Scoliosis: Risk of Progression

Rapid Curve Progression is the Biggest Fear of Scoliosis Sufferers

Patients that suffer from scoliosis may find it hard to understand the risk of curve progression at different stages. A good and simple way to understand what’s happening to the spine is by picturing a rubber band that’s twisted from top to bottom. If the rubber band is twisted too many times, it will start to coil down, twisting on top of itself.

Mild Scoliosis

Mild scoliosis has a risk of progression of up to 22%. It is important that even mild cases get addressed since the risk of progression more than triples to 68% once it passes the 22% mark. By treating the mild scoliosis early, you have a greater chance of stopping the progression and overcoming small curves that may cause cosmetic deformity.

Mild scoliosis symptoms

  • A curve is less than 20°
  • Tilted head, uneven shoulders or hips
  • Head may appear that it’s forward from the shoulders when viewed from the side. This is call the "Forward Head Posture"
  • Clothing/apparel may hang unevenly on the body
  • Uneven leg lengths

Mild scoliosis often goes unnoticed and may or may not be associated with pain. This type of scoliosis is often seen the most in adolescent, premenstrual girls, but can also be seen in boys or adults. It is important to note that bracing or surgery is not a recommended treatment for scoliosis.


Moderate scoliosis

Moderate scoliosis should be a cause for concern because it carries a 68% chance of progression. This is one of the reasons bracing is often recommended by medical doctors. Symptoms are more noticeable and patients tend to feel “clumsy” and suffer from poor body image, social anxiety, and depression. Moderate scoliosis can be easy to overcome when the curve is not severe. Successful treatment can provide an increased lung capacity and more room for organs, giving the patient more energy for physical activities.

Moderate scoliosis symptoms

  • A curve of 20-40°
  • Tilted head, uneven shoulders or hips
  • Clothing/apparel may hang unevenly on the body
  • One shoulder blade is often higher than the other which causes a "rib hump"
  • Easily winded during physical activities or fatigued afterwards
  • Pain in spine between the shoulder blades and at the base of the rib cage
  • Headaches

When bracing is recommended, it will often come in the form of a soft or rigid brace. The idea is to stop the curve progression, but recent scientific studies have called the effectiveness of this practice into questions. Braces have even been known to cause an increase in patients’ rib deformity, known as a “rib hump”. It is important to know that if a brace stops the progression it will still NOT reduce the deformity and the benefit will be lost once the brace is removed.

  • If your curve is 20° or above and you're younger than 12 years old, then your risk of curve progression is 100%.

Severe scoliosis

Severe scoliosis is the worst case and carries a 90-100% risk (depending on age) of progression. Many times the spine is seen to take on a "C" or "S" shape and it’s common for patients to struggle with poor body image, social anxiety, and depression, since their body is noticeably different. The pain associated with severe scoliosis is also far worse and patients often experience chronic pain and headaches, loss of balance, and digestive disorders. Postural imbalances are noticeable, which typically include a "rib hump" and off-centered belly button. Successful treatment can increase lung capacity and create room for the organs, giving the patient more energy for physical activities.

Severe scoliosis

  • Curves are above 40°
  • Spine may appear to have a "C" or "S" shape
  • Tilted head, uneven shoulders or hips
  • The torso will rotate, which pulls the belly button off center
  • Clothing/apparel may hang unevenly on the body
  • One shoulder blade is often higher than the other which aggravates a "rib hump"
  • Easily winded during physical activities
  • Fatigued after physical activity, including sitting or standing
  • Pain in spine between the shoulder blades and at the base of the rib cage
  • Headaches

Surgery is often recommended in severe scoliosis cases. There are several approaches to scoliosis surgery, but all use systems to apply hooks and screws to the spine to anchor long rods. The rods are used to hold the spine while bone that is added fuses with existing bone. 

At Precision Spine, we maintain a stand that scoliosis surgery is merely a cosmetic procedure when used to treat this complex condition. In other words, surgery might help you look like you have a straight spine, but often it does little to reduce the amount of pain you will have suffer from.

While we agree that surgical operation is necessary at times especially for significant spinal curvatures, we assert that hardware from spinal surgery can pose serious health risks, which can result to another form of operation. Spinal surgery can also have other risks like major neurological injury such as paralysis (citing Dr. Tod Sloan of the Anesthesiology Clinics of North America)

We feel that that scoliosis surgery should be considered the final resort for curing idiopathic scoliosis, and that it must only be made if all other non-invasive options have been explored.