Scoliosis in Adults: Symptoms and Treatment
· Scoliosis & Schroth Therapy
When scoliosis is mentioned, most people think of childhood and adolescence. Yet scoliosis is not limited to the growth years; it is also seen in adulthood. Sometimes it is a curvature that began in childhood and carried into adult life; sometimes it is a new curvature that develops at an older age, linked to wear in the spine.
The two types of adult scoliosis
In adults, scoliosis essentially appears in two forms, and the approach is shaped by this distinction:
- Adult idiopathic scoliosis: A curvature that began in childhood or adolescence and has continued into adulthood. The person may have received a diagnosis years earlier, or the curvature may have been noticed for the first time in adulthood.
- Degenerative (age-related) scoliosis: A curvature that develops in adulthood, linked to the asymmetric, age-related wear of the discs, facet joints and supporting tissues. It is a progressive condition and one of the significant causes of pain, restricted movement and reduced quality of life at an older age.
What both types have in common is that they are three-dimensional spinal curvatures and require individual assessment.
Symptoms in adults
In children, scoliosis is usually painless and is noticed mostly through postural asymmetry. In adults, the symptoms are generally more pronounced:
- Pain in the lower back and back
- Stiffness that increases in the morning or after standing for long periods
- A change in posture; asymmetry of the shoulders, waist or trunk
- Difficulty walking long distances, pain radiating into the leg
- A sense of losing height over time
Particularly in degenerative scoliosis, pain and postural changes accompany the deterioration in spinal alignment and increasing imbalance.
Does the curvature progress in adulthood?
This is one of the most frequently asked questions, and the answer depends on the degree of the curvature. In people who have completed skeletal development, curves below 30 degrees are generally considered stable. Curves above 30 degrees, however, may tend to progress over time, at around 1 degree per year. Long-term follow-up studies have shown that a significant proportion of curves can progress to some extent after skeletal maturity.
The core message is this: in adulthood too, a curvature should not be left as a static picture — it should be followed with regular monitoring. We covered how the degree of the curvature is measured in our article on scoliosis degrees and the Cobb angle.
Treatment goals: how adults differ from children
The approach to adult scoliosis differs from children and adolescents on one important point. In a growing child, the priority is to slow the progression of the curvature and, in appropriate cases, to work towards reducing the degree of the curve. In adults, because growth is complete, the process proceeds in this order:
- Pain and function first: In adults, scoliosis usually presents with pain, stiffness and restricted movement. The priority is reducing pain and supporting daily function, drawing on manual therapy where needed.
- Then posture, balance and alignment: Once pain is managed, the work focuses on posture, trunk balance and spinal alignment.
- Monitoring in follow-up: Changes in the curvature and functional status are evaluated over time with regular reviews.
In adults, the real goal is usually not reversing the curvature, but maintaining a pain-free, functional life of good quality — preserving the current state and improving it where possible.
The role of Schroth therapy in adults
Schroth therapy is a scoliosis-specific, three-dimensional exercise approach. In adults, the focus is on reducing pain, easing stiffness, supporting posture and trunk symmetry, and building posture awareness. Scientific studies show that scoliosis-specific exercises in adults can contribute to reducing pain and stiffness, improving posture and maintaining daily activities.¹ There are also long-term studies showing that these exercises can reduce the progression of advanced curves in adult idiopathic scoliosis.²
To be honest about the framework: in adult scoliosis, the evidence on the effect of conservative treatment on the degree of the curvature is more limited than in growing children. The realistic goals in adults are therefore managing pain, maintaining function and quality of life, and improving posture and balance. At our clinic, this process is carried out with an ISST Schroth-based, individualised programme. For details of the method, see our article What is Schroth therapy?.
When to see a physician — and when does surgery come up?
In adult scoliosis, surgery is considered only in certain situations, and the decision rests with a physician: an advanced curvature, progressive spinal imbalance, severe pain that does not settle with conservative methods, or leg symptoms linked to nerve compression. That said, surgery is relatively uncommon in adults; for most people, the priority is managing pain and maintaining function with non-surgical approaches. Where surgery is needed, physiotherapy is an important part of recovery afterwards.
Why early assessment matters
Time is valuable in adulthood too. When pain and postural changes are noticed early and managed well, quality of life is preserved and the process has a better chance of progressing smoothly. If you notice ongoing lower back or back pain, marked asymmetry in posture or difficulty walking, it is important to arrange a physician’s evaluation, followed by physiotherapy-based planning and follow-up.
At our clinic in Beşiktaş, adult scoliosis care is built on detailed assessment, individualised planning and regular monitoring. You are welcome to contact us for an assessment.
Sources
- Adult degenerative scoliosis: challenges in diagnosis, pain management, and surgical decision-making. Frontiers in Surgery, 2026.
- Scoliosis-specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study. Scoliosis, 2015.
- Idiopathic Scoliosis. Deutsches Ärzteblatt International. (The 30° threshold at skeletal maturity and the rate of progression.)