Scoliosis: who to see and what helps

Scoliosis · Kitchener, Waterloo & Cambridge

Scoliosis is a spine that twists and curves to the side. In a child or teenager who is still growing, what matters is having the curve measured and followed, because a brace can only do its work during growth. In adults the main problem is back pain, and treatment is mostly exercise. At CARESPACE a physiotherapist or a chiropractor can assess the back and treat the pain; a growing child also needs a physician or nurse practitioner, for an X-ray and a referral.

What scoliosis is

A scoliosis is a sideways curve with a twist in it, and it is confirmed when the curve measures 10 degrees or more on an X-ray. That measurement is the Cobb angle, and treatment decisions start from it and from how much growing is left. It can appear at any age but most often starts between 10 and 15, and curves of more than 10 degrees are reported in about 2% to 3% of adolescents. It is usually not a sign of anything serious, and mild curves often need no treatment.

Signs of scoliosis

• A visibly curved spine
• Leaning to one side
• Uneven shoulders
• One shoulder or hip that sticks out
• Ribs that stick out on one side
• Clothes that do not hang or fit well
• Back pain in some people, more often adults

Types and causes

• Idiopathic, about 8 in 10 cases. The cause is unknown. It cannot be prevented and is not linked to posture, exercise or diet, though it can run in families. Small curves are only slightly more common in girls than boys; curves over 30 degrees are about seven times as common in girls.
• Congenital. The bones of the spine did not form properly before birth.
• Neuromuscular. Caused by a nerve or muscle condition such as cerebral palsy or muscular dystrophy.
• Degenerative. Wear and tear in the spine of an older adult.

How scoliosis is diagnosed

The screening test is the forward bend: the child bends at the waist and the examiner looks, and measures with a small level called a scoliometer, for one side of the back sitting higher than the other. The diagnosis itself needs an X-ray, from which the Cobb angle is measured. X-rays and referral to a spine specialist are arranged through a physician or nurse practitioner. While a child is growing, the international scoliosis guideline suggests a clinical check at least twice a year, which is one of its weakest recommendations (grade D), and its experts agreed on X-rays every 6 to 12 months.

When to get medical help

See a physician or nurse practitioner if you think you or your child has scoliosis. Do not put it off in a child who is still growing: Canadian spine surgeons warn against missing the chance to brace a teenager who has more than a year of growth left and a curve over 20 degrees.

Call 911 or go to an emergency department right away if back or buttock pain comes with any of these: pain, tingling, weakness or numbness in both legs; a loss of feeling in one or both legs, or around your genitals or anus; changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself; changes in how your penis or vagina feels during sex, not being able to get or keep an erection, or not being able to orgasm; chest pain; or pain that started after a serious accident, such as a car crash. Do not drive yourself, and do not wait for an appointment: nobody at CARESPACE can rule these out.

The emergency departments in Waterloo Region are:

• WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
• WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
• Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge

If you cannot get there safely, call 911.

Get medical advice the same day, from a physician or nurse practitioner or at an urgent care clinic, if you feel hot, cold, shivery or generally unwell; if the pain is severe and started suddenly or is getting worse quickly; if weakness in one leg is new or getting worse; or if the pain is between your shoulder blades.

Our Back Pain page has the longer list of reasons to see a physician about back pain.

What the evidence says about treating scoliosis

• Where this comes from. The 2016 guideline of the international scoliosis society SOSORT, which covers children and teenagers who are still growing; a 2024 Cochrane review of exercise trials in adolescents; the Canadian Spine Society’s Choosing Wisely list; and the UK’s NHS, which also covers adults. SOSORT grades each recommendation from A, which must be applied to everyone with that need, down through C, which is voluntary, to D, which it rates as of very low importance. That is its panel’s judgment; the evidence is graded separately, from level I (several randomized trials) to level VI (consensus).
• Small curves are watched, not treated. Many children need no treatment. SOSORT recommends against bracing curves below about 15 degrees, and recommends regular follow-up for every child with scoliosis, treated or not (grade C, by consensus).
• Bracing has the strongest evidence. SOSORT recommends a brace for curves above about 20 degrees in a child who is still growing (grade B, level I evidence), worn full time or at least 18 hours a day at the start and kept up until growth ends. The Canadian Spine Society says bracing, in those properly braced, significantly reduces the need for a later operation. The NHS adds that a brace does not correct the curve but may stop it getting worse, and that not all specialists in the UK recommend one.
• Scoliosis-specific exercises: recommended, on thin evidence. These are taught programs of self-correction in three dimensions; Schroth is one of the schools SOSORT names. SOSORT recommends them as the first step to limit progression (grade C, level I), designed by therapists trained in the method they use, and during brace treatment (grade B). The Cochrane review is more cautious: it is uncertain whether they change the curve more than general exercise does (4 trials, 192 participants, very low certainty), and adding them to a brace may reduce the curve by about 2 degrees more than the brace alone (2 trials, 84 participants, low certainty). The NHS says it is unclear whether they improve scoliosis.
• Sport continues. SOSORT says sport is not a treatment for scoliosis but should carry on, with physical education, through every phase of care including bracing (grade B, level V).
• Hands-on treatment does not straighten a curve. SOSORT proposes manual therapy only together with scoliosis-specific stabilizing exercises (grade C, level V) and found no evidence to support osteopathic manual therapy for mild curves. The NHS says there is little reliable evidence that osteopathy, chiropractic or other therapies correct a curved spine or stop it getting worse.
• In adults, treatment is for pain. The NHS says activities that strengthen and stretch the back may reduce pain, that the type of exercise matters less than keeping the back moving, and that exercises from a physiotherapist are unlikely to change the curve but may ease pain. Braces are not often used in adults, and most adults will not need surgery.

What a doctor may offer

CARESPACE does not provide these, but it helps to know where they fit.

• Monitoring and bracing through a specialist team. SOSORT says a brace should be applied by a trained team that includes a physician, an orthotist and a therapist.
• Surgery in teenagers, if the curve keeps getting worse despite treatment or is severe once growth has stopped.
• For adults, a steroid injection if the curve is irritating a nerve (relief usually lasts weeks or months), and surgery when the curve is severe or worsening, pain is severe despite other treatment, or nerves are compressed. Recovery can take a year or more.

How each CARESPACE service treats scoliosis

Physiotherapy

For a growing teenager, the physiotherapy with a guideline behind it is scoliosis-specific exercise, and SOSORT is firm that it should be designed by a therapist trained in the particular method. Ask when you book whether a physiotherapist trained in a scoliosis-specific method such as Schroth is available, and who sees children and teenagers. For adults, a physiotherapist can teach back exercises aimed at the pain that comes with a curve.

See our physiotherapy team →

Chiropractic

A chiropractor can examine the spine, including the forward bend test, and can treat back pain in an adult who has a curve, although none of our sources tested manipulation in that group. Manipulation is not a treatment for the curve itself: hands-on care has not been shown to correct scoliosis or stop it progressing, and SOSORT supports manual therapy only alongside specific exercises. It is not a substitute for monitoring or bracing in a child who is still growing.

See our chiropractic team →

Kinesiology and Personal Training

For adults, the NHS advice is to pick strengthening and stretching you enjoy and will keep doing, and to check with a health professional before starting a new program. A kinesiologist or a personal trainer can build and progress that kind of program. It is general exercise, not scoliosis-specific exercise.

See our kinesiology team →

See our personal training team →

Other services people ask about

Massage therapy and osteopathy. None of our sources tested massage for scoliosis. SOSORT found no evidence to support osteopathic manual therapy for mild adolescent scoliosis, and the NHS says there is little reliable evidence that osteopathy corrects a curve or stops it getting worse.

Where most people start

For a child or teenager, start with a physician or nurse practitioner, so the curve is measured and a referral is made if it is needed. If you would also like exercise-based care here, ask when you book who sees children and teenagers. For an adult whose main problem is back pain, book with a physiotherapist or a chiropractor; both assess and treat at the first visit.

How your team works together

With a growing child, the specialist team decides on monitoring and bracing, and care here fits around that. With an adult, a physiotherapist or chiropractor leads on the pain, and a kinesiologist or personal trainer can keep the exercise going afterward.

Browse by service: physiotherapists, chiropractors, kinesiologists and personal trainers.

What to expect at your first visit

1. The history. When the curve was noticed, any X-rays and Cobb angle so far, and whether a brace has been prescribed. Bring any reports you have.
2. Pain questions, including the warning signs above.
3. An examination: the forward bend test, shoulder and hip levels, and how the spine moves.
4. What it points to, and whether a physician should arrange an X-ray or a referral.
5. A plan, and treatment at that visit where pain is the problem.

What you can do at home

• Keep active. Most children with scoliosis can do most types of exercise, and gym class, school teams and minor hockey can all stay on the calendar unless a specialist says otherwise.
• If a brace has been prescribed, wear it for the hours prescribed. The benefit was seen in those properly braced.
• Adults: keep your back moving, and ask a pharmacist about pain relief.

Outlook

Many mild curves never need treatment. What a curve does after growth ends depends on its size: SOSORT reports that the risk of progression in adult life rises above 30 degrees, and that curves over 50 degrees are almost certain to progress. Most adults never need surgery.

Scoliosis treatment in Kitchener, Waterloo and Cambridge

Kitchener. Physiotherapy in Kitchener, Chiropractic in Kitchener, Kinesiology in Kitchener and Personal Training in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.

Waterloo. Physiotherapy in Waterloo, Chiropractic in Waterloo, Kinesiology in Waterloo and Personal Training in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.

Cambridge. Physiotherapy in Cambridge. Location: Hespeler Road.

The city pages linked above show the locations and practitioners for each service, with their next availability.

Common questions

Can scoliosis be corrected without surgery?

A brace does not straighten the curve; its job is to stop it getting worse while a child grows. Exercises have the same aim, on weaker evidence.

What is the Schroth method?

One of several schools of scoliosis-specific exercise named in the SOSORT guideline, which teach a person to correct their own curve and hold that posture in daily life. Ask when you book whether a physiotherapist trained in it is available.

Can a chiropractor fix scoliosis?

No. There is little reliable evidence that chiropractic or osteopathy corrects a curve or stops it getting worse.

Can my teenager keep playing sports?

Yes. Sport and gym class should continue, including during brace treatment. While a brace is being worn, SOSORT advises caution with contact and highly dynamic sports.

Do you see children and teenagers with scoliosis in Kitchener, Waterloo and Cambridge?

Ask when you book. Call 519-208-2273 and our Central Reception Team will tell you who sees children and teenagers and find the closest location with an opening.

Can an adult with scoliosis and back pain be seen in Cambridge?

Yes: Physiotherapy in Cambridge. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.

Do I need a referral?

No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →

Sources

• Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis and Spinal Disorders, 2018;13:3.
• Romano M, Minozzi S, Bettany-Saltikov J, et al. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database of Systematic Reviews, 2024, Issue 2, CD007837. (We read Cochrane’s summary of the review.)
• Choosing Wisely Canada and the Canadian Spine Society. Spine: eight tests and treatments to question. Updated September 2021.
• NHS (UK). Scoliosis, Treatment in children and Treatment in adults. Reviewed April 2023; a review was due in April 2026.
• NHS (UK). Back pain, reviewed March 2026, and Slipped disc, reviewed April 2024 (emergency and same-day signs).
• HealthLink BC (Healthwise). Low Back Pain (when to call a doctor). Current as of November 2022.

Related conditions

Back Pain · Posture · Upper Back Pain · Spinal Stenosis

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