This page is about scoliosis in adults. Maybe a doctor pointed out a curve when you were a teenager and it never went away, or an X-ray for back pain in your 50s or 60s showed a curve no one had mentioned before. Either way, scoliosis physical therapy for adults at Lake Erie Physical Therapy in Buffalo has a clear purpose: easing pain, helping you stand and walk for longer, and building strength you can keep. It doesn’t straighten the spine, and we won’t suggest it can.
About children and teens: a child or teen with scoliosis should be followed by their pediatrician or a pediatric orthopedic specialist, who decides on monitoring, bracing or surgery while the spine is still growing. We do treat children and teens for orthopedic problems, so call us to talk through whether physical therapy fits alongside that plan.
How adults end up with a curve
Cleveland Clinic describes scoliosis as a side-to-side curve of the spine. In adults, it usually follows one of two paths:
- A curve from earlier in life. Some adults have had a mild, undiagnosed curve all along, noticed only on an X-ray taken for something else. A curve diagnosed after age 18, once growth is complete, is called adult idiopathic scoliosis.
- A curve that develops with age. Adult-onset, or degenerative, scoliosis happens when the discs and joints weaken or you lose bone density, according to Cleveland Clinic. In adults, the main concern is the lower (lumbar) spine.
Because bone density is part of that picture, our page on osteoporosis and bone health may also be useful.
Is the curve causing your pain?
Not always. In its answers about adult life with scoliosis, the American Academy of Orthopaedic Surgeons (AAOS) notes that people with curves under 30 degrees generally have the same risk of back pain as people without scoliosis, while people with untreated curves over 50 to 60 degrees are more likely to develop back pain, particularly in the lower back.
Cleveland Clinic lists back pain, difficulty standing upright, core muscle weakness, leg pain, numbness or weakness, and constantly leaning to one side among possible symptoms, along with height loss over time. If standing or walking brings on leg symptoms that ease when you sit or lean forward, the pattern may point to spinal stenosis, which we cover on our herniated disc and stenosis page. So the first question isn’t how big the curve is. It’s what is actually driving your symptoms.
When a physician should see you first
Physical therapy does not replace a medical diagnosis. Get medical care before starting therapy if:
- You have trouble breathing. Cleveland Clinic advises contacting emergency services.
- You notice bladder or bowel changes, or new weakness in your legs. Cleveland Clinic lists bowel, bladder or motor symptoms as possible signs of more serious nerve damage or pressure. Loss of bladder or bowel control, or numbness in the groin or inner thighs, needs an emergency department.
- Your curve, lean or height seems to be changing quickly. Your physician should re-check it.
- Back pain started suddenly after a minor fall or strain, especially with low bone density, since it may be a spine fracture.
- Pain comes with fever, unexplained weight loss or a history of cancer, or no position eases it, including at night.
What scoliosis treatment in adults can and can’t do
Cleveland Clinic is clear that treatment focuses on relieving symptoms and not necessarily straightening the curve, and it lists physical therapy and exercise to strengthen your core and improve flexibility among the nonsurgical options. AAOS, in guidance written for families, notes there is no evidence in the medical literature that physical therapy and similar treatments have a long-term effect on scoliosis curves; bracing and surgery are the only treatments shown to affect idiopathic scoliosis. And as the American Physical Therapy Association’s ChoosePT site puts it, you can’t correct scoliosis by “standing up straight.”
That leaves the goals that matter day to day. ChoosePT describes the main goals of physical therapy for scoliosis as managing symptoms and improving your ability to move and function.
Scoliosis physical therapy at Lake Erie PT
The evaluation
Your first visit is one-on-one. Bring your X-ray reports, which often list the size of the curve in degrees; Cleveland Clinic notes that X-rays taken from the front and side give a full picture of the spine. We’ll ask where you hurt, what standing, walking, sitting and lying down do to it, and what you’ve stopped doing because of it.
Then we test how your back and leg symptoms respond to repeated movements and sustained positions, using the McKenzie Method of Mechanical Diagnosis and Therapy (MDT). A curve doesn’t rule out a back problem that responds to a specific direction of movement, and finding one gives you a tool to use on your own. Dr. Will Tso, PT, DPT, Cert. MDT, is certified in Mechanical Diagnosis and Therapy, and Dr. Ryan Mitchell, PT, DPT, primarily uses the McKenzie Method in his orthopedic practice; read more about how a McKenzie evaluation works. We also check trunk and hip strength, balance and how far you can comfortably walk.
The plan
- Strength and endurance for your trunk and hips, progressed as you tolerate it
- Flexibility work for areas that have stiffened, chosen so it doesn’t stir up your symptoms
- Positions and pacing for standing at the counter, walking errands and sleeping
- Hands-on manual therapy when it helps you move, and pain-relieving modalities when indicated
- Posture education that fits the shape of your spine rather than an idealized one (see our page on posture)
- A home program you can keep doing after discharge
We’ll estimate how many visits make sense after your first appointment and adjust as you respond.
About the Schroth method
Schroth is a scoliosis-specific exercise approach taught by specially trained therapists. In its guidance for families, AAOS notes that scoliosis-specific exercises may be useful together with bracing and are still being studied. Our adult scoliosis care is built on the orthopedic evaluation, McKenzie testing, strengthening and hands-on treatment described above. If a Schroth program is specifically what you’re after, call us before booking and ask, so we can tell you whether we’re the right fit.
Before your first visit
With most plans, New York’s direct access law lets you start physical therapy without a referral for up to 10 visits or 30 days, whichever comes first, though some insurers still require one to pay. Medicare doesn’t require a referral to start; your physician (or nurse practitioner or physician assistant) certifies the plan of care we write. Wear clothing that lets us see your back move.
If a curve is making it harder to stand, walk or sleep, call (716) 332-4838 or schedule a visit online. We’re on Virginia Street, between Allentown and the Buffalo Niagara Medical Campus.
Sources
- Scoliosis, Cleveland Clinic
- Scoliosis Overview, OrthoInfo, American Academy of Orthopaedic Surgeons
- Physical Therapy Guide to Scoliosis, ChoosePT (American Physical Therapy Association)