A mild scoliosis curve can go unnoticed to the untrained eye. However, if the curve progresses, various signs and symptoms can become obvious.

See Types of Scoliosis

Common Early Signs of Scoliosis

Oftentimes scoliosis is first suspected when someone notices something slightly off and comments. Some examples could include:

  • Clothes fit awkwardly or hang unevenly. A parent, friend, or even the person with scoliosis might notice that a shirt or blouse appears uneven, which could be cause for further investigation.
  • Sideways curvature observed while in bathing suit or changing. For instance, a parent could first notice the sideways curvature in an adolescent’s back while at the pool or beach.

Even if a newly discovered asymmetry appears minor, it should be checked by a doctor because scoliosis is easier to treat when caught early.

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Symptoms of Moderate or Severe Scoliosis

Only about 10% of people with idiopathic scoliosis have a curve that progresses beyond mild and needs treatment. 1 Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2. If that progression happens, the deformity becomes more obvious to other people and more likely to cause noticeable symptoms.

See Spinal Fusion for Idiopathic Scoliosis

Some of the more common symptoms present in moderate or severe scoliosis could include:

  • Changes with walking. When the spine abnormally twists and bends sideways enough, it can cause the hips to be out of alignment, which changes a person’s gait or how they walk. The extra compensating that a person does to maintain balance for the uneven hips and legs can cause the muscles to tire sooner. A person might also notice that one hand brushes against a hip while walking but the other does not.
  • Reduced range of motion. The deformity from spinal twisting can increase rigidity, which reduces the spine’s flexibility for bending.
  • Trouble breathing. If the spine rotates enough, the rib cage can twist and tighten the space available for the lungs. Bone might push against the lungs and make breathing more difficult.
  • Cardiovascular problems. Similarly, if the rib cage twists enough, reduced spacing for the heart can hamper its ability to pump blood.
  • Pain. If curvature becomes severe enough, back muscles could become more prone to painful spasms. Local inflammation may develop around the strained muscles, which can also lead to pain. It is possible for the intervertebral discs and facet joints to start to degenerate due to higher loads.

    Watch: Causes of Back Muscle Spasms Video

  • Lower self-esteem. This symptom is commonly overlooked or minimized by outside observers, but it can be a significant factor for people who have a noticeable spinal deformity. Especially for adolescents who want to fit in with their friends, it can be stressful and depressing to look different, have clothes fit unevenly, or wear a noticeable back brace that may be uncomfortable or limit activity.

    See Types of Scoliosis Braces

It is possible but highly unlikely for scoliosis to ever progress to the point of causing death. Typically, a person would have access to a surgical solution before that type of deformity could set in.

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Possible Back Pain Symptoms

There is some controversy regarding scoliosis as a cause of back pain. Scoliosis by itself is typically not thought to cause pain. 2 Adolescent Idiopathic Scoliosis. Scoliosis Research Society website. http://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/adolescent-idiopathic-scoliosis. Accessed November 16, 2016. If a child or adolescent with scoliosis presents with back pain, the clinician will look for some other underlying cause to explain the pain.

See Common Causes of Back Pain and Neck Pain

That being said, many people who have idiopathic scoliosis report pain they feel is caused by the curve itself. There is conflicting research on that point, but the current trends in literature seem to point to more back pain reported in scoliosis patients compared to the general population. 3 Balagué F, Pellisé F. Adolescent idiopathic scoliosis and back pain. Scoliosis Spinal Disord. 2016;11(1):27. , 4 Sato T, Hirano T, Ito T, et al. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. Eur Spin J. 2011; 20(2): 274–279.

  • 1 Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2.
  • 2 Adolescent Idiopathic Scoliosis. Scoliosis Research Society website. http://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/adolescent-idiopathic-scoliosis. Accessed November 16, 2016.
  • 3 Balagué F, Pellisé F. Adolescent idiopathic scoliosis and back pain. Scoliosis Spinal Disord. 2016;11(1):27.
  • 4 Sato T, Hirano T, Ito T, et al. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. Eur Spin J. 2011; 20(2): 274–279.

Dr. Ali Baaj is the Chief of Spine Surgery at Banner Health and the Associate Professor of Neurological & Orthopedic Surgery at the University of Arizona. He specializes in complex and minimally invasive spine surgery for adults and children.

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