How Is Scoliosis Progression Monitored?

Mar 11

Written By Dr. Rosemary Carvajal, PT, DPT

After a scoliosis diagnosis, one of the most common questions patients and parents ask is: “How will we know if the curve is getting worse?”

Monitoring scoliosis progression is an important part of managing the condition, especially during periods of growth. Regular follow-up allows healthcare providers to track changes in the spine over time and make informed decisions about treatment, such as scoliosis specific physical therapy, bracing, or surgery.

Below are several ways scoliosis progression is typically monitored.

Physical Examination

A clinical evaluation is often the first step in monitoring scoliosis. During appointments, healthcare providers assess overall posture and spinal alignment. They may observe:

Shoulder height differences
Rib prominence
Waist asymmetry
Trunk balance and alignment

Changes in these physical features can sometimes indicate that a spinal curve is changing and may warrant further evaluation.

The Adam’s Forward Bend Test

One of the most common screening tools for scoliosis is the Adam’s Forward Bend Test. During this test, the patient bends forward at the waist while the clinician observes the back from behind.

This position can make asymmetries in the rib cage or spine more visible. If one side of the back appears higher than the other, it may indicate spinal rotation associated with scoliosis.

Scoliometer Measurements

A scoliometer is a small handheld tool used during the forward bend test to measure trunk rotation. This measurement helps clinicians quantify asymmetry and track changes between visits.

X-Rays and the Cobb Angle

X-rays allow clinicians to measure a scoliosis curve using the Cobb angle, which is the standard method used to evaluate curve magnitude. X-rays might not be taken at every visit, but they may be recommended periodically, particularly during growth. These images allow clinicians to determine whether the curve is remaining stable, increasing in size, or responding to treatment. The frequency of imaging depends on factors such as age, growth stage, and curve magnitude. In some areas, EOS imaging is available as a newer technology that provides detailed images of the spine while using lower levels of radiation compared to traditional X-rays.

Monitoring Beyond X-Rays

Monitoring scoliosis involves more than just measuring the curve on an X-ray. Clinicians also consider other factors, including growth and developmental stage, changes in posture and trunk alignment, angle of trunk rotation, response to treatment such as bracing or scoliosis-specific exercises, and symptoms such as pain or functional limitations. These factors help guide treatment decisions and determine whether adjustments to a care plan may be needed.

Why Consistent Follow-Up Matters

Scoliosis can change quickly, particularly during periods of rapid growth. Regular follow-up appointments allow healthcare providers to identify changes early and recommend appropriate next steps.

For many patients, monitoring may involve collaboration between physicians, physical therapists, orthotists, and other members of the healthcare team. Together, these professionals work to track changes in the spine and support long-term spinal health.

If you or your child has been diagnosed with scoliosis, understanding how progression is monitored can help you feel more informed and prepared throughout the process. Consistent monitoring allows healthcare providers to guide treatment decisions and support the best possible outcomes over time.

Ready to Learn More?

If you’re curious whether PSSE is right for you or your child, I’d be happy to help guide you through the next steps.

👉 Contact ScoliSource to schedule an initial evaluation, or free 15 minute chat to learn more about scoliosis-specific physical therapy.

Dr. Rosemary Carvajal, PT, DPT

Dr. Rosemary Carvajal, PT, DPT is a board-certified Doctor of Physical Therapy and scoliosis-specific rehabilitation specialist. She has dedicated her career to helping children, adolescents, and adults with scoliosis and other spinal conditions move with greater ease, manage pain, and achieve lasting improvements in posture and function.

Rosemary is certified in the Rigo Concept BSPTS (Barcelona Scoliosis Physical Therapy School) method (L1, L2, L3 Advanced Certification) and SEAS (Scientific Exercise Approach to Scoliosis) method, both internationally recognized systems of Physiotherapeutic Scoliosis-Specific Exercises (PSSE) that evolved from the original Schroth Method. These advanced certifications allow her to design individualized treatment plans rooted in the most current research and best practices in scoliosis care.

Her passion for scoliosis rehabilitation is deeply personal. As a teenager, Rosemary wore a scoliosis brace and later underwent spinal fusion surgery. She has experienced firsthand the physical, emotional, and social challenges that scoliosis can bring. Today, she continues to practice scoliosis-specific exercise herself, which fuels both her empathy and her belief in the effectiveness of the methods she teaches. This lived experience allows her to provide not only clinical expertise but also compassionate, understanding care that truly connects with patients and families.

Rosemary provides scoliosis-specific physical therapy across the lifespan, including pre- and post-surgical care, brace management support, and long-term exercise programs. Her clinical practice is complemented by active involvement in research.

Beyond clinical care, Rosemary serves on the Communication Committee of SOSORT (International Society on Scoliosis Orthopaedic and Rehabilitation Treatment), where she helps advance global education and collaboration in scoliosis treatment.

Her approach blends advanced clinical expertise with personal experience and compassion. By combining evidence-based scoliosis-specific exercise methods with a hybrid practice model- offering both in-home and private clinic sessions, Rosemary ensures that every patient receives personalized care designed to support both spinal health and quality of life.