Pregnant With Scoliosis: What the Evidence Shows About Curve Progression, Back Pain, and Delivery

By Dr. Justin Dick, DC · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published October 14, 2026

Most women with idiopathic scoliosis carry and deliver without scoliosis-specific complications. Pregnancy has not been shown to consistently accelerate curve progression. Back pain is more common, especially when a fusion extends low into the lumbar spine, and anesthesia planning takes more forethought after spinal instrumentation.

I am Dr. Justin Dick, and I care for women with scoliosis before, during, and after pregnancy at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. The questions I hear are consistent: will pregnancy make my curve worse, will my back pain be unbearable, and can I have an epidural. This post addresses the first two. The epidural question has its own post on epidurals and scoliosis.

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What Pregnancy Does to the Spine

Pregnancy changes spinal loading in predictable ways. Ligamentous laxity increases, lumbar lordosis and pelvic tilt change as the center of mass moves forward, and body weight rises over months. The 2025 review by Serhan and colleagues in JBJS summarizes these changes. For a spine that is already asymmetric, those loads land unevenly, which is the mechanical basis for the concern about progression and pain.

Does Pregnancy Make Scoliosis Worse?

The evidence says not consistently, and the details matter.

Singh and colleagues published a 2024 meta-analysis of 10 studies and 857 pregnant patients with adolescent idiopathic scoliosis. Mean curves increased from 33.9° before pregnancy to 38.5° after, with a pooled progression of 3.6°. Most of that came from patients without fusion, whose curves increased by about 5.0°. Five of the included studies found that pregnancy and the number of pregnancies were not associated with progression, and the authors concluded the change may reflect the passage of time, independent of pregnancy. A 5° change also sits close to the measurement error of the Cobb method, which I discussed in my post on scoliosis misdiagnosis and measurement error.

The 2023 scoping review by Theroux and colleagues, covering 50 studies, reached a similar conclusion: progression occurs in some but not all patients during pregnancy, regardless of the treatment they received. For women with modern pedicle screw fusions, Grabala and colleagues compared 62 women who became pregnant with 66 who did not and found no difference in loss of correction, 3.5° against 4.5°.

My clinical read: a woman with an unfused curve that was stable at skeletal maturity should not expect pregnancy alone to change its course dramatically. A woman whose curve was already progressing in adulthood, or whose curve was large at maturity, deserves closer follow-up before and after pregnancy.

Back Pain During Pregnancy With Scoliosis

Back pain is the most consistent finding. In the Singh meta-analysis, 45.9 percent of patients reported increased low back pain. The Theroux review associated pregnancy back pain in scoliosis with the size of the major curve and with reduced lumbar lordosis. The Serhan review found that women whose fusion ended at L3 or lower had a higher risk of low back pain during pregnancy, which makes mechanical sense: fewer mobile lumbar segments are left to absorb the postural changes.

Back pain in pregnancy is common in women without scoliosis too, so not every ache traces to the curve. What I look for is pain that follows the curve's mechanics, such as pain at the apex or junction of the curve, or at the segments just below a fusion.

Delivery

The Theroux review found cesarean section rates in women with scoliosis similar to controls and to national averages. A 2024 literature review by Grabala and colleagues reported that women with a prior fusion undergo cesarean section more often than healthy women, so the data is not fully consistent. Delivery mode is an obstetric decision. What I can contribute is accurate documentation of the curve and any instrumentation, so the obstetric and anesthesia teams have it before labor.

How Dr. Justin Dick Cares for Pregnant Patients With Scoliosis at Clear Life

Radiographs are generally deferred during pregnancy, so the most useful imaging is the baseline taken before conception and the follow-up after delivery. If you are planning a pregnancy, a pre-pregnancy standing study gives you and your providers a clean comparison point. During pregnancy, care at our Charlotte office is directed at mechanical pain and function, with positioning and techniques adapted to each trimester, and in coordination with the patient's obstetric provider. After delivery and once nursing and recovery allow, a follow-up study answers the progression question with measured numbers. Our adult scoliosis page and care after spinal fusion page cover the broader plan.

Comparison

Research and Evidence

Evidence tiering: the pregnancy and scoliosis literature is mostly retrospective and heterogeneous. The Singh meta-analysis is the highest level available and still depends on studies with different populations, curve types, and fusion techniques. The Theroux review explicitly calls for prospective longitudinal research. None of these studies tested conservative care during pregnancy, so any treatment approach in pregnancy rests on clinical reasoning and safety, not trial data.

My published work does not include pregnant patients. The most relevant paper is 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), which looks at how compensatory loading through the pelvis and lower extremities relates to pain in adults with long-standing scoliosis. Pregnancy is a temporary version of that same compensatory loading problem.

References

1. Serhan KA, Abraham VM, Shirley ED. The impact of adolescent idiopathic scoliosis on pregnancy. J Bone Joint Surg Am. 2025;107(7):771-777. doi:10.2106/JBJS.24.00850
2. Singh M, Yan Z, Daher M, et al. Curve progression and clinical outcomes in pregnant females with adolescent idiopathic scoliosis: a systematic review and meta-analysis. World Neurosurg. 2024;190:e525-e536. doi:10.1016/j.wneu.2024.07.165
3. Theroux J, Brown BT, Marchese R, et al. The impact of pregnancy on women with adolescent idiopathic scoliosis: a scoping review. Eur J Phys Rehabil Med. 2023;59(4):505-521. doi:10.23736/S1973-9087.23.08086-3
4. Grabala P, Helenius I, Shah SA, et al. Impact of pregnancy on loss of deformity correction after pedicle screw instrumentation for adolescent idiopathic scoliosis. World Neurosurg. 2020;139:e121-e126. doi:10.1016/j.wneu.2020.03.142
5. Grabala P, Kowalski P, Grabala M. From rib hump to baby hump: common questions of patients suffering from and undergoing treatment for scoliosis. A comprehensive literature review. J Clin Med. 2024;13(13):3814. doi:10.3390/jcm13133814
6. 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

• Adult Scoliosis
• Adult Scoliosis Treatment
• Scoliosis Care After Spinal Fusion
• Adult Scoliosis and Curve Severity
• Scoliosis Progression and Compensation
• Cobb Angle Explained
• Kinetic Chain Dysfunction in Scoliosis
• Scoliosis FAQ
• Treatment Options
• Dr. Justin Dick Research

Schedule an Evaluation in Charlotte

If you have scoliosis and are pregnant or planning a pregnancy, a baseline evaluation now makes every later decision easier. Dr. Justin Dick sees patients at our Charlotte office and works alongside your obstetric team.

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