What is Scoliosis?


Dr. Clayton J. Stitzel


October 28, 2021

Idiopathic scoliosis, which makes up over 80% of all cases, has no known cause. Yet, that doesn’t mean we don’t know much about the condition or its treatment. Below is an up-to-date summary of facts to answer the question of “what scoliosis is?”

Idiopathic scoliosis appears to be mostly a “neuro-hormonal condition” driven by genetic predisposition. The 3-D change in the spine’s alignment — the spine curvature — is the primary and most obvious symptom of the condition. That is why scoliosis is a whole-body condition that requires comprehensive treatment options. This is one of the great obstacles that has challenged health care professionals worldwide for centuries.

“The spine curve seen with scoliosis is only the most visible symptom. There is so much more to treating the condition.”

– Clayton J. Stitzel DC

Table of Contents

How Common Is Scoliosis?

The condition occurs most often in children aged 9 to 14, affecting females 7 times more than males. Scoliosis is a broad term that may describe a spinal curve of 10 degrees or higher. The curve occurs at different points of the spine in each case, but develops in 1 of 4 common curve patterns. It may or may not tilt the pelvis. Scoliosis causes a bent spine, curvy spine, or even an S-shaped spine. It may only have a curve on one side, elevates one shoulder, or make one shoulder blade prominent. But it is not life-threatening after the age of 5, prompting many doctors to conclude it does not need treatment. 

The condition is often progressive; but, ScoliSMART doctors know more about and how to treat scoliosis now than ever before. Get free scoliosis treatment recommendations sent to your email.

What Is the Main Cause of Scoliosis?

Is scoliosis hereditary? Is scoliosis genetic? Curvature of the spine (scoliosis meaning “crookedness” and deformity) has been documented in medical records dating back to 450 BC. Historically, it has been considered and treated only like a spinal problem. But a growing and overwhelming volume of evidence supports curves of the spine are so much more than a curved spine. 

Adolescent idiopathic scoliosis stems from a family history of genetic variant patterns. These affect neurotransmitters and hormones. These combine to create an incorrect “posture memory” of spine alignment during periods of rapid growth. These risk factors can not be helps by bracing. These DNA findings are the suspected causes of scoliosis and result in a twisted spine. Non-invasive, home-collected saliva and urine samples can help determine if a diagnosis of scoliosis is likely or if the genetic risk factors that cause severe cases during puberty.

What Scoliosis Looks Like

Most patients lose some degree of curvature in their necks, resulting in forward head position. The sideways curve of a scoliosis spine that is greater than 10 degrees. It causes the rib cage to twist and the normal curves of the spine to flatten. A scoliosis curve looks flat where the spine is curved when viewed from the front or side on x-ray, but the vertebrae appear twisted when viewed from the top down on MRI. 

Understanding the faulty “postural memory” of the spine on an x-ray is like watching the wind outside a window. You cannot actually see the wind, yet you can tell the direction and force in which it is blowing by the way it affects the grass, trees, and leaves.

What type of scoliosis do you have?

1 Idiopathic scoliosis

The most common type of scoliosis. Idiopathic means of unknown origin. Depending on the age of onset, it may be infantile (birth to 3 years), juvenile (age 3 to 8), adolescence (age 9 to 18), or adult scoliosis (after age 18)

2 Congenital scoliosis

These are rare cases of scoliosis, affecting the vertebrae of 1 in 10,000 babies in utero 

3 Neuromuscular or Syndromic Scoliosis

Developed by children who have neuromuscular disorders like muscular dystrophy or cerebral palsy and may involve the brain or spinal cord

4 Degenerative Scoliosis

Adult scoliosis; a degenerative condition (often accompanied with arthritis and back pain in older adults) that typically occurs after age 40

What Are the Early Signs of Scoliosis?

Catching scoliosis early is critical because once a curve measures 25 degrees or more, there is a 68 percent chance scoliosis may get worse. You may detect scoliosis in its early stages by observing five different points on your child’s body.

  • Eye line Are your child’s eyes level or is the eye line tilted?
  • Shoulder level Do your child’s shoulders hang even or is one higher than the other?
  • Hips Are your child’s hips even or is one hip higher or more pronounced?
  • Forward head position When you look from the side, does your child’s mid-ear line up with the tip of the shoulder?
  • Head to hip line Would a line from the center of your child’s eyes line up horizontal to the center of the hips?

You may also use a detection method called Adam’s forward bend test. Have your child do a full forward bend to see if the rib cage (shoulder blade) sticks out on one side, especially on the right side. If your child appears out of line using any of these views, he or she may have a spinal curvature. A trained expert physical therapy will help you determine if your child needs early-stage scoliosis intervention. Make sure any evaluation for scoliosis includes a standing full spine x-ray or standing MRI.


To learn more about how to treat the whole scoliosis condition and not only the curve, connect with our passionate providers at ScoliSMART. To explore a non-brace/ non-surgical treatment for your child’s scoliosis problem, you may schedule a no-cost Zoom or phone consultation with a ScoliSMART doctor. Please get in touch with us today!

Scoliosis often is associated with family history. Although progressive scoliosis of the spine affects girls more often, your boys will be just as likely to develop it. Remind your pediatrician to check your children for a spine curve, especially if it runs in the family. Many parents are opting for genetic testing for scoliosis in children who are still growing. This very simple and safe saliva test may predict if patients are at higher risk for severe scoliosis, differentiate different types of scoliosis, determine their need for treatment, and even predict some of the symptoms of scoliosis.

What Will Happen If Scoliosis Is Not Treated Correctly?

Adolescent idiopathic scoliosis is a neurological-hormonal condition rooted in a genetic predisposition. This is vital when it comes to choosing scoliosis treatments. Usually, an orthopedic doctor who only measures a Cobb angle will recommend: 

  • No treatment or Only observation. 
  • They may recommend a rigid back brace for up to 23 hours a day for a curve measuring 25 to 40 degrees. Full time bracing is almost impossible for kids. Some find nighttime bracing to be more tolerable. 
  • Surgical treatment to fuse the vertebra and reduce spinal deformity may be recommended for people with curves measuring over 50 degree Cobb angle. Unfortunately, injections and spinal fusion with metal rods often for severe curves leads to complications that include back pain, numbness along the incision following the backbone.


All three options may be limiting and frustrating to you and your child. These are not the only options, nor the best. The ScoliSMART Clinic doctors prefer to improve the patient’s posture memory in a way that reduces the curve. We don’t wait for a curve to get worse, use a rigid brace, or recommend spinal fusion surgery unless it is a last resort.

Don't Wait & Watch Mild Scoliosis

ScoliSMART Clinics doctors never recommend waiting and watching. This is because all large curves begin as small curves. Scoliosis is a chronic, progressive condition. It often progresses throughout childhood and into adulthood. We recommend starting a posture memory retraining approach like Small Curve Camp for scoliosis as soon as your child’s curve is detected. 

A one-week “Small Curve Camp” program, followed by a home exercise program. Thousands of children have had their scoliosis curve reduced and progression stopped with this approach.

Scoliosis Child X-Ray
Online consultation scheduling is available!

Now it’s even easier to connect with ScoliSMART. Schedule your no-cost, no-obligation phone or Zoom consultation online with a ScoliSMART physician right here!

Do orthopedic specialists support the ScoliSMART Approach? 

Yes! Many orthopedic surgeons support scoliosis exercise treatments. Our hope is to help families catch scoliosis early so children can start scoliosis-specific exercises that halt progression, improve spinal deformity, and reduce curvature. Early Stage Scoliosis Intervention is ideal; but, every child (and adult) with scoliosis deserves a better way to treat scoliosis regardless of their age or curve size!

Don’t know where to start?  Take our FREE “ScoliQuiz.”  (No x-ray required)

ScoliSMART Clinics is committed to treating the WHOLE scoliosis condition, not only the curve. Genetic & clinical testing with targeted nutrient therapies, expert in-office treatment programs, and the world’s only ScoliSMART Activity Suit provides patients of all ages with the most comprehensive, most effective, and least invasive treatment options available worldwide.