isn't always easy to identify, but if a patient suspects that they may be experiencing symptoms associated with the condition, they will usually be given a physical examination before being sent for an X-ray to confirm the presence of an abnormal spinal curvature. This curve is measured using a metric that is commonly referred to as the Cobb angle
, which is used to identify the degree of scoliosis present in each sufferer's spine.
If the Cobb angle is less than 10°, this is usually an indication of a perfectly normal spine (since the human spine always has a certain degree of deviation - nobody's back is totally straight). 10° is usually used as the threshold for diagnosing scoliosis; if the Cobb angle is identified as exceeding 20°, treatment is routinely recommended so as to prevent further curve progression, which can cause an increasing number of health problems if the Cobb angle is left to worsen. In some cases, treatment is also advised for those who have a curve between 10 and 20°, depending on a variety of different factors in each individual case.
What is 20 degree scoliosis?
In simple terms, the severity of an individual's scoliosis is assessed on a scale ranging from mild (Cobb angle of 10-25°) to moderate (26-40°) to severe (40°+). This means a curve that measures around 20 degrees would be classed as mild scoliosis, which is obviously the least debilitating form of the condition.
However, while the word 'mild' may suggest that this form of scoliosis is fairly harmless, it does carry a significant risk of progression. This risk can increase up to 100% for a diagnosis in very young children once the curve exceeds the 20° mark. In cases of mild scoliosis, it is beneficial to undertake preventative measures in order to reduce the curve at an early stage and give yourself the best chance at limiting progression.
What are the symptoms?
Patients with 20 degree scoliosis usually suffer from one or more of the following symptoms:
- Uneven shoulders and hips
- Forward or tilted head posture
- Legs appearing to be uneven
- Mild pain
- Clothes hanging unevenly
This form of scoliosis is most commonly found in adolescent females, although it can affect individuals of both genders, ranging from young people to fully-grown adults.
Treating 20 degree scoliosis
Young patients with mild scoliosis will usually be recommended to wear a specially-fitted back brace - read about bracing here
At the Scoliosis SOS clinic in London, we practice an alternative form of scoliosis treatment called ScolioGold therapy
. It is suitable for brace-wearers as well as those who opt to pursue a less restrictive form of curve prevention.
Our treatment programmes combine a variety of proven, non-surgical techniques, which are used to address multiple aspects of the condition and provide long-term results. Over the years, we have successfully treated patients with curves ranging from mild to severe, leading to Cobb angle reduction along with the improvement of pain, mobility, and visible symptoms.
We're often asked questions regarding the severity of an individual's spinal curve and whether or not this makes them a suitable candidate for ScolioGold treatment. While there is some debate regarding which treatments are best-suited to different cases, many doctors recommend surgical intervention for those with a Cobb angle of 40-50 degrees or more.
Despite this, there is sufficient evidence to suggest that scoliosis sufferers with a 55 degree curve or more can be successfully treated via non-surgical methods, which help to relieve pain, reduce the visibility of the scoliotic curve, and prevent the condition from progressing further. Here at Scoliosis SOS, we have treated countless patients whose angles exceed the proposed threshold for surgery, with consistently impressive results.
While we have treated curves ranging from 12 to 120 degrees, the majority of our patients fall within the range of 20-65 degrees, with many having explored the possibility of surgery already. One of our previous patients, Veronica Gabinet, had a curve of 55 degrees, and had attempted treatment with a Boston brace to no avail. She came across the Scoliosis SOS Clinic while researching non-surgical treatments online; in the end, she decided against undergoing an operation to treat her spinal curve, and decided to enrol on one of our treatment courses instead.
For Veronica, as for many young people who suffer from scoliosis, the risks associated with surgery were a daunting prospect. Veronica took part in activities such as dance, tennis, and other physically-demanding hobbies, and in cases such as these, a spinal operation can be an extremely restrictive and drastic solution, presenting an entirely new set of problems even as it helps with the scoliosis itself.
In an interview we conducted with Veronica after her treatment with us, she said that she would definitely recommend trying non-surgical therapies before surgery. Despite having a curve of 55 degrees, she was able to see a marked improvement in her symptoms, particularly with regards to her posture. You can hear her full story, and find out more about her experience at Scoliosis SOS here:
If you have a 55 degree curve or higher, and are unsure as to whether our treatment would benefit you, please don't hesitate to get in touch. We can arrange a professional consultation which will help you to select the best course of action for your individual case.
Many discussions about scoliosis
- and the treatment
of scoliosis in particular - centre on something called the Cobb angle
. The Cobb angle is among the most important indicators of scoliosis severity, and Cobb angle reduction
is the primary goal of the non-surgical scoliosis treatment courses
we deliver here at Scoliosis SOS.
Simply put, the Cobb angle is just a way of measuring the curve of a scoliosis sufferer's spine. It is named after John Robert Cobb, an orthopaedic surgeon from the USA; Cobb was born in 1903, and he conducted extensive research into scoliosis when relatively little was known about the condition. He identified that only 1 in 10 scoliosis sufferers actually requires surgical treatment, and so he devised the Cobb angle as a straightforward means of determining whether or not a patient's spinal curvature is severe enough to necessitate surgery.
Cobb angle examples
The X-rays below show Cobb angle measurements for five different scoliosis sufferers (all of whom were treated here at the Scoliosis SOS Clinic). The patients' ages range from 7 to 32 years old.
More examples can be found here
Using the Cobb angle to assess treatment needs
Scoliosis can only be diagnosed (and its severity assessed) by an experienced practitioner. However, here is a rough guide to what the Cobb angle means:
- A Cobb angle of less than 10° is entirely normal - there is no such thing as a perfectly straight spine, and everyone will have some slight deviation in their spinal alignment.
- 10° is generally accepted as the threshold for determining if somebody has scoliosis. Scoliosis will not be given as a diagnosis unless the patient's Cobb angle is 10° or more.
- When the Cobb angle is between 20° and 40°, a back brace is usually recommended; back braces come in many different shapes and sizes, and some are worn only at night. However, some patients may be prescribed a brace at 15° or at 50° - it all depends on the hospital that's administering treatment.
- How large does a patient's Cobb angle need to be before an orthopaedic surgeon will recommend surgery? The answer varies from country to country, and is often influenced by whether the patient is already wearing a brace and/or undergoing scoliosis-specific physiotherapy. In the UK, the threshold is often 40°; in continental Europe, it's more frequently 50°.
- 12° to 120°: This is the range of Cobb angles we treat using our ScolioGold therapy programme (although the majority of our patients exhibit curves of between 20° and 65°).
Click here to see how our treatment courses can help to reduce the Cobb angle, or contact us now to book an initial consultation for yourself or a family member.