Last reviewed: September 29, 2026

A brace can help. Chiropractic care and massage have not been shown to change the curve.

Treatment depends on the size of the curve and how much growing is left. According to the American Academy of Orthopaedic Surgeons, curves under 25 degrees are usually watched, and a brace is considered for curves of 25 to 45 degrees in a child who is still growing. Curves over 50 degrees tend to keep getting worse even after growth ends, so the goal of a brace is to keep the curve below that.

Age alone does not tell how much growth is left. Doctors combine age, sex, height and, in girls, when periods began. They also use X-rays. On a spine X-ray, the growth plate along the top of the pelvis slowly turns to bone as growth ends, which doctors call the Risser sign. An X-ray of the hand is also used to judge where a child is in the growth spurt. Bracing is usually started while the pelvic growth plate is still early and, in girls, less than a year after the first period.

The strongest evidence is for bracing. In a trial of teenagers with curves at high risk of getting worse, 75% of those assigned to a brace finished growing without reaching 50 degrees, compared with 42% of those who were only watched. The trial was stopped early because the brace worked so well.

There are two kinds of brace. A full-time brace is usually prescribed for 20 to 24 hours a day. A night-time brace is worn only during sleep, for 8 to 12 hours. The trial above used full-time braces prescribed for at least 18 hours a day, and more hours of wear meant better results.

In real life, many teenagers do not wear the brace as long as they are told. It can be uncomfortable, they may feel self-conscious in it, and it gets in the way of sports. Studies that measured actual wear found many teenagers wore it far fewer hours than prescribed. This matters. In one study, the curve did not get worse in 82% of teenagers who wore the brace more than 12 hours a day, compared with 31% of those who wore it less than 7 hours. Those who wore it less also needed surgery more often.

Night-time braces are an option for some curves. A review suggested they may work about as well as full-time braces for mild to moderate curves and are easier to wear, but they may not be enough for larger curves or during fast growth. The evidence is limited, and a large trial comparing the two is under way.

Reviews of chiropractic spinal manipulation found only a few small, low-quality trials and no good evidence that it changes the curve. Massage has not been shown to change it either.

In general:

  • Ask your child’s doctor how large the curve is and how much growth is left.
  • If a brace is prescribed, ask exactly how many hours a day it should be worn.
  • Talk openly with your teenager about how many hours the brace is really worn, and tell the doctor.
  • Ask whether a night-time brace is an option for your child’s curve.
  • Whatever else you try, keep regular visits with the doctor who measures the curve.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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