Write an article based on this "Look for uneven shoulders. Watch for a head that's not centered. Assess the symmetry of your hips / pelvis. Consider your history of skin changes. Be alert to constant (chronic) spinal pain."

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There are several physical signs that may indicate the presence of scoliosis. Because most cases of scoliosis affect the mid-to-upper back (called the thoracic spine), uneven shoulder levels is a common sign. Look in the mirror with your shirt off, relax your arms, and see if your shoulders are uneven.  "Humping" of shoulders blades (one that sticks out more) is also common with thoracic scoliosis. Bend over at the waist with your shirt off and ask a friend or family member to see if one shoulder blade sticks up more. Your ribs may also be distorted due to scoliosis, which can cause your shoulder blades to become distorted as well. Keep in mind that uneven shoulders are also common in certain types of athletes who use primarily one arm all the time, such as tennis players and baseball pitchers. In addition to uneven shoulders, watch for other signs of asymmetry in your body, such as your head being a little off center from your torso or pelvis. Both thoracic and lumbar (lower back) scoliosis causes a crooked posture that can often be seen in how the head is positioned over the rest of the body.  Due to input from the visual center of your brain, your head will normally be completely level, so if it looks like you're leaning to one side or crooked, the problem likely exists in your body (typically your spine). Stand away from the mirror and have a friend or family member take a picture of you in a bathing suit. Look at the picture for any signs of leaning or asymmetry in relation to your head. Scoliosis in the lower thoracic or lumbar regions of the spine invariably affect the balance and symmetry of your pelvis. One side will be raised and look unusually high, which makes your waist uneven. Stand in front of a mirror with just pants or shorts on. Position your hands above your waist on the sides of your hip bones (iliac crests) and see if they are uneven.  Although a crooked upper back with uneven shoulders can often be hidden with clothing, an uneven pelvis/hips is often obvious to onlookers, who might bring your attention to it. An uneven waistline affects how pants sit on your hips, which affects the relative leg lengths of the pants. Thus, people with scoliosis often notice that one pant leg is shorter than the other. Some people even notice that one leg looks longer than the other. Although skin changes don't happen in every case of scoliosis, some people experience skin changes early on in life and then develop scoliosis later on. If the appearance or texture of your skin overlying your spine develops dimples, hairy patches, rough spots and/or color abnormalities, these may be signs of dysraphism, or abnormal development of the spinal cord and nervous system. However, these skin changes usually happen early in life and lead to scoliosis at a young age.  Ask your spouse or friend to examine the skin of your back closely under good light. Have them take a high resolution picture and look at or show it to a dermatologist for a professional opinion. Other causes of similar skin changes on the back can include inflammatory arthritis, an underlying infection, skin cancer from too much sun and hormonal changes. Most people who develop idiopathic scoliosis, which means from unknown cause, don't feel much or any pain associated from the condition. However, between 20-25% of people with idiopathic scoliosis do feel pain, which is often described as a constant ache throughout the day punctuated by bouts of sharp pain with vigorous movements.  Upper or lower back pain that doesn't get better or fade away within a week should be looked at by a health professional. If you also have any of the above-mentioned signs, then scoliosis is a possibility. Manual therapy (chiropractic, physiotherapy, massage) does not make a significant long-term impact on back pain caused by scoliosis. Adult scoliosis caused by degenerative arthritis, tumors, spinal trauma and/or muscular diseases have a much greater incidence of pain compared to idiopathic scoliosis that starts during adolescence.