A parent notices one of their teenager's shoulders sits higher than the other. A shirt never hangs straight. Or an adult in their fifties has back pain that will not settle, and an X-ray shows the spine curving to one side. In both cases, the word that comes up is scoliosis, and the first question is usually the same: what do we do now?
Scoliosis is a sideways curve of the spine. It is common, it is often mild, and it does not always need surgery. But it does need honest advice, because the right treatment depends on the person's age, the size of the curve, and whether the curve is still changing. This guide explains scoliosis treatment in Surrey in plain language: what scoliosis is, what causes it, the symptoms to watch for, the treatment options that work, what physiotherapy can and cannot do, and when specialist care is the right call.
One honest note before we start. Surrey has a dedicated scoliosis clinic, The ScoliClinic, which specialises in Schroth-based scoliosis programs. Renew Physiotherapy is a general physiotherapy clinic, and this guide is written for the people we actually see: adults with scoliosis-related back pain, and parents of teenagers who have just been told their child has a curved spine. We will tell you plainly where physiotherapy helps and where a specialist clinic is the better option.
What Is Scoliosis?
Looked at from behind, a healthy spine runs in a straight line from the neck to the lower back. In scoliosis, the spine curves sideways, usually in a C shape or an S shape, and the bones of the spine also twist slightly. That twist is why one shoulder blade can stick out more than the other, or one side of the rib cage looks fuller.
Doctors measure the curve on an X-ray using something called the Cobb angle. It is simply the angle of the curve, measured in degrees. A curve of 10 degrees or more counts as scoliosis. Most curves are mild, between 10 and 25 degrees, and many people never know they have one until it shows up on an X-ray taken for another reason. Moderate curves run from about 25 to 40 degrees. Curves above 40 to 50 degrees are considered severe, and these are the ones that usually need specialist care.
Scoliosis affects about 2 to 3 in every 100 people. It can appear at any age, but it is most often found in children between 10 and 18, during the growth spurts of early adolescence. It also appears in adults over 40, usually because of wear and tear in the discs and joints of the spine.
Types of Scoliosis
Not all scoliosis is the same. The type matters, because it decides what treatment makes sense.
Adolescent Idiopathic Scoliosis
This is the most common type, and it accounts for about 8 in 10 cases. "Idiopathic" means the cause is unknown. It appears in children aged 10 to 18, usually during a growth spurt, and it is more common in girls than in boys. Most of these curves are mild and stay mild. A small number progress, and those are the ones that need monitoring, bracing, or a referral to a specialist.
Adult Degenerative Scoliosis
Other Types of Scoliosis
A small number of cases are present from birth, because the bones of the spine did not form properly. This is called congenital scoliosis. Another group is linked to conditions that affect muscles or nerves, such as cerebral palsy or muscular dystrophy. These are called neuromuscular scoliosis, and they are managed by specialist teams. There is also functional scoliosis, where the spine looks curved because of something else, such as one leg being shorter than the other, or a muscle spasm. Functional curves are not true scoliosis, and they often improve when the underlying cause is fixed.
What Causes Scoliosis?
For most teenagers with scoliosis, there is no single cause. Research points to a mix of genetics and growth. Scoliosis runs in families, so if a parent or sibling has it, a child is more likely to develop it. But no one has found one gene or one trigger that causes it. It is not caused by anything the child or the parent did wrong.
Two common myths are worth clearing up. Heavy school backpacks do not cause scoliosis. A heavy bag can cause back pain and poor posture, but it does not bend the spine sideways. Bad posture does not cause scoliosis either. Slouching can make an existing curve look worse, but it does not create one. The curve comes from how the spine grows, not from how a child sits or carries a bag.
Signs and Symptoms of Scoliosis
Mild scoliosis often has no symptoms at all. When there are signs, they are usually visible before they are painful, especially in teenagers.
In Children and Teens
Parents usually notice these first:
- One shoulder sits higher than the other
- One shoulder blade sticks out more than the other
- The waist looks uneven, with one side curving in more
- One hip is higher than the other, or one leg looks longer
- The body leans to one side when standing
- Clothes hang unevenly, or a shirt hem is always crooked
- When bending forward, one side of the rib cage or lower back looks higher than the other
Most teenagers with scoliosis feel no pain. That is why school screening and the forward bend test matter: the curve is often found by someone else looking, not by the child feeling something wrong.
In Adults
Adults usually notice symptoms rather than appearance:
- Back pain that comes and goes, or pain that gets worse with standing and walking
- Stiffness in the back, especially in the morning
- Muscle fatigue, because the muscles on one side of the spine work harder than the other
- Numbness, tingling, or pain running down a leg, if a nerve is being pressed
- Feeling shorter than you used to be, or clothes fitting differently
- In severe cases, shortness of breath, because a large curve can reduce space for the lungs
How Is Scoliosis Diagnosed?
Diagnosis usually starts with a simple test. The Adam's forward bend test is the one most people meet first: the person bends forward at the waist with their arms hanging loose, and the examiner looks at the back from behind. If one side of the rib cage or lower back is higher than the other, that is a sign of a curve with rotation, and an X-ray is the next step.
An X-ray of the whole spine, taken standing up, confirms the diagnosis and measures the Cobb angle. That number is the starting point for every treatment decision. A curve under 25 degrees is usually monitored. A curve between 25 and 40 degrees in a growing child often needs a brace. A curve above 40 to 50 degrees usually needs a specialist assessment, and surgery may be discussed.
The doctor will also check whether the curve is still changing. In teenagers, that means checking growth: how much growing is left, and whether the curve has grown since the last X-ray. In adults, it means checking whether the curve and the pain are getting worse over time. An MRI is only needed if there are nerve symptoms, such as weakness or numbness in the legs, or if surgery is being considered.
You do not need a doctor's referral to see a physiotherapist in British Columbia. If you already have an X-ray or a diagnosis, bring it to your first appointment. If you do not, a physiotherapist can do the forward bend test and a full assessment, and refer you for imaging if it is needed.
Scoliosis Treatment Options in Surrey
There is no single treatment for scoliosis. The right option depends on the size of the curve, the person's age, and whether the curve is still changing. These are the main options.
Monitoring
For mild curves, especially in teenagers who have nearly finished growing, the treatment is often watchful waiting. That means check-ups every four to six months, with a new X-ray each time, to see whether the curve is stable or growing. It sounds like doing nothing, but it is the correct treatment for most mild curves. Many never progress, and treating a stable mild curve with a brace or surgery would do more harm than good.
Bracing
A brace is used for teenagers who are still growing and have a curve between about 25 and 40 degrees. The brace does not straighten the spine. Its job is to stop the curve from getting worse while the child grows. Modern braces are worn for most of the day, usually 16 to 20 hours, and are fitted by an orthotist. Bracing works best when it is combined with scoliosis-specific exercise, and it only works while the child is still growing. It is not used for adults.
Scoliosis-Specific Exercise
This is the part of treatment that most people have not heard of, and it is where the honest distinction matters. Scoliosis-specific exercise programs, such as the Schroth method and SEAS, teach the person to correct their own posture in three dimensions: to lengthen the spine, to breathe into the flattened side of the rib cage, and to strengthen the muscles that hold the corrected position. It is very different from generic core strengthening or a standard back exercise sheet.
Surrey has a dedicated clinic for this kind of work. The ScoliClinic in Surrey runs Schroth, SEAS, and Rigo programs, and scoliosis screening. If your child has a progressing curve, or you want a program built entirely around scoliosis, that is the right place to go, and we will say so plainly. Renew Physiotherapy offers general physiotherapy for scoliosis: pain relief, mobility, strength, posture, and breathing work, built around your curve. For many adults with a stable curve and back pain, that is exactly what is needed. For a growing teenager with a progressing curve, a specialist program is the better investment.
Surgery
Surgery is only for severe or progressive curves, usually above 40 to 50 degrees, or when the curve is causing nerve problems or breathing difficulty. The most common operation is spinal fusion, where the curved section of the spine is straightened as much as possible and held in place with rods and screws. It is a major operation with a long recovery, and it is decided by a spinal surgeon, not by a physiotherapist. Most people with scoliosis never need it.
What Physiotherapy Can Do for Scoliosis
Physiotherapy does not straighten a structural curve. Anyone who promises that is not being honest. What it can do, and what it does well, is reduce pain, improve how you move, and help you live well with the curve you have.
Pain Relief and Movement
Strength, Posture, and Breathing
A structured exercise program builds strength in the core, back, and hip muscles that support the spine. It also works on posture: not standing up straight in a rigid way, but learning the position that takes load off the painful side. Breathing exercises matter too, because a curved spine can restrict how the rib cage expands. Learning to breathe into the compressed side of the chest is a core part of scoliosis exercise, and it is something a physiotherapist can teach in a session and you can practise at home.
What Physiotherapy Cannot Do
Honesty matters here, because false promises waste time and money. Physiotherapy cannot straighten a structural scoliosis curve in an adult. Once the bones have finished growing, the curve is set. Exercise can make the muscles around it stronger and the pain less, but it will not change the Cobb angle on an X-ray.
Physiotherapy also cannot replace a brace for a growing teenager with a progressing curve. A brace holds the spine while the child grows. Exercise alone does not do that. And physiotherapy cannot stop a curve from progressing if the curve is growing fast. In that situation, the right step is a referral to a specialist clinic or a spinal surgeon, not more of the same treatment.
What physiotherapy can do is help you decide, early, which situation you are in. An assessment tells you the size and type of your curve, whether it is stable or changing, and whether general physiotherapy is enough or a specialist program is needed. If it is the second one, we will tell you that and refer you, rather than keep treating something that needs a different kind of care.
Exercises and Daily Habits That Help
There is no single exercise sheet for scoliosis, because every curve is different. A curve that bends left needs different work from a curve that bends right, and an exercise that helps one person can load another person's curve the wrong way. That is why the exercises should come from an assessment, not from a video or a generic list. But some daily habits help almost everyone with scoliosis.
Safe Daily Habits
- Stay active. Walking, swimming, and cycling are all good for a curved spine. Swimming is especially useful because the water supports the body and the breathing work is built in.
- Change position often. Sitting in one position for hours stiffens the back. Stand up, walk around, and stretch every 30 to 45 minutes.
- Carry loads evenly. Use a backpack with both straps, and keep it light. Carry shopping in both hands rather than always on the same side.
- Sleep on a supportive mattress, on your back or your side, with a pillow that keeps your neck in line with your spine.
- Do the exercises your physiotherapist gave you, little and often, rather than one long session once a week.
What to Avoid
- Heavy one-sided lifting, such as always carrying a child or a bag on the same side.
- High-impact twisting sports during a pain flare-up, until your physiotherapist clears you.
- Ignoring pain that is getting worse, or new numbness or weakness in your legs.
- Generic "back strengthening" programs that were not designed for your curve. If an exercise makes your pain worse, stop and tell your physiotherapist.
When to See a Specialist
Most scoliosis is managed without a specialist. But some situations need one, and the sooner the better. Book a specialist assessment, or ask your physiotherapist for a referral, if any of these apply:
- A teenager whose curve is growing quickly, or has grown since the last X-ray
- A curve measured at 40 degrees or more
- Back pain that is severe, or pain that does not improve with physiotherapy
- Numbness, tingling, or weakness in the legs
- Changes in bladder or bowel control, which need urgent medical attention
- Breathing difficulty linked to the curve
- You have been told you may need a brace or surgery and want a specialist opinion
Surrey has a dedicated scoliosis clinic, The ScoliClinic, which runs Schroth, SEAS, and Rigo programs and scoliosis screening. For a growing teenager with a progressing curve, or for anyone who wants a program built entirely around scoliosis, that is the right referral. Renew Physiotherapy will refer you there when your case needs specialist care, and we will keep working with you on pain, strength, and daily function alongside it.
Frequently Asked Questions
Can physiotherapy straighten scoliosis?
No, not a structural curve. Once the bones have finished growing, the curve is set, and no exercise can change the Cobb angle on an X-ray. What physiotherapy can do is reduce pain, improve strength and posture, help you breathe better, and help you live well with the curve. In growing teenagers, scoliosis-specific exercise combined with bracing can slow or stop a curve from getting worse, which is a different goal from straightening it.
Does my child need a brace?
It depends on the size of the curve and how much growing is left. Braces are usually considered for teenagers who are still growing with a curve between about 25 and 40 degrees. A mild curve under 25 degrees is usually monitored, not braced. The decision is made by the doctor, based on X-rays taken over time. If your child is told they need a brace, scoliosis-specific exercise alongside it gives the best result.
Is scoliosis caused by bad posture or heavy backpacks?
No. Heavy backpacks and slouching can cause back pain and poor posture, but they do not cause the spine to curve sideways. Scoliosis in teenagers is mostly idiopathic, which means the cause is unknown, with genetics and growth playing a part. In adults, it is caused by wear and tear in the discs and joints. Good posture still matters, because it reduces the load on a curved spine, but it is not the cause of the curve.
Can adults with scoliosis exercise safely?
Yes, in most cases. Walking, swimming, cycling, and a structured strength program are all safe for most adults with scoliosis, and they help with pain and stiffness. The key is that the program should be built around your curve, not a generic routine. If an exercise makes your pain worse, or you develop numbness or weakness, stop and get assessed. A physiotherapist can tell you which movements are safe for your curve and which to avoid.
Will my child outgrow scoliosis?
No, a structural curve does not disappear as a child grows. What can happen is that a mild curve stays mild and never causes a problem, which is the most common outcome. A curve can also get worse during a growth spurt, which is why teenagers with scoliosis are checked every four to six months while they are growing. Once growth is finished, the curve usually stops changing, unless it is a large curve, which can slowly worsen in adulthood. Regular monitoring during the growing years is the best way to catch a progressing curve early.
Get Help for Your Curved Spine in Surrey
Scoliosis sounds worrying, and for a parent hearing it for the first time, it can be frightening. But most curves are mild, most never need surgery, and most people with scoliosis live active, normal lives. The important thing is to know what you are dealing with: the size of the curve, whether it is changing, and what treatment fits your situation.
If you or your child has scoliosis, or you have noticed uneven shoulders, a curved spine, or back pain that will not settle, book an assessment at Renew Physiotherapy for scoliosis treatment in Surrey. We will assess your curve, explain it in plain language, and give you an honest plan. If general physiotherapy is what you need, we will build it with you. If your case needs a specialist scoliosis program, we will tell you that and refer you to the right place.
5722 176a Street, Surrey, BC V3S 4H2
Phone: (236) 450-0171
Email: Info@renewclinics.ca
Website: www.renewclinics.ca
Book your scoliosis assessment today and get a clear, honest answer about your curved spine.