Can You Have Scoliosis Without Knowing? Charlotte NC | Adult Discovery | Clear Life Scoliosis

By Dr. Justin Dick, DC · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published October 22, 2026

Yes, and it is common. In a study of healthy volunteers over 60 with no known history of scoliosis, 68 percent met the radiographic definition of scoliosis on a standing X-ray. Many adults with a curve have no symptoms, and many curves are found by accident on imaging taken for something else.

I am Dr. Justin Dick, and at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC, adults regularly come in after a chest X-ray, a CT scan, or a back film mentions scoliosis for the first time. Some had a curve since adolescence that was never caught. Others developed one in adulthood. This post explains how to tell which and what matters for the next step.

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How Common Undiagnosed Scoliosis Is

Schwab and colleagues obtained standing full-spine radiographs in 75 healthy volunteers aged 60 to 90, average age 70.5, none of whom had a known history of scoliosis or prior spine surgery. Sixty-eight percent had a Cobb angle over 10°, with a mean of 17°. Rates did not differ significantly between men and women. The radiographic findings did not correlate with pain scores in the group as a whole. The authors noted that earlier reports put adult prevalence at up to 32 percent and that their higher figure likely reflected the older age of the group.

That study is small and targeted at older adults, so the 68 percent figure should not be generalized to younger adults. It makes the central point clearly: a curve on an X-ray is a frequent finding in older adults, and many of those adults function without notable impairment.

Two Ways an Adult Ends Up With an Undiscovered Curve

A curve from adolescence that was never caught

Adolescent idiopathic scoliosis is often painless. A curve that stopped progressing at skeletal maturity can go unnoticed for decades, particularly if screening was missed or the curve was balanced. In Weinstein's 50-year natural history study, untreated adults with adolescent-onset scoliosis were largely productive and functional, with more back pain than controls. Weinstein and Ponseti's 40-year follow-up found that curves under 30° at maturity tended not to progress, while larger curves often did.

A curve that developed in adulthood

Degenerative, or de novo, scoliosis develops in adulthood as discs and joints wear asymmetrically. It usually appears in the lumbar spine of older adults. Our documented case of adult de novo scoliosis and my post on adult scoliosis treatment cover that pathway.

Telling the two apart from one film is not always possible, but features such as vertebral rotation, curve location, and degenerative changes at the apex help.

Why It Was Missed

A curve that does not hurt and does not show through clothing has no reason to be noticed. Double curves can leave the trunk looking balanced, as described in my post on double major and S-shaped curves. Incidental reports often name a direction, such as dextroscoliosis or levoscoliosis, without a measurement. Our Cobb angle page explains the measurement that is missing.

What to Do After an Incidental Finding

This sequence is my clinical approach.

• Get a standing full-spine radiograph with a measured Cobb angle. A supine CT or a chest film is not a scoliosis measurement.
• Add a lateral standing view to assess sagittal balance, which relates more closely to adult symptoms than the coronal curve alone.
• Find any older imaging. A comparison from years ago tells you more about progression than any single film.
• If the curve is under about 30°, you have no symptoms, and nothing suggests progression, periodic monitoring is reasonable.
• If the curve is larger, you have pain or leg symptoms, or comparison films show change, a full evaluation is warranted.

My post on spinal stenosis with scoliosis covers what to watch for if leg symptoms develop.

How Dr. Justin Dick Evaluates an Adult Incidental Curve at Clear Life

At our Charlotte office, an adult incidental finding gets standing PA and lateral films, Cobb angle, rotation, lateral translation, sagittal alignment, and a neurological exam. Prior imaging is requested from wherever it exists. The result is a plain answer about what the curve is, whether it is likely to change, and whether anything needs treatment now.

Comparison

Research and Evidence

Evidence tiering: the prevalence figure comes from a small volunteer study of older adults. The natural history data come from long-term single-center cohorts. The degenerative curve description and the next-step sequence are clinical reasoning.

My own published work includes adults found with scoliosis later in life. The geriatric kinetic chain case series, Radiographic Sagittal Alignment and Kinetic Chain Alterations in Geriatric Patients With Scoliosis: A Case Series (Cureus, 2026, PMID 42037873), describes two older adults with a history of adolescent idiopathic scoliosis whose pain related more to kinetic chain compensation and sagittal alignment than to the curve itself. It is case-level evidence.

References

1. Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine. 2005;30(9):1082-5. doi:10.1097/01.brs.0000160842.43482.cd
2. Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289(5):559-67. doi:10.1001/jama.289.5.559
3. Weinstein SL, Ponseti IV. Curve progression in idiopathic scoliosis. J Bone Joint Surg Am. 1983;65(4):447-55. PMID 6833318
4. Whelan JP, Dick JM. Radiographic sagittal alignment and kinetic chain alterations in geriatric patients with scoliosis: a case series. Cureus. 2026;18(3):e105827. doi:10.7759/cureus.105827

Frequently Asked Questions

Service Area

Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin Dick.

Related Pages

• Scoliosis Treatment for Adults
• Adult De Novo Scoliosis Case
• Adult Scoliosis
• Spinal Stenosis Exercises With Scoliosis
• Double Major and S-Shaped Scoliosis
• Can Scoliosis Be Misdiagnosed?
• Adult Scoliosis and Curve Severity
• Getting Shorter With Age
• What Happens If We Do Nothing
• Dr. Justin Dick Research

Schedule an Evaluation in Charlotte

If a scan just told you that you have scoliosis, the useful next step is a measured standing film and a look at any older imaging. Dr. Justin Dick can do both at our Charlotte office.

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