Scoliosis in adults is common, especially after 60, and most adults with it NEVER need surgery. Many people with a mild curve have no pain at all and only find out from an X-ray taken for something else.
When adult scoliosis hurts, the pain usually comes from worn joints and squeezed nerves, not the curve itself. That’s why exercise, pain relief and sometimes injections help most people.
Surgery is a BIG operation. It’s kept for people whose pain, leg symptoms or posture seriously limit their life despite good nonsurgical care.
Two kinds of adult scoliosis
- Lifelong scoliosis: a curve that started in childhood or the teens, usually with no known cause. Most stay stable after growth ends. Larger curves, over about 50 degrees, are more likely to keep slowly increasing through adult life
- Degenerative scoliosis: a new curve that develops after about 50 as discs and joints wear unevenly. It’s usually in the lower back. See degenerative disc disease
- How it’s measured: the curve is measured in degrees on an X-ray. Anything over 10 degrees counts as scoliosis
Symptoms
- Back ache and stiffness that comes and goes, often worse after standing for a while
- Leg pain, numbness or heaviness when walking, eased by sitting or leaning forward on a shopping cart. This is narrowing around the nerves, called spinal stenosis
- Posture changes: leaning forward or to one side, an uneven waist, clothes hanging differently, or losing height
- Tiring when standing upright, because the back muscles work hard to hold you up
- A vertebra shifting over the one below it can happen alongside the curve. This is called spondylolisthesis
The curve on the X-ray isn’t the same thing as the pain in your back.
What helps
- Stay active. Walking, cycling and water exercise all count. If walking brings on leg pain, cycling is often easier because you lean forward
- Strength work: a physio-led program for the trunk, hips and legs. Exercise helps pain and function for many people. It won’t straighten an adult curve, and the evidence for special scoliosis exercise methods in adults is limited
- Pain relief: anti-inflammatories or other painkillers can help. Ask your doctor or pharmacist what suits you
- Injections: a steroid injection near a squeezed nerve can calm leg pain for a while
- Braces: they don’t correct an adult curve. They’re rarely used long term
- Bone health: your doctor may check for thinning bones, which matters for both fractures and any future surgery
The NHS overview of scoliosis notes that adults may need painkillers or spinal injections for pain, and only very occasionally surgery.
When surgery is considered
- Pain or leg symptoms that seriously limit your life after good nonsurgical care
- Nerve symptoms from stenosis. Sometimes a smaller operation to free the nerves is enough. See do I need back surgery?
- A curve that keeps getting worse, or leaning so far forward or sideways that you can’t stand upright
What the big operation involves
- Rods and screws hold several vertebrae in a better position while they fuse into one solid piece. See spinal fusion recovery
- It’s a long operation, usually with several days in hospital
- Recovery takes months. Many people are managing at home within weeks, but getting back to full activity often takes 3 to 6 months or longer. Your surgeon’s instructions on bending, lifting and activity come first
- Risks are real. Complications are more common than after smaller spine operations, and some people need further surgery later
- It can change lives for the right person. A good surgeon will talk you through what you’re likely to gain and what you might lose, including some stiffness where the spine is fused
Go to the emergency department now if
- You have numbness around your genitals, back passage or inner thighs
- You have new trouble peeing, can’t pee, or lose control of your bladder or bowels
- You have weakness in both legs, or one leg suddenly gets weak or your foot starts dragging
- You notice new changes in sexual function along with back or leg symptoms
Get it checked if
- The distance you can walk before leg pain stops you keeps shrinking
- Your posture is changing quickly over months
- You have night pain that no position eases, fever, weight loss you can’t explain, or a history of cancer
- You have new numbness or pins and needles in a leg
Most adult curves need a plan for your back, not an operation on your spine.