Scoliosis

Scoliosis is a spine that twists and curves to the side. It can affect people of any age, from babies to adults, but most often starts in children aged 10 to 15. It is not usually a sign of anything serious, and mild scoliosis often needs no treatment (NHS).

Signs include a visibly curved spine, leaning to one side, uneven shoulders, one shoulder or hip sticking out, the ribs sticking out on one side and clothes not fitting well. Some people also have back pain, which is more common in adults with the condition (NHS).

Types of scoliosis

In around 8 in 10 cases the cause is unknown, which doctors call idiopathic scoliosis. Less commonly it comes from vertebrae that did not form properly before birth (congenital scoliosis), from a nerve or muscle condition such as cerebral palsy (neuromuscular scoliosis), or from wear and tear of the spine with age (degenerative scoliosis, which affects older adults) (NHS).

An X-ray shows how big the curve is (NHS). Its size is given in degrees as the Cobb angle, and a common definition of scoliosis is a Cobb angle of more than 10 degrees (Schwab et al., 2005).

How common is scoliosis?

• In adolescents, studies report idiopathic scoliosis in between 0.47% and 5.2% of young people, with wide differences in methods. Girls are affected more often, and the gap widens with curve size: about 1.4 girls for every boy with curves of 10 to 20 degrees, rising to 7.2 to 1 for curves over 40 degrees (Konieczny et al., 2013).
• In older adults, it is surprisingly common. In 75 volunteers over 60 who had never been told they had scoliosis, 68% had a curve of more than 10 degrees. The size of the curve was not linked with their pain scores, and many had no marked physical or social limitation (Schwab et al., 2005).

Does sitting badly cause scoliosis?

No. The NHS says idiopathic scoliosis cannot be prevented and is not thought to be linked to bad posture, exercise or diet. Genes may make it more likely, as it sometimes runs in families (NHS). Back pain at a desk has its own explanations (see lower back pain from sitting), but slouching does not twist the spine sideways.

The braces used in scoliosis are prescribed by specialists for growing children, to stop the curve getting worse until growth ends (NHS). They are a different thing from the shop-bought straps covered in Do posture correctors work? Our wall posture test looks at the upper back and head from the side; it is not a scoliosis check.

Can exercise straighten scoliosis? What the evidence says

The NHS says it is not clear whether back exercises help improve scoliosis, but that general exercise is good for overall health and shouldn’t be avoided unless your doctor advises it (NHS). The research on scoliosis-specific exercise programmes, all in adolescents, points the same way:

• A 2024 meta-analysis of randomised trials found that these exercises improved the Cobb angle by 2.5 degrees on average compared with control groups. That was statistically significant but too small to matter clinically, and there was no improvement in trunk rotation or quality of life scores (Baumann et al., 2024).
• An earlier review found very-low-quality evidence that the exercises improved some measures of curve, function and pain (Thompson et al., 2019).

For adults, the NHS describes treatment aimed at relieving pain, such as painkillers, spinal injections and, very occasionally, surgery. Most people with scoliosis live normal lives and can exercise and play sport, and the curve tends to stay the same once you stop growing (NHS).

When to see a GP

See a GP if you think you or your child has scoliosis, or if a known curve gets worse after growth has stopped (NHS). A back that has changed shape, or a new lump or swelling, is also on the NHS list of reasons to see a GP about back pain (NHS); the other warning signs are in red flags.