What Really Causes Scoliosis?
Key Takeaways:
Scoliosis is a 3D curvature of the spine
There are 4 types of scoliosis- adolescent, congenital, and neuromuscular, and degenerative
Some scoliosis curves are more likely to cause pain than others
Ultimate treatment depends on the type, severity, age, and whether the curve is getting worse.
Many people with scoliosis live full, happy, lives- without ever needing surgery
Scoliosis is one of those conditions that sounds more mysterious than it should. You’ve probably heard it described as a “curvature of the spine,” but beyond that, most people—including patients who are diagnosed with it—don’t fully understand what causes it, what it means, and whether it needs to be treated.
At MyBackHub, we get this question often: “Why is my spine curved—and what caused it?”
Let’s break it down clearly, without the complex medical jargon, and give you the knowledge you need to feel in control.
What Is Scoliosis, Exactly?
Scoliosis is a three-dimensional curvature of the spine. That means the spine doesn’t just curve side-to-side—it also rotates. This is what gives scoliosis its signature appearance on X-rays, and in some cases, can be visible from the back as uneven shoulders, a tilted waist, or a prominent rib hump—some of the first things typically noticed by family members and primary providers.
It’s typically diagnosed when the curve measures more than 10 degrees on a spinal X-ray using something called the Cobb angle.
So What Causes Scoliosis?
This is where things get a little more complex—because it depends. There are different types of scoliosis, and each has different underlying causes.
1. Idiopathic Scoliosis (Most Common)
This type of scoliosis is by far the most common, especially in adolescents. The term “idiopathic” means “of unknown origin.”
It usually develops between ages 10 and 18
It’s more common in girls than boys
It tends to run in families, suggesting a genetic component, however has no known inheritance pattern
Importantly, it is not caused by poor posture, carrying a heavy backpack, or sports
While we don’t know exactly why idiopathic scoliosis occurs, research suggests a combination of genetic predisposition and how the spine and muscles grow during puberty. For some teens, the spine simply grows in an asymmetrical way, leading to the visible curve.
2. Congenital Scoliosis
This occurs when the bones of the spine (vertebrae) don’t form properly before birth.
It’s present at birth, though not always diagnosed immediately
Caused by spinal malformations during fetal development
Often linked with other organ system abnormalities (like the kidneys or heart which develop around the same time as the spine), so it usually requires care by multiple specialists
It is more likely to require surgery- many times at a young age
This type is caused by conditions that affect the nerves and muscles, such as:
Cerebral palsy
Muscular dystrophy
Spinal cord injury
Spina bifida
Because the muscles around the spine are severely imbalanced, the spine can be pulled into a curve over time. This type of scoliosis often progresses quickly and is more likely to need bracing or surgery to support function and posture.
4. Degenerative (Adult-Onset) Scoliosis
Scoliosis isn’t just a childhood issue. Adults can develop scoliosis due to age-related changes in the spine, such as:
Disc degeneration (think arthritis of the spine)
Facet joint arthritis
Osteoporosis
As these structures wear down unevenly, the spine can begin to curve. This type of scoliosis is also sometimes referred to as “De Novo Scoliosis” and often leads to pain, stiffness, and imbalance.
For a deeper understanding of how scoliosis affects older adults, you might find this article from the CLEAR Scoliosis Institute informative: Scoliosis in the Elderly.
Does Scoliosis Cause Back Pain?
Here’s where there’s a lot of misunderstanding.
In most adolescents, scoliosis does not cause back pain. Many kids with moderate curves feel totally fine. In fact, when teens report back pain, it’s often from muscular tightness or activity—not the curve itself.
In adults, scoliosis can cause pain, but the pain often comes from degenerative changes, not just the curve. It may show up as:
Muscle fatigue
Nerve compression
Hip or shoulder imbalance
Cramping and/or buttock/thigh pain
Many times, pain from degenerative scoliosis can be improved with strengthening and stretching of the back muscles to improve muscular balance and support of the spinal column. At MyBackHub, we help people with scoliosis—especially adults—manage these symptoms non-operatively with customized movement plans, posture work, and mobility training based on their specific curve type.
For more insights into managing adult scoliosis, the Mayo Clinic offers valuable information: Managing Scoliosis as an Adult.
How Is Scoliosis Treated?
Treatment depends on the type, severity, age, and whether the curve is getting worse.
Observation – For mild curves, especially in teens who are done growing.
Bracing – For moderate adolescent curves that are still progressing. Braces don’t straighten the spine, but they can stop it from worsening. The utility of bracing in other types of scoliosis (such as degenerative) is debated.
Physical/functional therapy – Can help improve posture, muscular balance, and pain control—especially in adults.
Surgery – Reserved for severe curves (typically >45–50 degrees) that are progressing, causing imbalance, or compressing nerves.
At MyBackHub, we specialize in the non-operative management of back pain—including scoliosis. Many adults with mild to moderate scoliosis, and even some with severe, can feel better, move better, and avoid surgery with a focused, virtual care program that improves spinal control and muscle strength.
For a comprehensive overview of adult scoliosis treatment options, consider this resource from the Hospital for Special Surgery: Scoliosis Treatment for Adults: Surgical & Nonsurgical.
When Should You Get It Checked by a doc?
If you or your child notice:
Uneven shoulders or waist
Ribs sticking out more on one side
A curve that looks like it’s increasing
Ongoing pain or nerve symptoms
…it’s time for a proper evaluation. A simple X-ray can confirm the diagnosis, and a spine expert can help you understand the next best steps.
Final Thought: You Have Options
A scoliosis diagnosis isn’t a death sentence—it’s just information. Most people with scoliosis live full, active lives. And many never need surgery.
With modern virtual tools, a supportive community, and expert guidance, you can take charge of your spine health, reduce symptoms, and move with confidence.
At MyBackHub, we believe in empowering you with the truth—and the tools—to feel better, faster. No scalpel necessary.
What are your thoughts about this article? Share them with the MyBackHub community on our community page here.
About the Author:
Rob Turk, MD, MBA
Chief Medical Advisor, MyBackHub
Rob Turk is the Chief Medical Advisor for MyBackHub, Inc. Dr. Turk has a broad foundation of talent in both medicine and business, previously obtaining his MD from the esteemed University of California, San Diego School of Medicine and his MBA at the University of Virginia Darden School of Business. As an entrepreneur and orthopaedic spine surgeon, he has unique and valuable insight on many topics. He is a published author in leading scientific journals such as JBJS and Arthroscopy, has written multiple book chapters, and has been a reviewer for a number of scientific journals. He is passionate about motion preservation and innovation in spine care, health equity, and Denver Nuggets basketball.
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