Your child’s school nurse sent home a letter about a possible curve in their spine, and now you’re staring at it trying to figure out whether it means scoliosis, a curve in the spine. Maybe you’ve been ignoring the uneven shoulders you see in the mirror every morning, and a calendar reminder told you it’s Scoliosis Awareness Month. Scoliosis Awareness Month gives families a reason to check for changes, understand screening and diagnosis and know when monitoring or treatment makes sense.
Why Scoliosis Awareness Month Exists
Most scoliosis curves develop silently. In adolescents, a curve can grow during a puberty growth spurt without pain or obvious change that a busy family notices day to day. Adults can develop degenerative curves over decades, and the curve itself often causes no symptoms until pain or postural shift gets your attention.
June is National Scoliosis Awareness Month, and the goal is education and early detection around how common scoliosis is. Early diagnosis is the key to catching the rare curve that needs treatment before options narrow, but many diagnosed children only need monitoring. Adolescent idiopathic scoliosis, which means scoliosis with no known cause in a teen, affects roughly four in 100 adolescents, and most people have a mild form.
What to Look For: Signs in Children, Teens and Adults
Scoliosis shows up differently depending on age. In a growing teenager, you’re watching for the shape of the back to change. For someone with adult scoliosis, a long-standing curve may start causing symptoms years later.
Signs Parents Should Watch For
Small curves often go unnoticed until a child hits a growth spurt during puberty. You can start watching around age eight and look for patterns rather than any single feature. Common signs parents notice include the changes below:
- One shoulder sitting higher than the other, or one shoulder blade that looks bigger or sticks out
- A waist that isn’t even, or one hip higher than the other
- More space between the arm and the body on one side when the arms hang loosely
- Clothes that fit unevenly, with a hemline or shirt that hangs crooked
One simple check you can do at home is the Adams Forward Bend Test, where your child bends forward at the waist with knees straight and arms hanging free. As the spine rotates, it pushes the ribs backward on one side and creates a rib hump, the most visible sign of scoliosis.
If you notice one side of the back sitting noticeably higher during that bend, or the asymmetry comes with back pain, raise it at your child’s next pediatrician visit and ask whether a referral to a spine specialist makes sense. None of these signs confirm scoliosis on their own, but they’re patterns worth showing a doctor.
Signs Adults Often Dismiss
In adults, the curve usually started years earlier or developed gradually from wear and tear. You might notice a gradual postural shift, one shoulder blade that sticks out or a head that doesn’t center above the pelvis. What usually brings adults in is pain and movement trouble, not the curve itself. Normal spine degeneration through adulthood can also trigger back pain, height loss and changes in appearance.
Degenerative scoliosis, an adult-onset curve that develops from disc degeneration and arthritic changes, frequently brings leg pain, numbness or weakness from a pinched nerve. People often write these symptoms off as normal aging when they deserve a spine evaluation. A noticeable lean to one side, trouble standing or walking for long stretches and new leg pain or numbness are worth mentioning to your doctor.
How Scoliosis Is Diagnosed
A school screening is a first filter that flags kids who should see a doctor. The forward bend test, sometimes paired with a handheld device called a scoliometer that measures trunk rotation, is the usual screening tool. A scoliometer reading of five to seven degrees typically triggers a referral for imaging, the step that confirms a diagnosis.
The standard for an actual diagnosis is a standing X-ray, because lying down can hide the true size of a curve, and your doctor calculates the Cobb angle by measuring the angle between the top and bottom vertebrae of the curve.
A measurement under 10 degrees counts as a minor curve rather than scoliosis, while 10 to 20 degrees is mild, 20 to 40 degrees is moderate and above 40 degrees is severe. Cobb angle measurement carries a typical error of about five degrees, so a small change between visits may not mean the curve is progressing. At Premier Orthopaedics & Sports Medicine, our neck and back specialists offer in-office X-rays across Northern New Jersey.
Conservative Treatment: What Happens When a Curve Is Found
For most people, finding a curve leads to a plan based on monitoring and conservative care. Treatment depends heavily on the size of the curve and, in children, how much growing is left to do.
Monitoring Most Mild Curves
Monitoring is active care, not a wait-and-see brush-off. Observation sits alongside bracing and surgery as a treatment category, and during monitoring your doctor tracks the curve with periodic standing X-rays and watches for change.
In growing children, monitoring frequency depends on remaining growth, because curves progress fastest during rapid growth. Kids who are still growing often get X-rays roughly every six months. In adults, growth is no longer a variable, so monitoring follows symptoms and curve stability, and your doctor uses a more individualized plan guided by symptoms.
Bracing for Growing Kids
Bracing comes into the conversation when a curve reaches 25 to 40 degrees in a child who still has more growing left. The goal is to keep the curve from getting worse during growth. A brace won’t straighten the spine that’s already curved, and it can’t always stop a curve from increasing.
Worn the recommended number of hours, a brace lowers the chance a curve reaches the point where surgery is on the table, and longer daily wear tends to help more. Kids generally wear braces 12 to 20 hours a day, and families can usually arrange the schedule around school and sports.
Physical Therapy and Exercise
Physical therapy supports core strength and helps manage symptoms in both kids and adults. Scoliosis-specific approaches like the Schroth method use curve-specific exercises and breathing work to improve posture and stability, and these exercises can be a first step for mild adolescent curves.
Supervised scoliosis-specific exercise outperforms doing nothing. Schroth exercise produced a 70 percent relative reduction in the risk of curves deteriorating beyond a meaningful threshold. The average Cobb angle change was around 3.2 degrees, below the five-degree clinically meaningful threshold. Supervision matters, because unsupervised home exercise has produced results similar to no treatment.
When Surgery Enters the Picture
Surgery comes up under specific circumstances. The decision depends on age, growth remaining, curve size, symptoms and how the curve responds to conservative care.
Surgery for Adolescents
For adolescents, surgeons usually discuss surgery when a thoracic curve, meaning a curve in the upper or mid-back, passes about 45 to 50 degrees in a still-growing child or keeps progressing despite bracing. Curves in that range and higher often become surgical candidates. The standard procedure is posterior spinal fusion, where rods and screws correct and stabilize the curve.
Vertebral Body Tethering (VBT)
Vertebral Body Tethering (VBT) is a motion-preserving alternative for the right candidates. VBT uses a flexible cord anchored to screws along the spine to gradually correct the curve as the child grows. Surgeons consider VBT for skeletally immature patients, meaning children who still have more growing left, with curves 30 to 65 degrees that haven’t responded to bracing.
It preserves more spinal motion than fusion and can reach comparable curve correction, but the tradeoff is a higher chance of repeat surgery, with about one in seven patients needing an unplanned reoperation and tether breakage remaining a recognized risk.
Surgery for Adults
For adults, symptoms and function drive the surgery decision more than curve degree alone. Surgeons usually treat it as a last resort for disabling pain, nerve compression causing leg symptoms or progressive imbalance when conservative care hasn’t helped, and spinal fusion is the standard adult procedure.
If your doctor has brought up surgery, Dr. Reidler offers VBT for pediatric candidates and fusion approaches for adults. His options run from motion-preserving techniques in growing children through reconstruction for adult deformity.
Living With Scoliosis: What Parents and Patients Should Know Long Term
Most people with scoliosis live without restrictions. Mild and moderate curves rarely limit activity or sports participation, and people with them generally keep good function into adulthood. Sports activity may protect against progression in adolescents with milder curves.
It helps to keep up with the recheck schedule your doctor sets and to stay aware of core strength and posture, without letting any of it take over your life. For parents, the adolescent curve conversation usually focuses on monitoring and normal activity. Scoliosis can also weigh on a teenager emotionally, and roughly a third of adolescents with scoliosis report reduced quality of life in psychological or physical well-being, so checking in with how your child feels about it matters too.
Awareness Means Getting Checked
Scoliosis Awareness Month is a reminder that early evaluation catches the rare curve that needs treatment before options narrow. Most curves turn out to be mild, stable and manageable without surgery.
Premier takes a conservative-first approach, which means many scoliosis patients hear that monitoring or conservative care is the right plan. Our adult and pediatric spine specialists build monitoring and conservative care around your specific curve and symptoms rather than a one-size-fits-all protocol.
If a school screening flagged your child, or you’ve been putting off a shoulder or posture change you keep noticing, Premier’s spine team in Northern New Jersey can give you a clear answer. Call 201-833-9500 or schedule a consultation online.
Frequently Asked Questions About Scoliosis Awareness Month
When is Scoliosis Awareness Month?
National Scoliosis Awareness Month takes place every June. The observance promotes public education and early detection, and it continues through Scoliosis Awareness Month activities each June. Each year, organizers ask U.S. governors to officially proclaim the month.
At what age should scoliosis screening start?
Screening is recommended for girls at ages 10 and 12 and for boys once at age 13 or 14. Girls are screened earlier and more often because they reach adolescence sooner and develop treatable curves more often than boys. Most pediatricians check the back during annual well visits, so if your child hasn’t had a recent back check, ask at the next appointment.
Can scoliosis develop in adults?
Yes, in two ways. One is a childhood curve that was mild and went undetected until symptoms increased with age. The other is a new degenerative curve that develops after skeletal maturity from disc degeneration and arthritis. Care for adults may include pain management treatments when pain or nerve symptoms limit standing or walking, which is why some adults with smaller curves still benefit from evaluation.
Does mild scoliosis always get worse?
Most people with mild scoliosis at skeletal maturity can expect to lead a normal life, and smaller curves often remain stable. Larger curves are different, especially when a child still has growth remaining. The size of the curve and how much growing is left are the biggest predictors of whether it will worsen.
This article is for general information only and isn’t a substitute for professional medical advice. Talk to your doctor about your specific situation before making treatment decisions.