Scoliosis Risk Factors

Scoliosis Risk Factors Image

There are many risk factors associated with scoliosis, but they vary widely from patient to patient. Characteristics of the condition that impact the types of risk factors present include the patient’s age, curvature type, curvature size, and the location of the curvature along the spine.

When it comes to the type of risk factors to expect with scoliosis, that answer will differ depending upon the nature of each individual’s condition. The risk factors associated with mild scoliosis can be quite different from those associated with more severe forms of the condition. Let’s start our discussion with risk factors associated with milder forms of scoliosis.

What are Common Risk Factors Associated with Mild and Moderate Scoliosis?

One of the main classification points for scoliosis is whether the condition is mild, moderate, or severe. This designation is determined by just how far out of alignment a patient’s spine is.

When a patient is first diagnosed with scoliosis, this designation is made based on the results of their scoliosis X-ray. The X-ray tells me everything I need to know about the patient’s condition, including their Cobb angle: a measurement in degrees taken from the most tilted vertebra at the apex of the curve.

picture of doctor holding scoliosis x-ray

If a patient has a Cobb angle measurement of 25 degrees or less, this is considered mild scoliosis. Patients with Cobb angle measurements between 25 and 40 degrees are considered moderate scoliosis, and Cobb angle measurements of 40+ degrees are considered as severe scoliosis.

With mild, and even some moderate forms of scoliosis, there aren’t a lot of limitations, noticeable symptoms, or risks of developing additional complications, at least until progression kicks in. The condition’s most common form, adolescent idiopathic scoliosis (AIS), can even be difficult to diagnose because its initial effects can be very subtle.

With mild and moderate forms of scoliosis, patients are most likely to experience subtle postural changes, changes in gait, and in how their clothing hangs on their bodies.

The big risk factors associated with most forms of scoliosis, and especially AIS, are related to progression. Growth is the number one trigger for progression, which is why adolescents are at a higher risk of experiencing rapid progression. Scoliosis progression means the curvature is getting larger.

As a condition progresses, related risk factors increase as the scoliosis moves from mild or moderate into the severe stage.

What are Common Risk Factors Associated with Severe Scoliosis? 

Scoliosis X-Ray When I see a patient with severe scoliosis, this means their condition has progressed and their curvature has increased. This also means they are far more likely to experience adverse symptoms and additional complications related to their condition.

With severe scoliosis, the aforementioned changes associated with milder forms of the condition are more severe. Postural changes become overt as there’s often an overall asymmetry to the body.

Postural changes and changes to how a person walks are extreme, as are some related risk factors associated with severe scoliosis.

Lung Impairment

Severe scoliosis can also impact organs, such as the lungs. Rib cage deformities are common at this stage, especially when a patient’s scoliosis is in the thoracic spine (middle back).

When scoliosis causes a rib cage deformity, lung impairment becomes a risk factor. This is because the deformity is pressing on the lungs, affecting lung volume and making it harder to take deep breaths.

This isn’t always noticeable in regular daily activities, but for athletes or long-distance runners, these impairments become more noticeable, and shallow breathing can be a result. 

This is why, here at the CLEAR Scoliosis Institute, we like to monitor this complication by measuring a patient’s lung volume before and after treatment. 

Mobility and Muscle Impairment Picture of woman stretching to touch toes

With severe scoliosis, mobility issues can also develop. Due to uneven pressure on the spine and its joints, motion can be limited as muscles are affected, causing intense pain and trigger points.

When a person is experiencing problems with muscles that support the spine, this impacts mobility both in terms of discomfort and function. 

Motor and Sensory Control Impairment

When there is instability in the spinal joints due to an abnormal curvature, the spinal cord is being stretched. As the spine works in tandem with the brain to form the body’s central nervous system, this can affect motor and sensory control.

Neurological disorders are commonly associated with scoliosis, and hormones can also be affected, as they are associated with the brain and central nervous system.

Balance Problems

Issues with balance and proprioception are also associated with scoliosis. Proprioception refers to the body’s ability to orient itself in space without visual cues. It can be very difficult for a person with severe scoliosis to close their eyes and stand on one foot.

Balance can also be affected as the body becomes more and more asymmetrical. Often, when someone with severe scoliosis sits down, they end up slouching; this places more pressure on the spinal joints and can cause more pain and misalignment to develop. This affects the overall biomechanics of the spine and those related joints.

Emotional Stress

Another risk factor that is often overlooked is the emotional strain that a spinal deformity like scoliosis can place on people, especially adolescents and teenagers.

Teenagers don’t want to look or walk differently from their peers, and when they start to feel different and they stand out, this can lead to intense emotional stress and anxiety.

When these young people are faced with a condition that has progressed rapidly or is progressing rapidly, they can lose hope and become depressed. Depression can affect their ability to concentrate on their school work and cause them to fall behind.

You can see how the emotional strain of a condition like scoliosis can affect multiple areas of a young person’s life.

Digestive Issues

Severe scoliosis is also associated with digestive issues such as constipation, stomach pains, and irritable bowel syndrome.

This can lead to nutritional deficiencies, as the body can’t absorb the nutrients it needs. This can be the result of a blockage or related issues with the nervous system or blood vessels.


There are multiple risk factors associated with scoliosis, and the more severe the condition is, the more extreme the risk factors become.

With mild and moderate forms of the condition, risk factors are mainly related to the condition’s progression and related postural changes. At this stage, additional complications are less common and extreme.

As a patient’s condition progresses and their curvature gets larger, so too do related risk factors. This is why it’s beneficial to treat scoliosis early on before those risk factors have increased and additional complications such as lung impairment and digestive issues have developed.

You can also listen to us discussing scoliosis risk factors on our podcast: Episode 19: Scoliosis Risk Factors

Additional Resources: - Scoliosis Symptoms

US National Library of Medicine - Evaluation of Balance in Young Adults with Idiopathic Scoliosis

Disclaimer: The author’s views are his or her own and may not reflect the views of CLEAR Scoliosis Institute.

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Author: Dr. Dio Kim

Dr. Dio Kim graduated from Palmer College of Chiropractic West in 2000 and practices in Tustin, California. He has been CLEAR Certified since 2011, and became one of the first members of the CLEAR Fellowship Program in 2019. Among the many certifications allowing him to be recognized as a CLEAR Fellow are the Cox Technic, Kinesio Taping, ScoliBrace, Scientific Exercise Approach to Scoliosis (SEAS) Level 1, and many more. Dr. Dio specializes in scoliosis, sports, and pediatric chiropractic. He holds a Diplomate in Clinical Chiropractic Pediatrics (DICCP) and Diplomate American Chiropractic Board of Sports Physicians (DACBSP®). The DICCP is a board-certified credential in pediatrics for doctors of chiropractic who specialize in children, from infants to teenagers. Moreover, he is one of only a few chiropractors invited by the United States Olympic & Paralympic Committees (USOPC) to the Olympic Training Center in Colorado Springs to treat elite athletes. He is a graduate of the World Masters of Scoliosis Conservative Treatment from ISICO, and is also a licensed acupuncturist.
Reach out to Dr. Dio Kim

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4 comments on “Scoliosis Risk Factors”

  1. Hi.
    I was diagnoses with scoliosis since I was 10 yrs old (now 56). I have gone through 2 braces, 1 trackation, halloo, body case, bed case, and two surgery's - rods in and removed: thoracic spine (fused) Now, at 56, I have been having issues with my lower back and neck along with breathing. Lower back has a degenerative disease mostly found in the S1 joint. I have low bone mase, I have asthma and scaradosis. Now , my neck is causes problems. When I look to the left or right, my neck cracks and crunching sound. I had an MRI done, but no results. yet.

    1. Hello, Joann,
      It is very common to have several issues following scoliosis surgery. It seems as if you have been through a lot with your scoliosis. It does cause degeneration to happen faster than the normal aging process as well. Our CLEAR Scoliosis Institute Doctors specialize in the treatment of scoliosis without surgery. Even though you have had a previous surgery, it does not mean that there is no hope or help that can be provided by one of our Doctors. I would suggest contacting the CLEAR Scoliosis Institute Doctor closest to you to determine if you would be a candidate for care. To find the nearest Doctor, please visit our website under "Find a Doctor". Best of luck to you.

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