Scoliosis in Adults: Symptoms and Treatment Options

01Adult scoliosis

Adult scoliosis and spinal curvature

Cambridge University Hospitals (CUH) explains that adult spinal deformity refers to abnormal curvatures of the spine in people who have finished growing. The curve may have been present since childhood or may be the result of the aging process.

The NHS notes that back pain is one of the main problems caused by scoliosis in adults, so treatment is mainly aimed at relieving pain, and that if the condition is not severe and is not causing pain, treatment may not be needed. Scoliosis is not caused by “bad posture”, and having a curve does not by itself mean something needs to be done about it. Treatment in children is different and is covered separately by the NHS.

02Types

Persistent idiopathic versus degenerative scoliosis

CUH describes several types of adult scoliosis:

• Adult idiopathic scoliosis: a curve that began during the teenage years in an otherwise healthy person and continues to increase slowly during adult life. CUH notes that smaller adolescent curves are unlikely to progress much into adulthood, while larger ones are more likely to get bigger.
• Adult degenerative (“de novo”) scoliosis: a curve that begins in adulthood because of wear of the discs, arthritis of the small facet joints and collapse of the disc spaces, typically in the lower back.
• Post-surgical deformity: curves seen after previous spinal surgery.

Less common causes listed by CUH include osteoporosis (brittle bones), previous spinal fractures, spondylolisthesis (a slipped vertebra) and, rarely, infections or tumors of the spine. So adult scoliosis is not only degenerative: it may also be a curve that has been present since adolescence.

03Symptoms

Pain, posture and leg symptoms

Back pain is the main symptom that brings adults with scoliosis to treatment, according to the NHS. Scoliosis can also irritate or press on the nerves in and around the spine, causing pain, numbness and tingling that can be felt from the lower back down to the feet.

The NHS notes that a curve that is not severe and causes no pain may need no treatment at all, so the decision depends on symptoms and on whether the curve is changing, not only on how it looks. Our guide on a pinched nerve in the lower back explains nerve-related leg symptoms.

04Assessment

When changes need clinical assessment

It is worth seeing a GP or specialist if back pain is not controlled with simple measures, if pain, numbness or tingling spreads into the legs, or if you or others notice the curve changing. The NHS advises seeing a GP if over-the-counter painkillers do not work.

CUH explains that once a degenerative scoliosis is associated with nerve root compression or worsening back pain, symptoms are unlikely to resolve on their own and are likely to get worse with time. That does not mean surgery is automatic, but it does mean these changes should be reassessed. Sudden weakness in the legs or problems controlling the bladder or bowel need urgent medical attention rather than a routine appointment.

05Examination

Examination and selected imaging

The sources used here do not describe a standard set of tests for every adult with scoliosis. Assessment starts with your symptoms and an examination by a GP, physiotherapist or specialist, and CUH mentions X-rays of the spine to plan treatment.

Further tests are used for specific questions. CUH lists, for people being considered for surgery, MRI to look at the nerves and spinal canal, lung function tests, an anesthetic risk assessment and a DEXA scan to assess bone density. Not every adult with scoliosis needs these tests; they are part of planning when surgery is being considered.

06Goals

Goals of conservative treatment

Most adults with scoliosis will not need surgery, the NHS explains. Non-surgical (conservative) treatment aims to relieve pain, keep you active and maintain function, rather than to straighten the spine. CUH agrees that all reasonable non-surgical measures should be tried first.

Setting clear, practical goals helps: for example, walking a certain distance, standing long enough to cook a meal, sleeping better or returning to a sport. Recording these goals and how they change over time gives you and your clinician a useful way to judge whether treatment is working.

07Exercise

Activity and physiotherapy for function

The NHS says activities that strengthen and stretch the back may help reduce pain, and exercise can help maintain a healthy weight, reducing strain on the back. The type of exercise matters less than keeping the back moving, so choose something you enjoy and can keep doing.

Some people benefit from back exercises taught by a physiotherapist. The NHS is clear that these are unlikely to improve the curvature of the spine, but they may help with pain. It advises speaking to a GP, scoliosis specialist or physiotherapist before starting a new exercise program. Our guide on scoliosis exercises covers examples. In our physiotherapy practice in Bilbao we offer individual rehabilitation for adults after assessment (consultations are in Spanish).

08Other treatments

Selected medicines, injections and braces

The NHS explains that anti-inflammatory painkillers (NSAIDs) are usually the first medicines recommended, but they are not suitable for everyone, so check the leaflet or ask a pharmacist. If over-the-counter painkillers do not help, a GP may prescribe stronger ones or refer you to a pain management clinic.

When scoliosis irritates nerves and causes pain, numbness or tingling, steroid and local anesthetic injections into the back may help, although the NHS notes that the benefit usually lasts only weeks or months. Back braces are not often used in adults, but they can relieve pain by supporting the spine and may be considered for people who are not well enough for an operation.

09Sources

Where the sources differ

The NHS page covers all treatment options for adults, while the CUH leaflet focuses on surgery in carefully selected patients. Points of difference:

• Age of the information. The NHS page was last reviewed in April 2023 and was due for review in April 2026; the CUH leaflet was approved in September 2025.
• Surgery. The NHS says surgery may be considered if the curve is severe or getting significantly worse, if severe back pain has not improved with other treatments, or if nerves are being irritated or squashed. It describes lumbar decompression and spinal fusion. CUH explains that surgeons tailor the operation to each person and may combine fusion with screws and rods, decompression of nerves and, in some cases, cutting and realigning the spine.
• Outcomes and risks. CUH gives figures for satisfaction and complications from its own service; the NHS lists risks such as failure to relieve pain, infection, blood clots and, rarely, nerve damage. These figures cannot predict an individual result, which is discussed with the surgical team.
• Recovery. The NHS says full recovery may take a year or more; CUH describes a staged return to activity over months. Plans vary between patients.

10Summary

In summary

Scoliosis in adults may be a curve that began in adolescence or a degenerative curve that develops later, usually in the lower back. Back pain is the main problem, and nerve irritation can cause pain, numbness or tingling in the legs. A mild, painless curve may need no treatment.

Most adults are treated without surgery: regular exercise, physiotherapy for pain and function, pain relief, and sometimes injections or a brace. Exercises help pain but are unlikely to straighten the spine. Surgery is a major operation considered for severe or worsening curves, persistent severe pain or nerve compression, after non-surgical measures. Keep a record of your goals and symptoms, and seek review if leg symptoms or pain worsen.