One shoulder higher than the other, an uneven waistline, a shoulder blade that sticks out — scoliosis is often spotted in a photograph or at a routine check rather than through pain. Mild curves rarely hurt, which is why they go unnoticed for years. The good news: caught in time, scoliosis can be kept under control, and in adults pain and function improve considerably with the right physiotherapy.
What is scoliosis?
Scoliosis is a sideways curvature of the spine, shaped like a C or an S, usually with rotation of the vertebrae. It appears most often in childhood and adolescence, but also in adults through degeneration. It differs from postural scoliosis — a flexible curve without vertebral rotation, caused by posture, a leg-length difference or muscle tightness — which responds best of all to physiotherapy.
Common symptoms
Uneven shoulders or a more prominent shoulder blade, an asymmetric waist, one hip sitting higher, the trunk leaning to one side. On bending forward, one side of the back appears raised. In children and adolescents scoliosis is usually painless — which is exactly why periodic postural checks matter. In adults it brings back pain, stiffness, one-sided muscle fatigue and sometimes pain travelling down the leg.
Types of scoliosis
By location: cervical, thoracic, lumbar or thoracolumbar. By direction of the curve: dextroconvex, with the apex to the right, or sinistroconvex, to the left — the term describes direction, not severity. By cause: idiopathic, with no identifiable cause and the most common form in adolescents, congenital, neuromuscular, or degenerative in adults.
Common causes and risk factors
In roughly 8 out of 10 adolescents no cause can be identified. Structural scoliosis is not caused by school bags, sport or sitting badly — those can produce postural curves at most. Family history and periods of rapid growth do matter, since a curve can progress within months. In adults, scoliosis develops through degeneration of the discs and facet joints, or continues from adolescence.
Diagnosis and grades
Diagnosis is clinical and radiological, using the Cobb angle: under 10 degrees is a postural curve; 10 to 25 degrees mild scoliosis; 25 to 40 moderate; above 40–45 degrees severe, with possible surgical indication. The grade, the age and the remaining growth potential decide the treatment — which is why a proper assessment matters far more than any universal exercise found online.
Can it be treated without surgery?
In the vast majority of cases, yes. In children and adolescents: periodic monitoring for small curves, specific physiotherapy, and bracing for moderate curves during growth — a brace halts progression, it does not permanently straighten the spine. Surgery is reserved for severe cases. In adults the realistic goal is not straightening the spine but reducing pain, halting progression and restoring function.
How we treat scoliosis at Medicine Park
We begin with a full postural assessment, then build an individual physiotherapy plan with goals set over 6–12 weeks: asymmetric corrective exercises chosen for your particular curve, active postural correction, corrective breathing, and strengthening of the paraspinal and core musculature. Physical therapy and manual therapy address the associated pain. Supervised sessions are paired with a home programme, and progress is checked at regular reassessments. For children we work alongside the orthopaedic consultant monitoring the curve radiologically.
Why personalised exercises matter
Effective scoliosis exercises are asymmetric — built as a mirror image of your own curve. The same exercises performed on the wrong side can make a curve worse. General strengthening does no harm, but it does not replace a corrective programme chosen after assessment and X-ray.
How long until results?
The first changes — less pain, better mobility — usually appear within 6–8 weeks of consistent work. Postural correction and strength build over 3–6 months, and in children and adolescents the programme continues throughout growth, with regular reassessment.
When to seek help
If you notice uneven shoulders or hips in your child, if a known curve seems to be increasing, or if your back aches constantly on one side, book a postural assessment. Your first assessment at Medicine Park is free.
