What Is Adolescent Idiopathic Scoliosis, and What Should Parents Do First?
Adolescent idiopathic scoliosis is a sideways curve of the spine. It appears during a teenager's growth spurt, usually between ages 10 and 18, and has no known single cause. Most curves are mild, but some progress quickly during growth. Finding it early, monitoring it properly and using low-dose imaging are the most important first steps a parent can take.
Key points
- Adolescent idiopathic scoliosis affects roughly 2 to 3 in every 100 teenagers, most commonly girls.
- The curve can worsen quickly during a growth spurt, so repeat imaging is often needed.
- Every repeat X-ray adds radiation. EOS imaging uses about 90% less radiation than a standard X-ray, around ten times less.
- A standing, weight-bearing image shows the true curve under gravity, not the relaxed position seen when lying down.
- Early referral to a specialist and careful monitoring give the best chance of catching progression before it becomes severe.
Finding out that your teenager has a curved spine is unsettling. You may have noticed something yourself. Or a school screening, your doctor or a physiotherapist may have pointed it out. Either way, the question most parents ask is: what do we do now?
This page explains what adolescent idiopathic scoliosis is and what to look for. It also explains why the type of imaging you choose matters, especially when your child may need scans more than once.
What are the signs of scoliosis in teenagers?
The earliest signs are usually visible, not painful. Most teenagers with adolescent idiopathic scoliosis do not feel pain when they are diagnosed. Instead, parents or teachers tend to notice that posture or body shape is uneven from one side to the other.
One shoulder sits higher or further forward than the other. This is often noticed in photos or in school uniform.
When bending forward, one side of the ribcage sticks out more. This is checked in the Adams forward bend test.
The gap between the arm and the body looks different on each side, or clothes hang unevenly.
The whole body seems to lean to one side, or the head does not sit centred over the pelvis.
If you notice uneven shoulders or any of these signs, it does not automatically mean the curve is severe. But it does mean imaging is worth doing, to set a baseline and guide the next steps.
Why does adolescent idiopathic scoliosis get worse during growth?
Growth is the main driver of a curve getting worse. The faster a teenager is growing, the higher the risk that the curve will worsen. This is why the condition is watched most closely during puberty, when growth spurts are at their peak.
Clinicians assess skeletal maturity to estimate how much growth is left. If a teenager still has a lot of growing to do and the curve is already moderate, more frequent monitoring, and possibly a brace, may be recommended.
"Idiopathic" simply means there is no single known cause. Research points to a mix of genetic, hormonal and biomechanical factors, but no single trigger has been found. It is not caused by heavy bags, poor posture or sport.
Why does radiation dose matter when monitoring scoliosis?
Radiation dose matters because adolescent idiopathic scoliosis often needs repeat imaging over months or years. This shows whether the curve is stable or getting worse. Each standard X-ray adds to the total radiation a young person receives, at a time of rapid cell growth.
This is why the choice of imaging technology is important for parents. EOS imaging uses about 90% less radiation than a standard X-ray, around ten times less. Over a monitoring plan of several scans, that difference adds up a great deal.
Worried about radiation? Read more on whether an EOS scan is safe for young patients.
The Scoliosis Research Society and the British Scoliosis Society both recognise how important it is to keep radiation exposure low during growth. Low-dose imaging is not a luxury. For a teenager who may need scans every six months, it is a practical safeguard.
How is scoliosis assessed standing up compared with lying down?
A standing image shows the spine as it really behaves under gravity and body weight. When your teenager lies down for a conventional scan, the muscles relax and the curve can flatten. The image may then underestimate the real situation.
Shows the true curve under gravity. The whole body, from the skull to the feet, is captured in one standing image. This shows how the spine, pelvis and legs work together as a connected chain, so compensatory shifts can be seen.
EOS captures this full picture with about 90% less radiation than a standard X-ray. That matters when repeat scans are planned.
May underestimate the curve. When lying flat, gravity is taken away and the muscles relax. The spine can look straighter than it really is. This can affect decisions about whether a brace or closer monitoring is needed.
Standard lying-down imaging also usually captures only the spine, not the pelvis and legs together, so compensation patterns may be missed.
At ScanAlign, low dose standing imaging, the scan is taken with your teenager standing in their natural posture. The result is a full-length, weight-bearing picture of alignment. It gives the treating specialist accurate information to work with.
When is MRI the better choice? EOS shows bones, joints and alignment clearly. If the specialist suspects a nerve problem, a disc issue or a concern with the spinal cord, MRI is usually the better tool because it shows soft tissue in detail. In many cases, both types of imaging are used together.
What should parents do first if they suspect scoliosis?
The most helpful thing you can do is get a clear baseline image and a specialist's opinion. Acting early does not mean rushing into treatment. It means having the information to make calm, well-informed decisions.
Ask your teenager to stand naturally, then bend forward at the waist with arms hanging down. Look for uneven shoulders, a rib hump, or a waist crease that is deeper on one side. This is the Adams forward bend test, and it takes seconds.
Your doctor can examine your child and refer you on. You can also book imaging directly yourself if you prefer not to wait.
A full-body standing scan sets a baseline. Because monitoring scoliosis means repeat imaging, choosing a low-dose option from the start reduces the total radiation across the whole plan. Read about paediatric imaging at ScanAlign.
Your report and images go to the treating clinician. They will use the findings to decide whether observation, a brace or further tests are right. ScanAlign does not provide treatment. It provides the imaging that informs treatment elsewhere.
Before your child starts treatment, or changes the treatment they are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.
Important: If your teenager develops sudden severe back pain, numbness or weakness in the legs, or any loss of bladder or bowel control, get urgent medical help from your doctor or the nearest emergency department. These symptoms need immediate assessment, not a routine scan.
Frequently asked questions about adolescent idiopathic scoliosis
It is most often diagnosed between the ages of 10 and 18, during or just before puberty. Curves can appear earlier, but the adolescent form develops specifically during this growth period.
Most teenagers do not have significant pain when they are diagnosed. The condition is usually noticed because the body looks uneven, not because of discomfort. If there is pain, the clinician may look into other possible causes alongside the scoliosis.
No. Research has not shown a link between carrying bags and developing idiopathic scoliosis. The word "idiopathic" means there is no single known cause. Genetics and growth patterns are thought to be the main factors.
This depends on the size of the curve and how much growth is left. Some teenagers are scanned every four to six months during peak growth. Others may need only a yearly check. Your specialist will set the schedule for your child's individual case.
Teenagers are more sensitive to radiation than adults, and monitoring scoliosis often means many scans over several years. EOS imaging uses about 90% less radiation than a standard X-ray, around ten times less. Over a full monitoring plan, the total difference is substantial.
No. You can book directly yourself. Many parents do this when they want a baseline image quickly, without waiting for a referral.
It is a simple screening check. Your teenager bends forward at the waist with their arms hanging down. You look from behind for a hump on one side of the ribcage or lower back. A visible hump suggests a rotational curve and is a reason for further imaging.
A brace is recommended for moderate curves in teenagers who are still growing. The treating specialist decides, based on the size of the curve, how much growth is left and other factors. Imaging provides the measurements that guide this decision, but ScanAlign does not prescribe braces or treatment.
The price for patients travelling from abroad is confirmed during your free video consultation, before you commit to anything.
Your teenager stands still inside the EOS scanner for around 15 to 20 seconds. It is open, not enclosed, and there is no need to undress fully. The process is quick and simple. You can book a paediatric scoliosis scan online or start with a free video consultation.
Worried about your teenager's spine?
Start with a free video consultation. We will help you decide whether a standing scan is the right next step, with no obligation.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. New England Journal of Medicine. 2013;369(16):1512-1521.
- Ilharreborde B, Ferrero E, Alison M, Mazda K. EOS microdose protocol for the radiological follow-up of adolescent idiopathic scoliosis. European Spine Journal. 2016;25(10):3234-3242.
- National Institute for Health and Care Excellence (NICE). Scoliosis overview. NICE Pathways. Available at: pathways.nice.org.uk
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.