You notice it at the pool, or when a school shirt keeps sitting crooked. One shoulder looks higher than the other, or one shoulder blade sticks out more. For a lot of parents, that is the first hint of scoliosis, and the first reaction is worry.
Here is the calm version. Scoliosis in teenagers is reasonably common, most curves are small and painless, and the first step is a simple look rather than an urgent scan. Knowing what to look for, and what happens next, takes most of the fear out of it.
In this article
What is adolescent scoliosis?
Scoliosis is a sideways curve of the spine. In adolescents, the most common form has no identifiable cause, which is why it is called adolescent idiopathic scoliosis. It is formally defined as a curve measuring at least 10 degrees on imaging.
It usually appears during the growth spurt years, roughly between 10 and 15, which is exactly when parents stop supervising showers and start noticing posture across a room instead.
How common is it?
Common enough that most schools will have several students with a curve, and most of those curves will never need anything beyond monitoring.
Most curves stay small
Girls are reported to be around 10 times more likely to progress to a curve of 30 degrees or more, which is why monitoring through the growth years matters.
That second figure is why monitoring through the growth years matters, particularly for girls, rather than checking once and forgetting about it.
What are the signs parents notice?
Scoliosis is usually painless in adolescents, so it is spotted visually rather than through complaints. Common things parents notice include:
- One shoulder sitting higher than the other
- One shoulder blade appearing more prominent
- The waist looking uneven, or one hip appearing higher
- Clothing that consistently hangs crooked
- The head not appearing centred over the pelvis
Worth noting that persistent back pain in an adolescent is not typical of idiopathic scoliosis and should be assessed on its own terms.
The forward bend check
The standard clinical screen is simple and takes under a minute. Your teenager stands with feet together, knees straight, and bends forward at the waist with arms hanging and palms together, as if diving. You look along the back, at eye level, from behind.
What you are looking for is asymmetry, one side of the rib cage or lower back sitting higher than the other. That asymmetry, not the curve itself, is what usually prompts a referral for further assessment.
This is a screen, not a diagnosis. Some health bodies do not recommend routine population-wide screening of adolescents who have no symptoms, so treat this as information for a concerned parent rather than something every child needs.
What happens if a curve is found?
The pathway is usually staged, and most of it is watching rather than doing. Depending on the size of the curve and how much growing is left, it may involve:
- A clinical assessment and, where appropriate, imaging to measure the curve
- Monitoring at intervals through the growth years, since many curves stay small
- Bracing, which international guidelines describe as the recommended approach for progressive curves above 25 degrees during growth
- Scoliosis-specific physiotherapy exercises, used as part of conservative care rather than as a substitute for medical management
- Specialist referral for larger or rapidly progressing curves
Our team offers physio Mount Gravatt families rely on for adolescent assessment, and we work alongside your GP and specialist where that is needed.
When should you seek help?
Consider getting assessed if
Book an assessment if you notice a shoulder, shoulder blade, waist or hip that looks consistently uneven, if the forward bend check shows one side sitting higher, or if a curve has already been mentioned and you want it monitored properly through the growth years. Persistent back pain, numbness, weakness or changes in bladder or bowel function in an adolescent should be assessed promptly.
The Quick Guide
A one-page summary you can save or print. Tap the image or the button to download the free PDF.
Helping You Perform at Your Best
Most teenagers with a small curve keep playing every sport they love and never need anything more than a periodic check.
At ACE Sports Medicine in Upper Mount Gravatt, our physiotherapists assess adolescent spines for families across Brisbane's southside, explain clearly what has been found, and set up sensible monitoring alongside your GP.