Scoliosis is a condition which causes abnormal curvature of the spine. If you’re concerned that you might have scoliosis or you’re worried that your child might have scoliosis, an X-ray or MRI scan can help to diagnose the condition. It can also monitor whether the condition is getting worse. Our guide will talk you through the signs and symptoms of scoliosis and how X-rays and MRIs can help people with the condition.

What is scoliosis?

Scoliosis is the name given to an abnormal curvature of the spine. The spine twists and curves to one side and can affect a person at any stage of life. However, it usually starts in adolescence, at around the ages of 10 to 15. Girls are much more likely to develop scoliosis at this age than boys.

In around 80% of scoliosis cases, experts don’t know what causes it (idiopathic scoliosis). However, we know it’s more likely if another family member has it, suggesting that genes can play a part. Other causes of scoliosis include:

The spine not forming correctly in the womb (congenital scoliosis).
An underlying condition that affects the nerves or muscles, such as cerebral palsy or muscular dystrophy (neuromuscular scoliosis).
Age-related wear and tear (degenerative scoliosis or adult onset scoliosis).

Unfortunately, in most cases, there is no way to prevent scoliosis. Bad posture or wearing a heavy backpack does not cause the condition. However, there are plenty of treatments available. In fact, many people with scoliosis do not need any treatment and can live full and active lives while having the condition.

How many people in the UK have scoliosis?

Scoliosis generally affects fewer than 3 in 100 people in the UK. However, it does increase with age. Some studies have found that 40% of adults over 60 have scoliosis, while two-thirds of adults over 70 are thought to be affected.

Can you get scoliosis as an adult?

Yes, scoliosis can develop in adulthood. Some people have scoliosis in childhood and notice the condition worsening in adulthood. That’s why Scan.com offers spinal X-rays for children.

Scoliosis in adults over 50

Adults can develop scoliosis after the age of 50 because the spine has gradually deteriorated, sometimes due to arthritis. The discs and joints in the spine wear out, causing the vertebrae to slip out of place and the spine to curve.

Scoliosis in adults over 70

There is a much higher risk of scoliosis at this age, mainly due to degenerative conditions linked to old age, such as arthritis and osteoporosis.

How to tell if you have scoliosis

There is a quick test called the Adams Forward Bend that can help check for scoliosis. A curve in the spine is sometimes visible when bending forward from the waist with legs and arms straight. There may also be a clear bulge from the ribs. Other signs and symptoms of scoliosis may include:

back pain
uneven shoulders, hips, or waist
a visible curve in the spine
fatigue from muscle strain
breathing problems from pressure on the lungs
radiating leg pain
poor posture and mobility issues

How severe symptoms are can depend on the degree of the curve in the spine and the age when scoliosis develops. The curve is more likely to worsen in children and teens as they grow. In adults, the main issue is back pain and mobility problems.

How does a doctor diagnose scoliosis?

If you think you or a family member has scoliosis, it’s best to talk to a specialist who can discuss the best scoliosis diagnosis. A specialist will suggest an X-ray or MRI scan to examine the spine in greater detail. If you think you need a scan but are unsure where to start, our telephone consultations with expert clinicians can help you decide your next steps, and there’s no obligation to book a scan.

Scoliosis X-ray

A scoliosis X-ray helps confirm the condition or check whether it has worsened.

During the X-ray, you’ll stand or lie down while the technician takes images of your spine from the front and side. The X-ray machine will send radiation beams through your body that capture clear images of your bones and spine.

A clinician can measure the ‘Cobb angle’ from the X-ray images. The larger the angle, the more severe the scoliosis curve.

X-rays also allow your clinician to see if the spine is rotated or off-centre and if it is curving to one side. This can help them decide which treatment is best.

For children, the X-ray is essentially the same. However, paediatric X-rays involve a smaller amount of radiation to minimise your child’s exposure. Depending on your child’s age, they may need extra positioning support to help them stay still (and stop wriggling!) during the X-ray.

Scoliosis MRI scan:

An MRI scan for scoliosis is a way to take detailed pictures of the spine without radiation.

During the MRI scan, you’ll lie flat on a table that slides into a large, tunnel-like machine. The machine uses strong magnetic fields and radio waves to create clear images of the spine.

An MRI for scoliosis can be beneficial to see if there are any problems or abnormalities in the spinal cord or surrounding areas, as well as the scoliosis curve itself. This is important because sometimes scoliosis can be caused by tethered spinal cords, cysts, or other issues.

For children and teens with scoliosis who may need surgery, experts recommend having an MRI scan first. An MRI scan for scoliosis can pick up any underlying spinal cord or nerve problems that may affect surgery.

What does scoliosis look like on an X-ray?

On an X-ray image, scoliosis appears as an abnormal sideways curvature of the spine. Knowing how to read scoliosis images can help you understand what your clinician will explain after the scan.

Instead of the spine being straight when viewed from the back, there will be an S or C-shaped curve to the side. It may be less noticeable in mild scoliosis X-rays and more noticeable in severe scoliosis X-rays.

The scoliosis X-ray can also show if the condition is causing the spine to twist or rotate in addition to curving to the side. This rotation is commonly seen in severe scoliosis; the spine may look more like a ribbon.

A severe scoliosis X-ray may show a raised or protruding rib cage, and the vertebrae in the curved area of the spine may look abnormally wedge-shaped from the pressure and rotation of the spine in scoliosis pictures.

How is scoliosis treated?

The right treatment for scoliosis depends on your age, the severity of the spinal curve, and how likely the condition is to get worse. Most people with scoliosis don't need treatment, but some with more severe curves or pain may need surgery.

Infants and toddlers: Many young children have mild scoliosis curves that have the potential to improve over time as they grow. However, a clinician may recommend a back brace or a cast to help the spine align and prevent curves from worsening as the spine develops and grows.
Older children and teenagers: Bracing is a standard treatment to stop the curve from worsening as their bones are still growing and developing at this age. A clinician may sometimes recommend surgery to control the growth of the curve until your child stops growing, and they can have an operation to straighten the spine.
Adults: The main goals are to manage symptoms and prevent further deterioration in the spine. Treatments like painkillers, spinal injections, and physical therapy can help relieve scoliosis-related back pain and discomfort, while back braces can help support the spine. Your clinician may recommend surgery if your curve or back pain is severe or if the condition is affecting the nerves in your spine.

What degree of scoliosis needs surgery?

A clinician will recommend surgery for scoliosis if the degree of curvature is above 40 degrees or if the curve is likely to progress. Around 1 in 4 people with scoliosis will need surgery.

A scoliosis operation aims to correct and stabilise the spine to stop the curvature and prevent further degeneration. It’s considered major surgery and involves inserting screws on both sides of the spine. A surgeon will then insert two metal rods to hold the corrected spine in place. The surgeon will add bone graft material from the patient or a donor to help fuse the vertebrae in the corrected position. The surgeon may use further stabilisation tools like plates, wires, or hooks to keep everything in place.

Scoliosis surgery requires plenty of recovery time and careful monitoring, though you should be able to get out of bed on the first day after surgery and leave the hospital in around four days. Normal life at school or work can resume within four to six weeks. There will, however, be a large scar on the back, which may feel tender or numb at first. The scar will fade gradually.

While there is no definitive best age for scoliosis surgery, studies suggest that surgical intervention may be considered in children under ten years old, particularly in cases of congenital scoliosis.

Natural treatments for scoliosis

Exercises called physiotherapy scoliosis-specific exercises, or PSSE for short, can help. These exercises can help straighten the spine and ensure it stays stable and strong. PSSE focuses on doing particular movements and adjusting how you stand or sit to help correct the curve in the spine. Doing these exercises regularly may make the curve less severe and reduce any pain it might cause.

These exercises aren't just for children. They can also help adults with scoliosis, especially if their curve worsens over time. Some studies have shown that doing these exercises regularly can stop the curve from getting worse as quickly.

There isn’t enough evidence to support visiting a chiropractor, receiving physical therapy, or doing yoga as a treatment for scoliosis.

Does scoliosis get worse with age?

It can, yes. As people with scoliosis get older, the curve in their spine can get worse over time. Studies show that scoliosis may continue progressing, especially in cases where it starts at a young age. Even after surgery to straighten the spine, the curving can continue to worsen.

Untreated scoliosis can lead to problems like decreased lung function, mobility issues, and poor posture. Surgery can reduce and prevent the abnormal spine curve from worsening, so early treatment is important.

How to get a scoliosis X-ray or MRI scan

You can book a private scoliosis X-ray or MRI scan near you today with Scan.com. We can help you fast-track your diagnosis with no GP referrals required and expert clinical consultations within days. Choose from over 150 centres nationwide with flexible appointment times and get fast online results, including a digital imaging report. It’s easier than ever to skip the waiting lists and get your health back on track.

Sources:

Adult-Onset Scoliosis: Causes, Symptoms, and Treatments. (N.D.). https://www.hudsonvalleyscoliosis.com/adult-scoliosis/adult-onset/

Information about surgery for scoliosis (Over 16 years of age).(N.D.). https://www.cuh.nhs.uk/patient-information/information-about-surgery-for-scoliosis/

Lavelle et al. (2020). Clinical Outcomes of Idiopathic Scoliosis Surgery: Is There a Difference Between Young Adult Patients and Adolescent Patients? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292702/

Scoliosis radiography. (2023). https://radiopaedia.org/articles/scoliosis-radiography?lang=gb

Scoliosis. (2023). https://www.nhs.uk/conditions/scoliosis/

Scoliosis. Treatment in adults. (2023). https://www.nhs.uk/conditions/scoliosis/treatment-in-adults/

Scoliosis. Treatment in children. (2023) https://www.nhs.uk/conditions/scoliosis/treatment-in-children/

Scoliosis: Know the facts. (2024). https://ssr.org.uk/wp-content/uploads/2024/03/Know_The_Facts_SSR_2024_FINAL.pdf

The Scoliosis X-Ray: What You Need to Know. (N.D.). https://clear-institute.org/blog/scoliosis-x-rays/