Scoliosis: What Causes a Sideways Curve in Your Spine and How Is It Found?
Scoliosis is a sideways curve of the spine. It can affect your posture, comfort and movement. In most adults, the cause is unknown. The curve changes under gravity, so it is best checked while you are standing and bearing weight, not lying down. A standing whole-body image can show the full picture in a single scan.
Key points
- Scoliosis means the spine curves to one side instead of running straight.
- Most cases in adults have no single cause that can be found.
- The curve often looks different when you stand up compared to when you lie down.
- Pain often appears away from the curve itself, because other areas compensate.
- A standing whole-body scan shows the spine under real weight-bearing conditions.
What is scoliosis?
Scoliosis is a condition where the spine curves sideways when seen from behind. A healthy spine has gentle front-to-back curves, but from behind it should look roughly straight. In scoliosis, part of the spine bends to the left or right. Sometimes it twists at the same time.
It can start in the teenage years and continue into adult life. Or it can appear later in life as joints and discs wear down. Some people live with a mild curve and never notice it. Others have stiffness, aching or visible changes in posture that get worse over time.
What are the symptoms of scoliosis in adults?
The most common symptoms are visible changes in posture and aching in the back, hip or shoulders. Many people also notice that one side of the body feels tighter than the other. Pain is not always where the curve is. Your body works as a connected chain from your feet to your head. So a curve in your mid-back can put strain on your lower back, hip or even your knee.
One shoulder sits higher than the other. You may notice it in a mirror or in photos.
Persistent tightness or a dull ache, often worse after standing or sitting for a long time.
One hip may look higher, or clothes may hang unevenly around the waist.
Your body may lean slightly when you stand, even though it feels straight to you.
Important: If you develop sudden numbness, weakness in your legs, or any loss of bladder or bowel control, this could be a sign of a more serious problem. Please get urgent medical help from your doctor, or go to your nearest emergency department.
What causes scoliosis?
In most cases, there is no single known cause. This type is called idiopathic scoliosis, and it makes up the majority of diagnoses. Other forms can develop because of degenerative changes in the spine as you age, past injuries, or underlying conditions that affect the bones or muscles.
The most common type. No cause can be found. It often begins during growth and continues into adult life.
Develops later in life as the joints and discs of the spine wear down. It is sometimes called adult-onset scoliosis.
Linked to conditions that affect the nerves or muscles, such as cerebral palsy or muscular dystrophy.
How is scoliosis diagnosed?
Scoliosis is usually diagnosed with a physical examination, followed by imaging. A clinician will look at your posture from behind. They may ask you to bend forward to check whether your ribs or back stick out on one side. Imaging then confirms the curve and helps measure how big it is.
Standard X-rays are the traditional method. However, most conventional X-rays are taken lying down, or show only one section of the spine. This can be misleading, because the curve changes when gravity is taken away. A lying-down scan may make a curve look milder than it really is when you stand.
Why should scoliosis be checked while standing?
A scoliosis curve is affected by gravity, muscle tone and posture. When you lie down for a conventional scan, your muscles relax and the curve may partly straighten. This means the image does not show how your spine really sits in daily life, when you are standing, walking or carrying weight.
A standing whole-body scan captures the full spine and legs in a single upright scan. It shows how the curve behaves in real conditions. Just as importantly, it shows how the rest of your body compensates. For example, a curve in the upper back (thoracic curve) may cause your pelvis to tilt. This in turn shifts the load through your hips and knees. Seeing all of this in one image gives your clinician a much clearer picture.
EOS is a low-dose standing X-ray system that captures your full skeleton from head to feet in one pass. It uses about 90% less radiation than a standard X-ray, around ten times less. This makes it well suited to monitoring scoliosis over time, when repeated imaging may be needed.
Would you like to see how your scoliosis looks when you are standing and bearing weight? A whole-body EOS scan at 19 Harley Street, London shows your full alignment in a single image.
Book a free video consultationWhat helps manage scoliosis in adults?
Management depends on how severe the curve is, your symptoms, and how the curve is affecting the rest of your body. Common approaches include physiotherapy, targeted exercise programmes, pain management and, in some cases, a surgical consultation. The right plan starts with accurate diagnostic imaging that shows your full alignment, not just the curve on its own.
ScanAlign is a diagnostic imaging clinic. We do not provide treatment. What we do is give you and your treating clinician a detailed, weight-bearing picture of your whole skeleton. That way, any decisions about management are based on what your body really looks like when upright.
Before you start treatment, or change the one you 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.
When MRI is the better choice: EOS shows bones, joints and alignment clearly. If your clinician suspects disc problems, nerve compression or soft-tissue problems, MRI is usually the better tool for those specific questions. The two types of imaging often work well together.
Frequently asked questions about scoliosis
Yes. Some curves stay stable for decades, but others get worse slowly, especially degenerative scoliosis. Regular monitoring with standing imaging helps track any changes over time.
Not always. Many people with mild curves have no pain at all. When pain does occur, it often appears in the lower back, hip or shoulders. Sometimes it is away from where the curve is, because other areas compensate for the imbalance.
When you lie down, gravity is taken away and your muscles relax. This can make the curve look milder than it really is. A standing scan captures your spine under real weight-bearing conditions. This gives a more accurate picture of your daily posture and alignment.
EOS is a low-dose X-ray system that images your full skeleton while you stand. It captures everything from your head to your feet in a single pass. It uses about 90% less radiation than a standard X-ray, around ten times less. Learn more on the ScanAlign homepage.
No. ScanAlign is a private, self-pay clinic. You can book directly, without a referral from your doctor or a consultant. We start with a free video consultation to make sure the scan is right for you.
The price for patients travelling from abroad is confirmed during the free video consultation. You can also see the ScanAlign FAQs page.
It can contribute. A curve in the spine may tilt the pelvis, which shifts the load through the hips and knees unevenly. Over time, this compensation can lead to discomfort in areas well away from the spine. Whole-body imaging helps find these linked problems.
Yes. EOS uses about 90% less radiation than a standard X-ray, around ten times less. You can find more details on safety and preparation on the FAQs page.
Targeted exercise and physiotherapy can help manage symptoms, improve strength and reduce discomfort. They do not typically reverse a structural curve, but they can make a meaningful difference to how you feel. Accurate imaging helps a physiotherapist design the right programme for your body.
You speak with a specialist diagnostic radiographer, who will ask about your symptoms and history. They will explain what the scan involves and confirm whether it is the right next step for you. There is no pressure to book.
See how your scoliosis looks when you are standing
A whole-body EOS scan in London captures your full alignment under real weight-bearing conditions. Start from home with a free, no-pressure video consultation.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. "Scoliosis." nhs.uk. Available at: https://www.nhs.uk/conditions/scoliosis/
- Scoliosis Research Society. "Scoliosis in Adults." srs.org. Available at: https://www.srs.org/patients-and-families/conditions-and-treatments/adults/scoliosis
- Illés, T. et al. "The EOS imaging system and its uses in daily orthopaedic practice." International Orthopaedics, 2012; 36(7): 1405–1411.
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.