Scoliosis (Adolescent and Adult)

Overview

Scoliosis is a sideways curve of the spine, usually with some twisting, so that one shoulder, shoulder blade or side of the waist can look higher or more prominent than the other. Many curves are mild and cause no pain at all; others are linked with back ache, stiffness or muscle tiredness after standing or sitting for long periods.

There are two common types. Adolescent idiopathic scoliosis appears during the growth spurt, most often between about 10 and 16, and has no single known cause. Because a curve can change while a young person is still growing, it needs monitoring by a GP or specialist, who measures it on X-ray and decides whether bracing or further review is needed. Adult (degenerative) scoliosis develops later in life as the discs and joints wear unevenly, and may come with stiffness, back pain or leg symptoms.

Physiotherapy cannot straighten or correct the curve. What it aims to do is support comfort, strength, flexibility, function and confidence, and help you stay active alongside any medical monitoring you need.

Causes and risk factors

• A family history of scoliosis
• The adolescent growth spurt, when most curves are first noticed
• Girls are more likely than boys to have curves that need monitoring
• Age-related wear of the discs and facet joints (adult degenerative scoliosis)
• Osteoporosis or previous spinal fractures in older adults
• A leg-length difference or muscle spasm causing a temporary "functional" curve
• Less commonly, conditions present from birth or neuromuscular conditions, which are managed by specialist teams

How we may be able to help

We start with a thorough assessment: your history, any previous X-rays or specialist letters, how you stand and move, spinal flexibility, strength and, where relevant, a check of the nerves to the legs. If you or your child have not yet been assessed medically, or a curve seems to be changing, we will advise you to see your GP or can arrange an online private GP consultation for an X-ray or specialist referral. Measuring the curve and decisions about bracing or surgery are made by the specialist, not by us.

Physiotherapy focuses on exercises to build strength and endurance in the trunk and hips, improve breathing and flexibility, and make everyday activities and sport more comfortable. Our chiropractor may use gentle mobilisation and soft-tissue techniques for stiff or sore areas to help with comfort; this does not change the curve itself. Kinesiology taping can be used as a short-term comfort aid.

A 3D posture scan can show asymmetry of the shoulders, trunk and pelvis and help track your posture over time. It is a useful guide for exercise, but it does not replace an X-ray and cannot measure the curve the way a specialist does.

What you can do at home

• Stay active; walking, swimming and most sports are usually encouraged
• Do your prescribed exercises regularly — consistency matters more than intensity
• Break up long periods of sitting or standing with short movement breaks
• Use heat on sore, tight muscles for 15 minutes when needed
• Keep all monitoring and X-ray reviews your GP or specialist recommends
• Tell your GP if you notice the curve, shoulder height or waist shape changing