The human body isn’t perfect, painless or symmetrical. So it’s easy to miss signs of scoliosis, dismissing them as mild variations in how our shoulders or hips line up, or even writing them off as just a little back pain as we age.
But physicians know to look for these clear signs of scoliosis, which is most commonly diagnosed in kids starting at age 11, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Adults can have this condition too, which involves a C- or S-shaped spinal rotation.
Here’s what to watch for to determine if you should get medical attention for potential scoliosis.
Scoliosis Symptoms to Watch For
- Back pain. Though a twisted spine sounds painful, a 2024 study found that only 48% of adolescent patients reported back pain. So, back pain can be a symptom, but kids especially can have scoliosis without pain. People who do have pain sometimes describe it as dull or achy, while others with more severe scoliosis might call it sharper or more localized, one provider blog reports.
- Asymmetry. Typically, a caregiver notices one shoulder is higher than the other, a shoulder blade sticks out further or the waist crease is higher on one side than the other, according to Dr. Archie C. Perry, Jr., a board-certified orthopedic surgeon for the Spine Institute of Nevada affiliated with Desert Orthopedic Center in Las Vegas. “There’s also the opposite where a person has some physical asymmetry; they are thought to have scoliosis but when they actually get an X-ray, you don’t see much of a curve,” he says, noting this can lead to a false positive. In adults, they may not even be aware that they have a curvature until they get an X-ray because they are just presenting for evaluation of back pain like 70% of other Americans have at some point.
- Difficulty with the forward-bend test. In most kids’ physicals, the doctor will ask them to touch their toes. They aren’t watching only for flexibility, but for signs of scoliosis. “One of the classic screening maneuvers is the forward-bend test. When the person bends forward, rotation of the spine and ribs can make one side of the rib cage or back appear higher than the other,” says Dr. Paul R. Gause, a board-certified orthopedic surgeon and fellowship-trained spine surgeon at the Spine Institute of Arizona. “In children and teenagers, scoliosis is often discovered during a routine physical examination, school screening, sports physical or by a parent. Sometimes the child doesn’t notice anything at all.”
- Clothes don’t fit quite right. For adults, you can sometimes notice the asymmetry in how clothes fit or feel. “Adult scoliosis can also develop gradually. A person may initially notice that they’re standing differently or that one side of their clothing fits differently before they develop significant pain,” Gause says. The concern is the association with aging-related arthritic changes in the discs and joints of the spine. “Adults are therefore much more likely to have back pain, leg pain, numbness, weakness, spinal stenosis and difficulty standing or walking,” Gause says. For children, the concern is whether it will progress as they grow, while adults might worry about additional pain or loss of function, such as from nerve compression, he adds.
- No signs at all. It’s typical to not have any scoliosis signs or symptoms at all. “Many people with scoliosis have few or no symptoms, particularly adolescents with idiopathic scoliosis. A teenager can have a fairly significant curve without experiencing back pain. That’s one reason scoliosis can sometimes go unnoticed until a parent, physician or athletic trainer notices an asymmetry,” Gause says. “The important point is that scoliosis is not one single disease with one single treatment.”
Reporting by Alexandra Frost, USA TODAY. This article originally appeared on USA TODAY.
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