Where scoliosis in adults comes from
In adults we see two main types of scoliosis. The first is idiopathic scoliosis, which developed in childhood or adolescence and remained once growth had finished. The second is degenerative scoliosis, which usually appears after the age of 50, when the intervertebral discs and facet joints wear unevenly and the spine gradually bends to one side – most often in the lumbar region.
Having a curve does not in itself mean it has to hurt. Many people with scoliosis go through their whole lives without major symptoms. Pain is more common with larger curves, with degenerative scoliosis, and when narrowing of the spinal canal is added to the changes – we cover this in more detail on the page about spinal osteoarthritis.
What you can realistically expect from physiotherapy
To be honest: in an adult, physiotherapy will not straighten the spine. Neither exercise nor manual therapy will reverse an established curve, and promises of “straightening” scoliosis in adults have no support in research. The aim of therapy is something else: less pain, better muscle endurance, freer movement and confidence in everyday activities.
Among the methods, it is worth mentioning scoliosis-specific exercise, such as the Schroth method. It combines active correction of trunk position with targeted breathing. It has been studied best in adolescents who are still growing. In adults the evidence is limited, although some people feel less pain and better postural control after it. Its principles – conscious positioning of the trunk and working with the breath – can be one element of the plan, but they do not solve every problem.
What treatment at our practice looks like
At the first visit we assess the shape of the curve, the mobility of the trunk, hips and rib cage, muscle strength, and sensation and reflexes in the legs. We ask when the pain appears and whether the curve has been monitored before. If you have a standing X-ray of the whole spine, bring it with you.
We start by reducing the symptoms – manual therapy, work on tight muscles and finding more comfortable positions. Then we move on to medical training: strengthening the trunk, glutes and legs, with breathing and balance exercises. We increase the load gradually, watching how you respond.
We do not look for perfectly symmetrical exercises, nor do we forbid movements “in the wrong direction”. A spine with scoliosis needs movement in all directions, and we use one-sided exercises where the assessment shows a clear difference in strength or mobility. Changing everyday habits also makes a big difference: changing position more often at work, breaks from long periods of standing and a regular walk. Improvement in pain and function is usually visible after a few weeks, while consolidating the results takes several months of regular exercise.
When you need an orthopaedic specialist
Physiotherapy does not replace medical monitoring. It is worth seeing an orthopaedic specialist when the curve is clearly increasing, your posture is changing, or numbness, leg weakness or difficulty walking appear. The orthopaedic specialist assesses the angle of the curve on the X-ray and decides on further investigations and how often you should be checked. In a small proportion of people with a large, progressive curve or neurological symptoms, surgical treatment is considered. If you want to find out what can be done with movement in your situation, you can arrange an appointment via the Contact page.