Most people think scoliosis is a kid’s problem. Doctors screen for it in middle school. Teenagers get fitted for braces. Then it gets forgotten.
But scoliosis does not always go away. For many adults, the curve found at age 12 keeps changing quietly over time. For others, a new curve develops after age 40, caused by decades of wear on the spine’s joints and discs. This type is called degenerative scoliosis, and it is far more common than most people realize.
June is Scoliosis Awareness Month. It is a good time to look at what research tells us about adult scoliosis, why it sometimes causes pain, and what treatment options are actually backed by evidence.
Can Scoliosis Get Worse in Adults?
Yes. Spinal curves can progress over time in adults, even after the teenage growth spurt ends. A 2024 review in EFORT Open Reviews found that adults who had scoliosis as teenagers face ongoing risks including continued curve progression, chronic back pain, and reduced lung function as they get older. [1]
The most common form that develops in adulthood is degenerative scoliosis. It appears gradually, usually in people over 50, as the discs and joints of the spine wear down unevenly on one side. Research estimates that curves greater than 20 degrees affect up to 24% of the older adult population. [2]
Does Scoliosis Always Cause Back Pain?
Not always. Some adults live with a spinal curve and feel nothing unusual. But when pain does occur, a 2024 study in the Journal of Orthopaedic Surgery and Research found that pain levels are closely tied to how severe the curve is, how mobile the spine is, and how much visible asymmetry is present. [3]
The pain tends to show up in the lower back. It can also cause leg pain that resembles sciatica, because the curved spine can press on nearby nerve roots. Muscle tightness and fatigue on one side of the back are also common.
How Is Adult Scoliosis Treated Without Surgery?
Most adults with scoliosis do not need surgery. A 2024 prospective cohort study in BMC Musculoskeletal Disorders found that a combination of exercise, manual therapy, and physical rehabilitation helped adults with degenerative scoliosis meaningfully reduce pain and improve daily function. [4]
The exercises most supported by evidence are called physiotherapeutic scoliosis-specific exercises (PSSE), which includes the well-known Schroth method. These teach the body to activate certain muscle groups to counteract the pull of the curve. A 2024 systematic review and meta-analysis in Frontiers in Sports and Active Living confirmed that exercise-based care significantly improved both curve measurements and pain outcomes. [5]
Other non-surgical options include:
- Physical therapy to strengthen the core and improve posture
- Spinal adjustments from a chiropractor to reduce stiffness and improve range of motion (learn about chiropractic care for back pain)
- Anti-inflammatory medications during pain flares
- Bracing in select cases, which is more common in younger patients
When Should You See a Doctor About Scoliosis?
Get evaluated if you notice one shoulder sitting higher than the other, a visible curve in your upper or lower back, persistent one-sided back pain, or pain that travels down one leg. A simple X-ray gives a clear picture of the spine and can confirm whether a curve is present and how significant it is.
Scoliosis care works best when it is identified before the curve progresses significantly. For adults who already have a diagnosis, regular monitoring and consistent spinal care can help slow progression and manage symptoms over the long term.
The Bottom Line
Adult scoliosis is more common than most people realize, and it does not always stay the same. Degenerative scoliosis tends to worsen gradually without care, particularly in adults over 50. The curve itself may be silent for years before symptoms appear.
The good news is that most adults do not need surgery. Exercise, manual therapy, and routine spinal monitoring all have solid research support. If you have been told you have a curved spine, or suspect that you might, this month is a good time to look into your options and speak with a healthcare provider about next steps.
Sources & Further Reading
- Konieczny MR, et al. “Adolescent idiopathic scoliosis in adulthood.” EFORT Open Reviews. 2024;9(7). https://eor.bioscientifica.com/view/journals/eor/9/7/EOR-23-0162.xml
- Prevalence data cited in: Jaber S, et al. “Determination of predictors associated with pain in non-surgically treated adults with idiopathic scoliosis.” J Orthop Surg Res. 2024. PMC11253333.
- Jaber S, et al. “Determination of predictors associated with pain in non-surgically treated adults with idiopathic scoliosis.” Journal of Orthopaedic Surgery and Research. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11253333/
- Conservative Treatment in Adult Degenerative Scoliosis: A Prospective Cohort Study. BMC Musculoskeletal Disorders. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11079735/
- “Treatment of idiopathic scoliosis with conservative methods based on exercises: a systematic review and meta-analysis.” Frontiers in Sports and Active Living. 2024. https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2024.1492241/full
