is seriously wrong, but it is best to get it checked (NHS). For back pain, the NHS also lists a back that has changed shape, or pain that does not improve after a few weeks, as reasons to be seen (NHS). If you stopped growing with a curve, see a doctor if it gets any worse (NHS). Other guides that may help: Back Pain, Neck and Osteoporosis.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Monitoring with X-rays; a custom brace for growing children with moderate curves; spinal surgery for severe curves; and, for adults, mostly pain management, with surgery for some. Cost estimate being researched. Medicare covers outpatient physical therapy: after the Part B deductible you pay 20% of the Medicare-approved amount. A large trial stopped early because bracing helped prevent curves from reaching the surgery range. Only surgery reduces a curve, and it rarely straightens it completely.
Chiropractic Spinal adjustments and soft-tissue care aimed at back pain, not at the curve. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments to correct a subluxation. AAOS says it may help back pain linked to scoliosis but has not been shown to reduce or stop a curve. Reviews found insufficient evidence for the curve itself. See a spine specialist too.
Acupuncture Fine needles used for back pain linked to scoliosis. About $90 to $185 per follow-up visit paying cash, per The Pricer; community clinics about $50 to $90. Medicare covers acupuncture only for chronic low back pain. AAOS says pain relief is possible but unpredictable, and acupuncture has not been shown to change the curve. Tell the acupuncturist about any spinal implants.
Herbal medicine No role in treating the curve. Bone-health supplements such as calcium and vitamin D are sometimes discussed. Cost estimate being researched. We found little research, and no herb or supplement has been shown to straighten a curve or stop it from worsening. Ask your doctor first, especially before surgery.
Massage therapy Relaxing, gentle massage for muscle tension and back pain; it does not change the curve. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. AAOS says massage may help back pain linked to scoliosis but has not been shown to reduce or prevent curve progression.
MBHA Wellness Coach Everyday support: sticking with a brace and home exercises, staying active, mood and body image, bone health, adult pain self-management and getting the most from appointments. Cost estimate being researched. Supports — never replaces — monitoring, bracing and surgery. Routines only work when they are followed.

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Conventional medicine (AMA)

For children, care is usually led by a pediatric orthopaedic surgeon or spine specialist. Treatment depends on where the curve is, how large it is, the child’s age and how many growing years remain (AAOS OrthoInfo). Sources put the cut-offs a little differently, so treat the degree numbers below as rough guides, not rules for your child. We don’t list doses.

Watching the curve (observation)

  • For a curve under about 20 to 25 degrees, or a child who is almost fully grown, the usual plan is to monitor it with a recheck about every 6 to 12 months, plus follow-up X-rays, until growth is finished (AAOS OrthoInfo, AAOS OrthoInfo).
  • Age and curve size best predict worsening: larger curves (over 30 degrees) in children under 10 are most likely to progress to surgery. Once someone is fully grown, curves under 30 degrees tend to stay the same, while curves over 50 degrees almost always worsen slowly, by about 1 degree a year (AAOS OrthoInfo).
  • AAOS says most children get less radiation from a year of scoliosis X-rays than from natural background radiation and air travel (AAOS OrthoInfo).
  • Babies and toddlers may not need treatment because the curve can improve as they grow, though careful monitoring matters; a plaster cast is sometimes used, changed every few months as the child grows (NHS).

Bracing

A brace is usually recommended for a growing child whose curve is roughly 20 or 25 to 40 or 45 degrees. It will not straighten an existing curve but often prevents it from worsening to the point of surgery (AAOS OrthoInfo, AAOS OrthoInfo). Most are custom-made underarm braces of rigid plastic, designed to be hard to see under loose clothing, and are worn until the spine stops growing (NHS, AAOS OrthoInfo).

  • The evidence: in the BrAIST trial, 242 high-risk adolescents chose or were randomly assigned to a brace worn at least 18 hours a day, or to observation. Treatment success (avoiding a curve of 50 degrees or more) was 75% with bracing and 42% with observation in the randomized group; the trial was stopped early because bracing worked, and the benefit grew with more hours of wear (Weinstein et al., 2013). A Cochrane review agreed that all studies showed bracing prevented progression, but graded the evidence low to very low quality (Negrini et al., 2015). The Task Force found adequate evidence that bracing may slow curve progression, but not enough to say whether that changes health in adulthood (USPSTF).
  • Wear time: AAOS says wearing a brace about 6 hours a day is nearly useless, while those wearing one over 16 hours a day are less likely to need surgery; even so, some curves keep growing in a brace (AAOS OrthoInfo). The NHS says uncertainties remain about how well braces work, so not every specialist recommends them (NHS).
  • Feelings: a BrAIST analysis found no significant differences in body image or quality of life between braced and observed girls through two years (Schwieger et al., 2016), though a brace can still be tough on self-esteem (NHS).
  • Other types: braces and casts do not correct the curve from abnormal vertebrae in congenital scoliosis (AAOS OrthoInfo), and a brace will not prevent progression in neuromuscular scoliosis, though it may support sitting (AAOS OrthoInfo).

Surgery

  • When: most surgeons agree children with curves of about 45 to 50 degrees and higher will need surgery; curves of 40 to 50 degrees in a growing child are a grey area to discuss with the surgeon (AAOS OrthoInfo). Surgery is the only treatment that can reduce a curve, though it will not usually straighten the spine completely (AAOS OrthoInfo).
  • What: the most common operation is spinal fusion, in which curved vertebrae are straightened and fused into one solid bone with metal rods, screws and bone graft. The fused section is permanently stiff, but most people keep enough motion in the rest of the back for daily life and most sports (AAOS OrthoInfo). Younger children may have rods that are lengthened as they grow (NHS). Vertebral body tethering, a “fusionless” operation, needs more follow-up, and fusion remains the gold standard (AAOS OrthoInfo).
  • Recovery: most patients spend 3 to 4 days in hospital, miss 4 to 6 weeks of school and are back to activities in 2 to 6 months; solid fusion takes 6 to 12 months (AAOS OrthoInfo).
  • Risks: infection, bleeding, pain where bone graft was taken, a fusion that does not heal (more likely in older teens and adults who smoke), blood clots and lung problems; nerve or spinal cord injury is extremely rare but not zero. Repeat surgery was reported in 4 to 13% in the first few years, and AAOS calls the operation expensive, with costs varying by region and insurance (AAOS OrthoInfo).

For neuromuscular curves, surgery is considered for curves over 50 degrees, trouble sitting, pain, or heart or lung problems (AAOS OrthoInfo). Adult care is covered in the adult section below.

What it costs

Cost estimate being researched. For people on Medicare, outpatient physical therapy is covered after the Part B deductible, with 20% of the Medicare-approved amount owed (Medicare.gov).

Find a medical doctor in our directory

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Chiropractic

Chiropractic care can be part of managing back pain, but it is not a treatment for the curve itself.

What the sources say

  • AAOS says chiropractic may be effective for back pain linked to scoliosis, but it has not been shown to reduce or prevent curve progression, and people who choose it should also see an orthopaedic or neurosurgical spine specialist for monitoring (AAOS OrthoInfo). It also reports no evidence that chiropractic care or other options besides bracing and surgery have a long-term effect on curves (AAOS OrthoInfo).
  • The NHS says there is little reliable evidence that chiropractic or osteopathy can correct a curved spine or stop it getting worse (NHS).

Research

We found only small, low-quality studies. A meta-analysis of four randomized trials concluded there was insufficient data and no evidence to support spinal manipulation for adolescent idiopathic scoliosis, because the studies were of very low quality (Sun et al., 2023). A 2024 review of five studies concluded that high-velocity manipulation does not seem to reduce spinal deformity or improve quality of life, though it may reduce pain (Piqueras-Toharias et al., 2024). A review of chiropractic scoliosis treatment found 27 reports, mostly case reports and case series, with only one randomized trial (Morningstar et al., 2017).

Safety

NCCIH reports that mild side effects such as soreness, stiffness or headache are common after spinal manipulation and usually pass within 24 hours; serious problems are very rare, and may be more likely in people with underlying health problems. Neck manipulation has been linked to rare tears in neck arteries that can lead to a stroke, though experts disagree on whether it causes them (NCCIH). MBHA suggests telling the chiropractor about your scoliosis, any spinal surgery or implants and any numbness or weakness, and asking whether forceful thrust techniques suit you.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first appointment (The Pricer). Medicare covers only spinal adjustments by a chiropractor to correct a subluxation (Medicare.gov).

Find a chiropractor in our directory

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Acupuncture

Acupuncture is used mainly for the back pain that can come with scoliosis. It is not a way to straighten a curve.

What the sources say

AAOS says acupuncture is an option for back pain linked to scoliosis and that many people get pain relief, though it is not predictable who will; it has not been shown to reduce or prevent progression of the curve (AAOS OrthoInfo). For back pain in general, an American College of Physicians guideline includes acupuncture among first-line nondrug options for chronic low back pain (NCCIH); that guideline is about back pain overall, not scoliosis.

Research on the curve

  • A small pilot study of 24 teenage girls compared one session of real acupuncture, sham acupuncture and lying on their side. The group as a whole showed no significant changes; in an exploratory look at girls with curves of 35 degrees or less, surface measurements changed after real acupuncture, and the authors called for more research (Weiss et al., 2008). One session cannot show whether acupuncture changes a curve over time.
  • A 2025 meta-analysis of Chinese trials of traditional Chinese medicine methods (spinal manipulation, exercises, acupuncture and massage) reported a smaller Cobb angle and called them effective. We read only the abstract, cannot separate acupuncture from the other methods, and the conclusion conflicts with orthopaedic sources, so treat it as unproven (Li et al., 2025).

Safety

Relatively few complications have been reported, and most come from nonsterile needles or improper technique; serious ones can include infections and punctured organs (NCCIH). One case report describes a deep spinal infection that needed surgery after dry needling in a teenager who had a spinal fusion (Callan et al., 2016). MBHA suggests telling any acupuncturist about spinal implants and choosing a licensed practitioner who uses single-use needles.

What it costs

The Pricer lists about $90 to $185 per follow-up visit and up to about $230 for a first private appointment, with community acupuncture around $50 to $90 (The Pricer). Medicare covers acupuncture only for chronic low back pain that meets its rules, up to 12 treatments in 90 days (Medicare.gov); ask whether scoliosis-related pain qualifies.

Find an acupuncturist in our directory

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Herbal medicine

No herb or supplement has been shown to treat scoliosis or stop a curve from worsening. We looked for trials and found little research.

Bone-health supplements

Scoliosis research has looked at bone health. A meta-analysis of six studies of adolescents with idiopathic scoliosis found that vitamin D insufficiency and deficiency were common, but that deficiency was not related to curve size (Llopis-Ibor et al., 2023). In a randomized trial of girls with idiopathic scoliosis and lower bone density, two years of calcium plus vitamin D improved bone measurements, but the effect mostly faded four years after the supplements were stopped (Lam et al., 2021). Those results are about bone strength, not about the curve. AAOS says it is not clear whether scoliosis contributes to bone loss, and recommends bone-healthy habits for everyone: not smoking, adequate calcium and vitamin D, and weight-bearing exercise (AAOS OrthoInfo). See our Osteoporosis guide. MBHA suggests asking your doctor whether bone health needs checking; we don’t list doses.

Safety

Natural does not always mean safe. Supplements can interact with medicines or pose risks before surgery, some may increase bleeding or affect response to anesthesia, and many have not been tested in children (NCCIH). If surgery is planned, tell your care team about every supplement as far in advance as possible. Be wary of any product that claims to straighten or “cure” a curve.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage may ease sore, tight muscles around a curve. It does not change the curve.

What the sources say

AAOS says massage treatment may help with back pain associated with scoliosis but has not been shown to reduce or prevent progression (AAOS OrthoInfo). NCCIH reports only weak evidence that massage helps low back pain in general (NCCIH). We found little research on massage alone for scoliosis; the trials we found combined it with other methods, so its effect cannot be separated (Li et al., 2025).

Safety

NCCIH says the risk of harm from massage appears low, but rare serious problems, including a blood clot, nerve injury or bone fracture, have been reported, some after vigorous deep-tissue work or in people at higher risk of injury, such as older adults. Most states license massage therapists (NCCIH). MBHA suggests asking for gentle to moderate pressure, and telling the therapist about your scoliosis, any spinal surgery or implants and any numbness.

What it costs

One national chain’s membership runs about $70 to $90 a month on a 12-month term, which includes one 60-minute session a month; each franchise sets its own prices (The Pricer).

Find a massage therapist in our directory

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MBHA Wellness Coach

An MBHA Wellness Coach can help you build the everyday habits that support your care — alongside, never instead of, monitoring, bracing or surgery.

Stay with the plan

A brace only works if it is worn as prescribed, and AAOS says the more time it is actually worn, the more effective it is (AAOS OrthoInfo). A coach can help a teen and family build a routine, track wear time and prepare questions for visits, and help you keep up any home exercises your therapist assigns.

Stay active

Children with scoliosis can usually do most exercise and need to avoid certain activities only if a specialist says so (NHS); they can take part in any sport up to their own tolerance (AAOS OrthoInfo). For adults, the NHS says it does not matter which exercise you pick; the key is to keep your back moving with something you enjoy, and it helps you stay at a healthy weight, reducing strain on your back (NHS). Check with your doctor or physiotherapist before a new program. If back pain limits you, see our Back Pain guide.

Feelings and body image

Having scoliosis or wearing a brace can be tough and may affect body image and self-esteem, particularly for children and teenagers; support groups can help (NHS). In BrAIST, poorer body image went along with poorer quality of life, whichever treatment a girl had (Schwieger et al., 2016). A coach can offer a listening ear and help families find counseling. See our Depression and Anxiety guides.

Bones and smoking

AAOS advises not smoking and doing weight-bearing exercise (AAOS OrthoInfo), and notes that older teens and adults who smoke are more likely to have a spinal fusion that fails to heal (AAOS OrthoInfo). A coach can help with a quit plan before a planned operation.

What it costs

Cost estimate being researched.

Another approach

Physical therapy and Schroth-type exercises

Physical therapy for scoliosis comes in two kinds: general exercise for strength and comfort, and scoliosis-specific exercises, such as the Schroth method, which teach a person to correct and hold a better posture of the trunk in three dimensions. Specific exercises are not considered an alternative to bracing or surgery; they are used alone or alongside them (Berdishevsky et al., 2016).

What the sources say

  • AAOS says it has not been proven that physical therapy helps the scoliosis itself. There is no high-quality evidence that physical therapy alone stops a curve from worsening during growth; some low-quality research suggests it may help a person look straighter and breathe better, and physical therapy plus a home program can be very helpful for the back pain linked to scoliosis (AAOS OrthoInfo).
  • The NHS says it is not yet clear whether specific back exercises or physiotherapy improve scoliosis, and not all specialists recommend them; it adds that general exercise is good for health (NHS). For adults, physiotherapy exercises are unlikely to improve the curve but may help pain (NHS).

Research

  • A 2024 Cochrane review of 13 randomized trials (583 participants) found the evidence sparse. Specific exercises added to bracing may reduce the Cobb angle slightly, but most results were low or very low certainty, and none of the trials looked at side effects (Romano et al., 2024).
  • In a Canadian trial of 50 adolescents, six months of Schroth exercises added to usual care led to a smaller curve than usual care alone (3.5 degrees less in the largest curve) (Schreiber et al., 2016). A Turkish randomized trial found supervised in-clinic Schroth exercises worked better than a home program or no treatment, with no change in quality of life (Kuru et al., 2016).
  • A 2025 meta-analysis of 11 randomized trials (446 participants) found Schroth exercises were linked to a smaller Cobb angle, but the average change did not reach the conventional 5 degree threshold for a clinically meaningful difference, and the authors highlighted significant methodological limits in the research (Zhu et al., 2025). The Task Force also rated the exercise evidence inadequate (USPSTF).

Getting started

MBHA suggests asking your orthopaedic team whether a referral makes sense, and asking a physical therapist about their scoliosis-specific training. Exercises should not replace prescribed brace wear (Berdishevsky et al., 2016). If you are on Medicare, outpatient therapy is covered with 20% owed after the Part B deductible (Medicare.gov).

Another approach

Adult scoliosis and pain management

In adults, back pain is one of the main problems caused by scoliosis, so treatment is mainly aimed at pain relief, and if the curve is not severe and not painful, treatment may not be needed (NHS). AAOS notes that people with curves under 30 degrees have the same risk of back pain as people without scoliosis, while larger untreated curves (over 50 to 60 degrees) are more likely to cause back pain, especially in the lower back (AAOS OrthoInfo).

Common options

  • Pain medicine. The NHS says anti-inflammatory painkillers (NSAIDs) are usually the first treatment, though not suitable for everyone, so check with a pharmacist; if over-the-counter medicine does not work, see a doctor, who may prescribe stronger painkillers or refer you to a pain clinic (NHS). See our Medication Safety guide.
  • Exercise. Activities that strengthen and stretch the back may reduce pain. Exercises from a physiotherapist are unlikely to improve the curve but may help pain (NHS).
  • Spinal injections. When scoliosis irritates a nerve, causing pain, numbness and tingling that can reach the feet, steroid and local anesthetic injections may help, but the benefit usually lasts only weeks or months (NHS).
  • Braces. Not often used in adults, but a brace can give pain relief by supporting the spine, or serve as an alternative to surgery for someone not well enough for an operation (NHS).
  • Surgery. Most adults will not need it. It may be considered if the curve is severe or getting significantly worse, if severe pain has not responded to other treatment, or if nerves are being irritated or squashed. Options include decompression to relieve pressure on nerves, and fusion. Spinal surgery is a major operation, recovery can take up to a year or more, and risks include infection, blood clots and, rarely, nerve damage with permanent leg numbness or weakness (NHS).

What the research says

A systematic review of nonsurgical treatments for symptomatic degenerative scoliosis in adults aged 50 and older found only six studies. Evidence for injections was low quality and for bracing and yoga very low, and the authors found no specific evidence on physical therapy or pain medicines; they could not advise for or against these methods (Schoutens et al., 2020). A 2025 narrative review of seven studies reported that bracing slowed curve progression and that physiotherapy and rehabilitation programs reduced pain and disability, while injections gave relief for at least a month in over half of people with leg pain from nerve irritation, fading over two years (Zlatanos et al., 2025). A major review calls non-operative care the first-line response and reports favorable surgical outcomes (Diebo et al., 2019).

Good to know

AAOS says scoliosis should not affect the ability to bear and deliver a child; an epidural is possible, though a very severe curve makes it harder, and an obstetrician and anesthesiologist should know about any fusion (AAOS OrthoInfo). For falls and balance, see our Balance guide. New weakness, numbness or bladder or bowel changes are warning signs; see the box at the top of this page.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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