Scoliosis symptoms can vary from child to child. Some signs are obvious, while others are so subtle that many families don’t notice them until a doctor or school screening points them out. Scoliosis can appear in children, teens, and adults—and it often runs in families.

Doctors classify scoliosis in two ways:

Nonstructural scoliosis: The spine itself is normal, and the curve is temporary.
Structural scoliosis: The spine has a fixed curve, often caused by genetics, birth differences, neuromuscular conditions, injury, or infection.

Common Symptoms of Scoliosis

Parents may notice one or more of the following:

Uneven shoulders or hips
One shoulder blade sticking out more
Clothing hanging unevenly
The head not centered over the body
One arm that hangs lower than the other
Back pain or fatigue (more common in teens and adults)
A visible curve in the spine
When bending forward, one side of the ribs appears higher

Because symptoms can be mild at first, scoliosis is often missed until a growth spurt makes the curve more noticeable.

Mild, Moderate & Severe Scoliosis: How Symptoms Change

Scoliosis can affect the neck (cervical), mid-back (thoracic), or lower back (lumbar). It may involve just one area—or several at once. Most cases (80–85%) are idiopathic, meaning there is no known single cause. Others are neuromuscular (linked to conditions like cerebral palsy or muscular dystrophy) or congenital (present at birth).

Below is a simplified look at how symptoms progress from mild to severe.

Mild Scoliosis (Under 25°)

Early cases are easy to miss. Symptoms may include:

Slightly uneven shoulders, hips, or posture
Clothing that doesn’t hang evenly
One leg appearing a bit shorter
The child may look like they are “slouching”
Little or no pain

Mild scoliosis has a risk of progressing, especially during growth spurts. Early detection gives the best chance to keep curves small.

Moderate Scoliosis (26°–40°)

Moderate curves become more noticeable and may cause:

Prominent rib hump when bending forward
More visible unevenness in shoulders or hips
Fatigue during physical activity
Clumsiness or poor balance
Pain near the ribs or shoulders
Occasional headaches

Bracing is often recommended at this stage to prevent the curve from getting worse.

Severe Scoliosis (Over 40°)

Severe scoliosis is more obvious and may lead to:

Clear “S-shaped” or “C-shaped” spine
Pronounced rib hump
Clothing consistently fitting unevenly
Increased fatigue from standing, walking, or activity
Back and rib pain
Headaches
Reduced space for the lungs or organs in very large curves

Severe scoliosis has a high chance of progressing. Surgery is often considered to prevent further curvature and improve quality of life.

When to Seek Medical Evaluation

Contact a doctor if you notice:

Any visible unevenness in posture
A curve that seems to be getting larger
Pain combined with posture changes
Difficulty with balance or coordination

Early evaluation can prevent curves from reaching the moderate or severe stages.