Scoliosis Explained: Causes, Monitoring and Treatment Options
Written by Daryl Ansell | Reviewed by Robert Foster | Last reviewed: July 2026
Quick answer: Scoliosis monitoring and treatment depend on the type and size of the spinal curve, the person’s age, remaining growth and whether the curve is progressing. Some curves remain mild and stable, while others may require observation, exercise, periodic imaging, bracing or specialist care.
Scoliosis is a sideways curvature of the spine that usually also involves some degree of spinal rotation. Chiropractic care does not straighten or cure structural scoliosis. Where appropriate, it may play a supportive role by helping manage joint stiffness, muscle tension, mechanical discomfort and movement restrictions as part of a broader care plan.
This guide explains the causes and types of scoliosis, signs to look for, how curves are measured and monitored, available treatment options and when imaging or specialist referral may be necessary.
Concerned About Your Child’s Posture?
If you have noticed uneven shoulders, hips, ribs or posture, an assessment can help determine whether scoliosis is suspected and whether monitoring, imaging or referral may be appropriate.
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What Is Scoliosis?
The word scoliosis comes from a Greek word meaning bent or curved. In medical terms, scoliosis describes an abnormal sideways curvature of the spine that usually also involves rotation of the vertebrae.
A healthy spine is not completely straight when viewed from the side. It has natural forward and backward curves that help with balance and movement. However, when viewed from behind, the spine should appear relatively straight.
With scoliosis, the spine may curve into a C-shape or an S-shape. The rotation associated with structural scoliosis may also cause one side of the ribs or lower back to become more prominent.
The Scoliosis Research Society generally defines scoliosis as a spinal curve measuring more than 10 degrees using the Cobb method on an appropriate X-ray.
A visible postural difference does not automatically mean that someone has scoliosis. Clinical assessment and, when indicated, standing spinal imaging are used to distinguish scoliosis from other causes of asymmetry.
What Causes Scoliosis?
Scoliosis is not one single condition. Different types can develop for different reasons.
Idiopathic scoliosis
Idiopathic scoliosis is the most common type. “Idiopathic” means that no single underlying cause has been identified.
It is commonly grouped according to the age at which it develops:
- Infantile idiopathic scoliosis: develops before three years of age
- Juvenile idiopathic scoliosis: develops between approximately three and ten years of age
- Adolescent idiopathic scoliosis: develops from around ten years of age until skeletal maturity
Adolescent idiopathic scoliosis is the most frequently recognised form. It often becomes noticeable during a growth spurt.
Idiopathic scoliosis is not caused by poor posture, carrying a school bag, using a mobile phone or sleeping in the wrong position. Genetics and growth-related biological factors appear to play an important role, although the precise cause is not fully understood.
Congenital scoliosis
Congenital scoliosis results from differences in vertebral development before birth. One or more vertebrae may be incompletely formed or joined together.
Children with congenital scoliosis generally require medical assessment because progression and treatment needs depend on the type and location of the vertebral difference.
Neuromuscular scoliosis
Neuromuscular scoliosis can develop in people with conditions affecting muscle control, strength or the nervous system. Examples include cerebral palsy, muscular dystrophy and some spinal cord conditions.
This type often requires coordinated medical and specialist care.
Degenerative adult scoliosis
Degenerative scoliosis develops later in life due to uneven age-related changes affecting spinal discs and joints. These changes can cause the spine to gradually curve or shift.
Adults may experience back pain, stiffness, changes in posture, reduced walking tolerance or nerve-related symptoms affecting the legs.
Functional or postural curves
Not every sideways curve is structural scoliosis. A functional curve may occur because of factors such as leg-length difference, muscle spasm, pain or an uneven standing position.
A functional curve may reduce when the underlying factor is corrected or when the person changes position. Structural scoliosis generally remains present because the vertebrae and spine are rotated within the curve.
What Are the Signs of Scoliosis?
Scoliosis is often first recognised because of a change in posture rather than pain. Many children with mild scoliosis feel well and remain active.
Possible signs include:
- One shoulder sitting higher than the other
- One shoulder blade appearing more prominent
- Uneven waist creases
- One hip sitting higher or appearing more prominent
- The head not appearing centred over the pelvis
- The body leaning slightly to one side
- Clothing hanging unevenly
- A rib prominence when bending forward
- One side of the lower back appearing higher during forward bending
These signs do not confirm scoliosis by themselves. Postural asymmetry can have several causes, and a professional assessment is needed when changes are persistent or noticeable.
Read our step-by-step guide to how to tell if your child may have scoliosis.
How Is Scoliosis Assessed?
Scoliosis assessment usually begins with a health history and physical examination. Imaging is then considered when the findings suggest a structural curve or when known scoliosis needs to be measured or monitored.
A clinical assessment may include:
- Reviewing when the postural change was first noticed
- Discussing growth, development and family history
- Comparing shoulder and hip height
- Assessing waist and trunk symmetry
- Observing overall spinal alignment
- Performing an Adams forward bend test
- Using a scoliometer to estimate trunk rotation where appropriate
- Assessing spinal movement and balance
- Checking muscle strength, reflexes and sensation when indicated
- Screening for pain, neurological symptoms and other clinical red flags
A home check can identify possible signs, but it cannot diagnose scoliosis or measure the spinal curve.
The Cobb angle
When scoliosis is confirmed on an appropriate standing X-ray, the curve is commonly measured using the Cobb angle. This involves drawing lines along selected vertebrae at the upper and lower ends of the curve.
The Cobb angle helps establish:
- Whether the curve meets the definition of scoliosis
- The size and location of the curve
- A baseline for future comparison
- Whether progression has occurred
- Whether bracing or specialist review may need to be considered
The Cobb angle should not be considered alone. Age, remaining growth, curve pattern, symptoms and progression are also important when deciding what to do next.
Scoliosis in Children and Teenagers
Most childhood scoliosis is mild when first detected. Some curves remain stable and require observation only, while others may progress as the child grows.
The likelihood of progression is generally influenced by:
- The child’s age
- How much growth remains
- The size of the curve when first identified
- The location and pattern of the curve
- Whether the curve has changed between assessments
- The type of scoliosis
- Skeletal maturity
A smaller curve in a child who is close to skeletal maturity may behave differently from a similar curve in a younger child with substantial growth remaining.
Early recognition does not mean every child needs treatment. It allows appropriate monitoring so that meaningful progression can be identified while treatment options are still available.
Not sure what you are seeing? Learn more about scoliosis assessment and supportive care in Townsville, or book an assessment if the changes are persistent or becoming more noticeable.
Does Scoliosis Get Worse?
Scoliosis can worsen, but progression is not inevitable. Many mild curves remain stable, particularly after skeletal maturity.
The greatest risk of progression generally occurs during rapid growth. This is why monitoring can be important for children and teenagers who still have considerable growth remaining.
Progression is normally assessed by comparing Cobb-angle measurements on suitable standing X-rays taken at different times. Small measurement differences do not always represent genuine progression, so imaging must be interpreted alongside growth and clinical findings.
In adults, progression may be associated with degenerative changes affecting discs and spinal joints. Adult curves can sometimes contribute to pain, stiffness, imbalance or narrowing around spinal nerves.
For a detailed explanation, read Does Scoliosis Get Worse?
When Are X-Rays or EOS Imaging Needed?
Not everyone with uneven posture needs an immediate X-ray. Assessment generally comes first.
Imaging may be appropriate when:
- Structural scoliosis is suspected clinically
- The Cobb angle needs to be measured
- A baseline is needed for future monitoring
- A growing child has an established curve
- Progression is suspected
- Bracing or specialist care is being considered
- The curve pattern or symptoms are unusual
Imaging should be recommended when it is likely to clarify the diagnosis or influence management—not automatically for every postural difference.
Read more about when an X-ray is actually necessary for scoliosis.
EOS low-dose imaging
EOS is a specialised imaging system that can produce standing images of the spine and lower limbs using a lower radiation dose than many conventional multi-image spinal X-ray examinations. The precise dose depends on the examination and imaging protocol.
EOS may be particularly valuable when a growing child requires repeated imaging because it can show overall spinal, pelvic and lower-limb alignment while the patient is standing.
Learn more about EOS low-dose imaging and scoliosis monitoring.
Is MRI needed?
MRI is not normally required simply to measure a typical scoliosis curve. It may be recommended when there are neurological findings, unusual pain, rapid progression, an atypical curve pattern, congenital differences or concern about the spinal cord or another underlying condition.
MRI and specialist referral are generally coordinated through a GP, paediatrician, orthopaedic specialist or spinal specialist.
Scoliosis in Adults
Adult scoliosis may be a curve that developed during childhood or a curve that formed later because of degenerative spinal changes.
Some adults have no significant symptoms. Others may experience:
- Back pain or stiffness
- Muscle fatigue
- Uneven posture
- Reduced tolerance for standing or walking
- Difficulty maintaining balance
- Pain, numbness or weakness affecting a leg
The severity of symptoms does not always match the size of the curve. Disc degeneration, spinal joint changes, muscle capacity, nerve compression, general health and activity levels may all influence how an adult feels and functions.
Management is therefore based on symptoms and function as well as imaging findings.
What Are the Treatment Options for Scoliosis?
There is no single treatment suitable for every person with scoliosis. Management depends on age, curve type, remaining growth, symptoms, progression and overall health.
Observation and monitoring
Many mild curves do not require active treatment. Monitoring may include periodic postural assessment and, when clinically justified, repeat imaging.
The purpose of monitoring is to identify meaningful progression rather than repeatedly treating or imaging a stable curve.
Exercise and physical activity
Most people with scoliosis can remain physically active. General exercise can support strength, fitness, balance, confidence and overall spinal function.
Individualised rehabilitation may include:
- Trunk-strengthening exercises
- Spinal mobility exercises
- Balance and coordination work
- Breathing exercises
- Postural awareness
- Activities adapted to the person’s symptoms and goals
Scoliosis-specific exercise programs may be used as part of conservative management. Evidence suggests they may help some patients with posture, function and quality of life, but outcomes vary and they should not be presented as a guaranteed way to straighten the spine.
Bracing
Bracing may be recommended for selected growing children whose curves are at meaningful risk of progression.
The main purpose of a brace is generally to reduce the likelihood of the curve worsening during growth. It is not usually expected to permanently straighten the spine.
Brace decisions should be made with an appropriately qualified orthopaedic or spinal specialist and depend on more than the Cobb angle alone.
Surgery
Surgery may be considered for severe or progressive curves, particularly when there is substantial deformity, impaired function, significant imbalance or concern about future progression.
Most people with scoliosis do not require surgery. Decisions about surgery require detailed specialist assessment.
Can Chiropractic Care Correct Scoliosis?
No. Chiropractic care does not straighten or cure structural scoliosis.
Current evidence does not establish chiropractic adjustments as a reliable method of permanently reducing the Cobb angle or preventing curve progression.
Some treatment systems—including Chiropractic BioPhysics or other intensive corrective programs—may report postural or radiographic changes. However, the available evidence is limited, outcomes vary and these approaches should not be presented as a dependable correction for structural scoliosis.
Where clinically appropriate, chiropractic care may instead provide supportive help with:
- Spinal joint stiffness
- Muscle tension
- Mechanical back discomfort
- Movement restrictions
- Postural awareness
- Exercise and activity advice
- Maintaining comfortable physical activity
Any chiropractic treatment should be adapted to the person’s age, curve, symptoms, bone health and medical circumstances. Care should not replace appropriate imaging, medical monitoring, bracing or specialist referral.
For information about assessment and supportive care at our clinic, visit our Scoliosis Treatment and Assessment in Townsville page.
How Ansell Chiropractic Centre May Help
Our role is to help determine what may be contributing to your symptoms, explain what the examination findings mean and identify when monitoring, imaging or referral may be appropriate.
Depending on the individual, care may include:
- Postural and spinal assessment
- Review of previous imaging and reports
- Gentle joint mobilisation or manipulation where appropriate
- Soft-tissue treatment
- Individualised mobility or strengthening exercises
- Advice about activity, work, school or sport
- Referral for imaging when clinically justified
- Communication with a GP or specialist when needed
We do not promise to straighten scoliosis, recommend automatic X-rays or place patients on unnecessary long-term treatment plans.
Concerned About Scoliosis?
If you have noticed uneven shoulders, hips, ribs or posture in yourself or your child, an assessment can help determine whether scoliosis is suspected and whether monitoring, imaging or referral may be appropriate.
When Is Medical or Specialist Referral Needed?
Some findings require medical or specialist assessment rather than chiropractic management alone.
Referral may be appropriate when:
- A child’s curve appears to be progressing
- A moderate or larger curve is present during growth
- Bracing may need to be considered
- The curve has an unusual pattern
- There is significant or unexplained pain
- A congenital or neuromuscular cause is suspected
- Surgical assessment may be required
Seek urgent medical care if spinal symptoms are accompanied by:
- New loss of bladder or bowel control
- Numbness around the saddle area
- Rapidly progressive weakness
- Sudden difficulty walking or maintaining balance
- Severe pain following significant trauma
Children with suspected scoliosis should be assessed by an appropriate healthcare professional. Referral to a GP, paediatrician, physiotherapist, orthopaedic specialist or spinal specialist may form part of coordinated care.
Why Townsville Families Choose Ansell Chiropractic Centre
For more than 40 years, Ansell Chiropractic Centre has helped Townsville families understand spinal and musculoskeletal conditions through careful assessment, honest advice and conservative care.
- More than 40 years serving the Townsville community
- Clear explanations without exaggerated correction claims
- Assessment before treatment recommendations
- Imaging only when clinically indicated
- Review of existing imaging whenever possible
- Gentle care adapted to age and individual needs
- No unnecessary prepaid or long-term treatment plans
- Referral and collaboration with GPs and specialists when appropriate
Key Takeaways
- Scoliosis is a sideways spinal curve that usually includes vertebral rotation.
- A curve greater than 10 degrees measured using the Cobb method is generally classified as scoliosis.
- Most scoliosis in children is idiopathic and is not caused by poor posture, school bags or device use.
- Many mild curves remain stable, but progression is more likely during periods of rapid growth.
- Not every postural difference needs an immediate X-ray.
- EOS can provide lower-dose standing imaging when repeated monitoring is required.
- Treatment may include observation, exercise, bracing or specialist care.
- Chiropractic care does not straighten structural scoliosis but may support comfort, mobility and function.
Frequently Asked Questions
What are the first signs of scoliosis?
Early signs may include uneven shoulders, one prominent shoulder blade, uneven hips or waist creases, leaning to one side or a rib prominence when bending forward. These signs do not confirm scoliosis, so persistent changes should be professionally assessed.
Can a chiropractor diagnose scoliosis?
A chiropractor can assess posture, spinal movement and clinical signs associated with scoliosis. An appropriate standing X-ray is generally required to confirm and measure a structural curve using the Cobb angle. Referral should be arranged when medical or specialist assessment is needed.
Does scoliosis cause pain?
Many children with scoliosis do not experience pain. Adults are more likely to report discomfort, stiffness or fatigue, but the severity of pain does not always correspond with the size of the curve.
Does every child need to be checked for scoliosis?
Not every child requires repeated spinal examinations or X-rays. Assessment is appropriate when a parent, child, school health professional or healthcare provider notices persistent asymmetry, particularly during growth.
Can scoliosis be prevented?
Most idiopathic scoliosis cannot be prevented because it is not caused by posture, exercise habits or carrying a school bag. Early recognition and monitoring may help identify curves that are progressing while management options remain available.
Can exercise straighten scoliosis?
Exercise can support strength, mobility, balance and quality of life. Scoliosis-specific exercises may help some people with posture and function, but exercise should not be presented as a guaranteed way to permanently straighten a structural curve.
Can chiropractic treatment correct scoliosis?
No. Current evidence does not show that chiropractic adjustments reliably straighten structural scoliosis or prevent progression. Appropriate care may help manage stiffness, muscle tension, mechanical discomfort and movement restrictions.
Can adults develop scoliosis?
Yes. Some adults have scoliosis that began during adolescence, while others develop a curve later because of uneven degeneration affecting spinal discs and joints.
When does scoliosis require bracing?
Bracing may be considered for selected growing children whose curves have a meaningful risk of progression. Decisions depend on curve size, remaining growth, progression and curve pattern and should be made with an appropriate specialist.
How often should scoliosis be X-rayed?
There is no single imaging schedule suitable for everyone. The timing depends on age, remaining growth, curve size, previous progression and whether the result is likely to influence management.
Related Scoliosis Guides
- Scoliosis Assessment and Support in Townsville
- How to Tell if Your Child Has Scoliosis
- Does Scoliosis Get Worse?
- Do You Need an X-Ray for Scoliosis?
- EOS Low-Dose Imaging
- When Are Chiropractic X-Rays Recommended?
- Chiropractic Care for Children
- Spinal Exercise Guides
Trusted External Resources
- Healthdirect Australia: Scoliosis
- Scoliosis Research Society: Diagnosing Scoliosis
- NHS: Scoliosis Overview
Final Takeaway
Scoliosis varies considerably from one person to another. Some curves remain mild and require observation only, while others need imaging, closer monitoring, bracing or specialist care.
The most appropriate approach is based on the type of scoliosis, the size and pattern of the curve, remaining growth, progression, symptoms and individual goals—not simply the appearance of the spine.
Chiropractic care does not straighten structural scoliosis, but appropriate conservative care may support comfort, movement and function while ensuring that imaging and referral are arranged when needed.
Book a Scoliosis Assessment in Townsville
If you are concerned about your child’s posture, have questions about an existing scoliosis diagnosis or need help understanding an imaging report, Ansell Chiropractic Centre can assess the clinical signs and explain the most appropriate next step.
Ansell Chiropractic Centre
159 Ross River Road
Mundingburra QLD 4812
Phone: (07) 4779 3633
Dr Daryl Ansell is an experienced chiropractor and clinic director at Ansell Chiropractic Centre in Townsville, Queensland. With more than four decades of clinical experience, he has helped patients with low back pain, neck pain, headaches, sciatica, posture-related strain and other musculoskeletal problems.
His approach is evidence-informed and patient-centred, with a focus on careful assessment, clear explanations, improving joint movement, reducing muscle tension and supporting better functional movement. Care is tailored to the individual and may include spinal adjustments, low-force techniques, soft-tissue therapy, rehabilitation exercises and posture advice.
Dr Ansell has served on the Chiropractors Board of Queensland for more than 10 years and as ACA NQ Regional Coordinator and Media Liaison Officer — roles that reflect his longstanding commitment to chiropractic standards and community health in North Queensland.
Daryl places a strong emphasis on safety screening, communication and appropriate referral when needed. He works collaboratively with local healthcare providers, including GPs and imaging services such as Queensland X-Ray and I-MED Radiology.
Ansell Chiropractic Centre has been part of the Townsville community for more than 40 years, serving patients from Mundingburra, Aitkenvale, Annandale, Douglas, Idalia, Kirwan South Townsville, Townsville CBD and surrounding suburbs.