How To Prevent Scoliosis

Understanding scoliosis

Scoliosis is a condition where the spine is curved at 10 degrees or more, which commonly presents as C- or S-shaped curvatures.1 While some people with scoliosis do not experience any obvious symptoms, others may have a more apparent curved spine, and even back pain. 

Scoliosis is most commonly diagnosed during childhood and persists through to adulthood. However, it is possible for scoliosis to only start to develop in adulthood. In some cases, scoliosis can worsen as it progresses.1 

What causes scoliosis? 

There are 3 types of scoliosis that are categorised based on their causes. The cause of most scoliosis cases are actually unknown, and these are known as idiopathic scoliosis.1 Idiopathic scoliosis is further categorised according to the age groups affected - infantile, juvenile, or adolescent idiopathic scoliosis. Idiopathic scoliosis is also likely to be caused by multiple factors rather than just one single factor.

The second type of scoliosis is known as congenital scoliosis. People with congenital scoliosis are born with abnormalities in the spine, which are due to an unusual development of the spine as the foetus forms. 

The third type of scoliosis is called neuromuscular scoliosis. As the name suggests, neuromuscular scoliosis is associated with underlying conditions affecting the muscles and nerves. Examples of disorders that can cause neuromuscular scoliosis are spinal cord trauma, muscular dystrophy, spina bifida, and cerebral palsy.1

Signs and symptoms of scoliosis

A lot of people with scoliosis do not have obvious or painful scoliosis symptoms, which is why people often do not notice the condition. However, some people might present with these observable signs and symptoms:2

How can it be diagnosed 

Because the cause of most scoliosis cases are unknown, doctors initially need to collect patient’s information to help with diagnosis if they suspect scoliosis. This information includes the patient’s medical history, family history, and the symptoms that the patient is experiencing. Doctors will then perform a physical examination to check a few components, including:2

  • Walking behaviour
  • Height measurement
  • Neurological functions, such as movement, senses, balance, and reflexes
  • Symmetry of the shoulders and hips   

Several imaging techniques are also used in diagnosing scoliosis. These include CT scans, magnetic resonance imaging (MRI), and X-rays.1 

Risk factors


Scoliosis is more prevalent among females, especially younger girls who are still developing. The female-to-male ratio of adolescent idiopathic scoliosis tends to increase with age and ranges from 1.5:1 to 3:1.3 Girls are also more likely to suffer from more severe scoliosis compared to boys.

It was suggested that perhaps the genetic makeup in a region on the X-chromosome may contribute to the higher risk of scoliosis in females, who have 2 copies of the X-chromosome.1 


While scoliosis can affect people of all ages, scoliosis appears to be more prevalent among people aged 15 and above, after puberty has hit.3

In under 21-year-olds, the age group 11-18 contributes to about 90% of idiopathic scoliosis cases. Among adults above 25 years old, the prevalence of scoliosis is lower, at > 8%. However, once above the age of 60 years, the prevalence increases greatly to 68%. It was suggested that as adults age, there may be degeneration in the spine that increases the risks for scoliosis among older adults.3

Family history

Scoliosis cases are more common in families with a family history of the condition. This is because there are genetic mutations and variations that are associated with scoliosis that can be passed down through generations. There is not one single gene that can cause scoliosis, but certain gene variants identified can contribute to higher risks for scoliosis.4


Several studies suggested that there are differences in the prevalence and severity of scoliosis between different ethnic groups. 

One study done in 2015 reported that more Black adolescent patients were diagnosed with severe idiopathic scoliosis compared to patients of other ethnicities. The Black adolescent patients in the study were also more likely to present with spinal curves that required surgery. The authors suggested that genetic factors and differences in accessing healthcare may contribute to the differences in scoliosis severity that we see in different ethnicities.5


The curved spine in scoliosis can shift the ribs and put pressure on internal organs such as the lungs and heart. This can lead to breathing difficulties in scoliosis patients.

In some cases, the curved spine may also compress the nerves in their surroundings, causing numbness and pain in the regions that are affected. Loss of bowel and bladder control may also happen as a result of the nerve compression.

Some scoliosis patients have visible misalignment or may need to wear a spinal brace, which can cause them to have lower self-esteem and a lower quality of life

Can scoliosis be prevented before it’s too late?

You’ve probably heard people advising others to sit or stand up straight to prevent the curving of the spine. While maintaining a good posture does help maintain the correct alignment of your spine and avoids straining the muscles, Dr Robert Lark, a paediatric orthopaedic surgeon, has stated that good posture cannot prevent scoliosis.

Because the majority of scoliosis cases have unknown causes, it is currently unknown how it could be prevented. Moreover, scoliosis may be caused by genetic factors and impairments that happen during foetal development which are unpreventable. 

However, it is advised to get diagnosed and subsequently treated as early as possible if you suspect you or someone you know has scoliosis. If scoliosis is diagnosed early, the condition can be more manageable and treatments may also be more effective in preventing the condition from worsening. 

Treatments if you have scoliosis

Depending on the severity of the patient’s condition, doctors may suggest a variety of different treatments. 

Doctors usually advise patients with mild scoliosis (<20°) to monitor their condition closely. Doctors may check the patients’ height measurements to keep track of the spinal growth and the progression of scoliosis.

For patients with a spine curvature of 20° - 40°, they may need to get braces, which help to restore the spine alignment and prevent the worsening of their conditions.1,6 There are many different brace designs, with some being more rigid and others being more flexible. They can also cover different lengths of your spine. Some may also be more effective in correcting certain sections of the spine compared to others.

For severe scoliosis (>40°), patients may be advised to consider surgery. There are 2 types of scoliosis surgery - fusion and non-fusion surgeries.

Spinal fusion surgery may be recommended for scoliosis patients who have severe curving of the spine and who are beyond the growing stage. Spinal fusion surgery involves fusing two or more vertebrae together and placing metal implants in the body to help hold the vertebrae together during the fusion. This surgery helps prevent motion in the fused area and hence prevents the worsening of curves. However, fusion surgery may reduce the flexibility and mobility in the region where the vertebrae are fused, which can affect patients’ ability to exercise. Posterior fusion surgery is the most common scoliosis fusion surgery, which involves operating from the back. 

As the name suggests, non-fusion surgery does not join vertebrae together. This corrective treatment actually preserves the mobility and flexibility of patients, as opposed to fusion surgery. There are different types of non-fusion surgery, some involve inserting a tether such as Vertebral Body Tethering to help align the spine, while others involve inserting an internal brace, like ApiFix.

What is the most effective treatment? 

Not everyone with scoliosis will require treatment For treatments to achieve optimal effectiveness, they need to be carried out according to the severity and age of the patient. This is because patients who are still maturing will experience growth and movements in the spine, which needs to be taken into account to avoid affecting their development. 

Treatment is most effective when scoliosis is diagnosed and managed early on. If children or adolescents are diagnosed with scoliosis, treatments may be more effective before the growth spurt prior to puberty, because they can prevent the worsening of the condition. 


Scoliosis is a condition that causes the spine to curve at a degree of more than 10°. In milder cases (< 20°), scoliosis usually does not require treatment and only requires close monitoring. In more severe scoliosis cases, braces and surgery may be advised. The majority of scoliosis cases are actually idiopathic, meaning the cause is unknown. Therefore, there are currently no prevention methods for scoliosis. It is strongly encouraged to look out for any signs and symptoms of scoliosis if you have a family history or medical history that puts you at a higher risk. Early diagnosis and treatment are the key to preventing the worsening of scoliosis, and in some cases, improving the condition. 


1. Lee GB, Priefer DT, Priefer R. Scoliosis: causes and treatments. Adolescents [Internet]. 2022 Jun [cited 2022 Nov 8];2(2):220–34.

2. Janicki JA, Alman B. Scoliosis: Review of diagnosis and treatment. Paediatrics & Child Health [Internet]. 2007 Nov [cited 2022 Nov 10];12(9):771–6.

3. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. Journal of Children’s Orthopaedics [Internet]. 2013 Feb [cited 2022 Nov 11];7(1):3–9.

4. Grauers A, Einarsdottir E, Gerdhem P. Genetics and pathogenesis of idiopathic scoliosis. Scoliosis Spinal Disord [Internet]. 2016 Nov 28 [cited 2022 Nov 12];11:45.

5. Zavatsky JM, Peters AJ, Nahvi FA, Bharucha NJ, Trobisch PD, Kean KE, et al. Disease severity and treatment in adolescent idiopathic scoliosis: the impact of race and economic status. The Spine Journal [Internet]. 2015 May 1 [cited 2022 Nov 12];15(5):939–43.
6. Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med [Internet]. 2013 Oct 17 [cited 2022 Nov 9];369(16):1512–21.

This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Pei Yin Chai

Bachelor of Science - BS, BSc(Hons) Neuroscience, The University of Manchester, England

Pei Yin (Joyce) is a recent neuroscience degree graduate from the University of Manchester. As an introvert, she often finds it easier to express herself in written words than in speech, that's when she began to have an interest in writing. She has 2 years of experience in content-creating, and has produced content ranging from scientific articles to educational comic and animation. She is currently working towards getting a career in medical writing or project management in the science communication field.

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