Pilates guide
Pilates is a safe, sensible way to stay strong and mobile with scoliosis, a sideways curve of the spine. The UK charity Scoliosis Support & Research says it can help posture, muscle tone, balance and back pain, but it won't straighten the curve or stop it growing.
The Pilates trials in scoliosis are few, small and low quality. In the only head-to-head trial, a small one in 24 teenage girls, Schroth, an exercise method designed for scoliosis, reduced the curve more than Pilates. For a growing child, bracing has the strongest evidence, and the scoliosis team's plan comes first.
This guide covers what the NHS, the scoliosis charities and the trials say, Pilates in a brace and after surgery, how to do one-sided moves, twists and side bends evenly, and a free 20-minute routine done the same on both sides.
Scoliosis Support & Research says Pilates "will help only to strengthen and exercise muscles, which can help to ease pain but will not reduce or slow the growth of a spinal curve". The Scoliosis Research Society says curves "can't be reversed without surgery".
The NHS says general exercise "should not be avoided unless advised by your doctor", and children with scoliosis only need to avoid activities a specialist tells them to. The charity lists yoga, Pilates and swimming as good for keeping the back muscles strong.
The pooled evidence comes from a few small trials of low quality, and a 2023 review called it "very limited". In the only trial that compared the two, 24 teenage girls did 12 weeks of Schroth or Pilates, and the curve fell more with Schroth.
Even exercise designed for scoliosis changes curves by only a few degrees, and the evidence is low certainty. In teenagers who are still growing, a brace has the strongest evidence for stopping a curve from getting worse.
Do one-sided moves the same number of times on each side, and keep twists and side bends comfortable (our suggestion). In a brace or after surgery, your team's advice comes first.
See a GP if you think you or your child has scoliosis, or if an adult's curve gets worse. Typical teenage scoliosis isn't painful, so back pain or tingling in a teenager with scoliosis needs checking.
On a standing X-ray, the curve is measured as an angle (the Cobb angle). A curve of more than 10 degrees is scoliosis; less than that is a small difference between the sides. The twist shows as a hump of the ribs or lower back when you bend forward.
Signs include uneven shoulders, a shoulder blade or hip sticking out, leaning to one side, the ribs sticking out on one side and clothes not fitting well.
In about 8 in 10 cases the cause is unknown (idiopathic scoliosis), and it "is not thought to be linked to things such as bad posture, exercise or diet", the NHS says. Less often, scoliosis is present from birth, comes from a nerve or muscle condition, or develops with wear and tear of the spine in older adults (degenerative scoliosis).
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Scoliosis in teenagers affects up to 4 in 100 young people aged 10 to 18. Curves grow mainly during growth spurts and most slow down when growth stops, though large curves, especially those over 60 degrees, can keep growing slowly in adult life. In adults, back pain is more common, and degenerative scoliosis can bring back pain, leg weakness and stiffness.
Curves under about 25 to 30 degrees in a growing child are usually watched, with X-rays every 4 to 6 months. A brace is used for curves of about 25 to 45 or 50 degrees while a child is still growing, usually for 23 hours a day in the NHS's description. Larger curves may need surgery to straighten and fuse part of the spine. Adults are mainly treated for pain.
Exercise methods designed for scoliosis, such as Schroth, teach you to correct your own curve in three dimensions. The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) says they should be designed for each person and taught one to one by therapists trained in the method. In the UK, Schroth is mostly offered at private clinics, "is not usually available on the NHS and is very costly", the charity says.
Pilates is general exercise. In a 2024 Cochrane review, a Pilates programme counted as general exercise, the kind scoliosis-specific exercise is compared against. A Pilates teacher-training school notes there is "little if no research to guide movement prescription" for people with scoliosis in Pilates.
"It's not clear whether back exercises help improve scoliosis, but general exercise is good for overall health and should not be avoided unless advised by your doctor." Regular exercise is important for children with scoliosis, and specific back exercises are "not recommended by all specialists". For adults, the NHS says "It does not matter what type of exercise you choose, the important thing is to keep your back moving", and that physiotherapy exercises "are unlikely to improve the curvature of your spine, but may help with your pain".
"Regular Pilates practice can help to improve posture, muscle tone, balance, and joint mobility, as well as help with back pain." Some people with scoliosis can't do every exercise, so don't push too hard, and "if something hurts then stop". The charity suggests checking with your specialist or GP that a class is right for you, and choosing a qualified teacher, ideally one who teaches people with scoliosis. Its pain and adult scoliosis pages say swimming, yoga and Pilates can help with pain.
Unless you're in pain or your doctor says otherwise, "you should continue to participate in the activities and sports you love", even if you wear a brace, and "keeping your core trunk strong is good for your back". The society says exercise has a role alongside bracing, and that you should discuss scoliosis-specific exercises with your doctor.
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SOSORT recommends scoliosis-specific exercise as the first step for mild curves, and says general sport isn't a treatment for scoliosis but is good for well-being and should continue, including during brace treatment. It says nothing about Pilates specifically.
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A 2021 review pooled 10 small trials with 359 people in all. Most were of poor quality, and the results varied so much between trials that the pooled figures can't be trusted. A 2023 review of 7 studies concluded that "the level of evidence regarding the effect of Pilates exercises on scoliosis-related deformity is very limited".
In the one trial of Pilates against no exercise in people with idiopathic scoliosis, 34 people aged 15 to 30 did 16 sessions of physiotherapist-led Pilates. Pain eased more than without exercise, but the deformity and quality of life didn't change. Nobody in the trial was blinded, and we could read only its summary. A 2024 review rated the evidence that Pilates improves posture in adults with scoliosis very low to low certainty.
One small trial in 24 girls aged about 15, with no blinding reported, compared 12 weeks of Schroth or Pilates, 3 times a week. The curve fell from about 24 to 12 degrees with Schroth and from about 24 to 16 degrees with Pilates, a difference in Schroth's favour. These are large changes for 12 weeks, and the 2024 review graded "Schroth is better than Pilates" very low certainty.
The 2024 Cochrane review (13 trials, 583 teenagers) was very uncertain whether exercise reduces the curve, by about 3.6 degrees against no treatment. Against general exercise, including a Pilates programme, scoliosis-specific exercise probably reduced the twist of the trunk by about 3 degrees, and in one trial 7 in 100 teenagers had a curve that grew by more than 5 degrees, against 38 in 100 with general exercise (low certainty). None of the trials measured side effects.
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In a US and Canadian study of 242 teenagers with high-risk curves, 72% of those who wore a brace reached the end of growth without the curve reaching 50 degrees, against 48% of those who were watched, and more hours of wear meant more benefit. In a Swedish trial of 135 teenagers with curves of 25 to 40 degrees, a night brace stopped the curve growing by more than 6 degrees in 76%, against 53% with physical activity alone, while scoliosis-specific exercise (58%) didn't clearly do better than activity alone.
Three trials comparing or combining Schroth and Pilates are registered. One, in 46 people, finished in June 2025 but hasn't posted results; another is due to run until the end of 2027.
For a growing child with a moderate curve, a brace is the treatment with the best evidence. Scoliosis-specific exercise may help a little, especially alongside a brace, and is offered by some scoliosis teams. Pilates is general strength and fitness: worth doing if you enjoy it, but not a way to treat or hold a curve.
In one small trial, exercise alone let the curve grow by about 2.7 degrees more than a brace (very uncertain evidence). If a brace is recommended, the NHS says it usually comes off only for baths, showers, swimming and contact sports.
In a survey of 173 Schroth therapists, nearly half (46.6%) had used Pilates alongside Schroth at some point. Scoliosis Support & Research says there is "no reliable long-term evidence" that Schroth can reduce a curve or slow its growth, "as clinics sometimes claim", and that anyone who does Schroth should keep seeing a scoliosis specialist.
For adults, the NHS says "Activities that strengthen and stretch your back may help reduce your pain", and suggests speaking to a GP, scoliosis specialist or physiotherapist before starting a new programme. Most adults with degenerative scoliosis are treated without surgery, including "low impact exercises to improve strength", and the charity says swimming, yoga and Pilates can help with pain.
In 130 adults with milder curves, a 20-week programme of self-correction, everyday task practice and cognitive behavioural therapy (CBT) reduced disability by 12 points more than general physiotherapy, and the gain lasted a year. That wasn't Pilates, and the curve changed by only 4 degrees, which the researchers didn't think mattered.
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No trial has tested Pilates in older adults with degenerative scoliosis. Our suggestion: follow the Pilates for back pain approach and keep balance work in. The NHS says to see a GP if your back "has changed shape", and our osteoporosis guide covers new back pain with height loss.
SOSORT recommends carrying on with physical education (PE) at school and with sport during brace treatment, taking care with contact or very dynamic sports. Whether to do Pilates in or out of the brace is a question for the scoliosis team: we found no advice on Pilates in a brace.
In 785 teenagers braced full time, those who did sport at least twice a week were more likely to see their curve improve at 18 months, and the more often they did it, the better. This was an observational study, so it may partly reflect who chooses sport, but it is reassuring.
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SOSORT recommends avoiding competitive activities that "greatly mobilize the spine" in people whose curve is at high risk of getting worse. This is expert opinion rather than trial evidence. In a class, keep twists and side bends smooth and comfortable (our suggestion).
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The fused part of the spine heals into "a solid block of bone which cannot bend" over 4 to 6 months, the Scoliosis Research Society says. Scoliosis Support & Research says regular sports are usually possible 3 to 6 months after surgery, and that you'll usually be told to avoid sports that jar or jolt the back, such as horse riding, squash and contact sports, for a year or more. Many people are back to normal activities at around 6 months.
Our reading for Pilates, from those general timelines: wait for your surgical team's go-ahead, expect less bending and twisting through the fused section and don't force it, and leave out rolling moves and moves that put weight on your neck. No study has tested Pilates after a fusion.
Holding a side plank on one side reduced curves by 32% in an uncontrolled series of 25 people, but made no difference in a trial of 64 teenagers, in which only about a third kept it up. The pose's originator says it is meant only for curves in the lower back, and "actually exaggerates thoracic curves" in the upper back. A one-sided exercise copied without knowing your curve could push the wrong way.
In a general class, do side-lying, twisting and side-bending moves the same number of times and over the same comfortable range on both sides. Don't add extra sets to one side or try to correct the curve yourself: SOSORT says scoliosis-specific exercise should be designed for each person by a trained therapist.
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No study has tested whether Pilates twists or side bends affect a curve. SOSORT's only caution is about competitive activities that strongly bend and twist the spine when a curve is at high risk. Our suggestion: keep the spine twist, saw, mermaid and side bend small, upright and smooth, and don't force the stiffer side.
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Rolling like a ball, the roll-over, the jack knife, the open-leg rocker, the boomerang and control balance roll on the spine or put weight on the neck. There's no scoliosis evidence either way, but a curved spine rolls unevenly, so our suggestion is to leave them out. As the charity says, if something hurts, stop.
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Scoliosis Support & Research suggests checking with your specialist or GP that a class is right for you, and choosing a qualified teacher, ideally one who teaches people with scoliosis. Some Pilates teacher-training schools run courses on adapting Pilates for scoliosis. Tell your teacher about your curve, and any brace or surgery.
Two or three sessions a week, for 8 to 12 weeks: 3 times a week for 12 weeks in the Schroth comparison, and 16 sessions in the trial against no exercise.
The 20-minute routine below twice a week, alongside the sport and activity you enjoy, which the scoliosis bodies encourage. Do one-sided moves the same number of times on each side, and stop any move that hurts.
Start each session here. The workout below gives a dose for each move.
Same number, same hold and same range on each side. The knee side plank here is general strength on both sides, not the one-sided curve exercise tested in trials.
Keep twists and side bends upright and comfortable, and don't force the stiffer side. For older adults, our editorial starting point for the single-leg stand is 3 holds of 20 to 30 seconds on each leg, next to a counter.
3D demoCat-cowBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoKnee hover (Pilates tabletop hover)Beginner · No equipment
3D demoSide-lying open bookBeginner · No equipment
3D demoMermaid (Pilates seated side bend)Beginner · No equipment
3D demoSpine twist (Pilates)Beginner · No equipment
3D demoSingle-leg standBeginner · A wallThe Pilates for scoliosis routine is general fitness, done evenly on both sides, not a treatment for the curve. With a brace, after surgery or with a curve your team is watching, follow their advice first.
A 20-minute Pilates routine for scoliosis: back, hip and trunk strength, with each one-sided move done evenly. General fitness, not a curve treatment.
20 minBeginner15 movesNo equipmentA 20-minute beginner mat Pilates session for over-50s with no deep or repeated rounding of the spine, plus back strengthening and standing balance.
20 minBeginner13 movesA wallA gentle 15-minute Pilates-based routine for ongoing low back pain, built from neutral-spine moves with options for backs that dislike bending or arching.
15 minBeginner10 movesNo equipmentA 20-minute Pilates routine for posture: breathing, head and shoulder-blade control, back strength and upper-back mobility, with no loaded rounding.
20 minBeginner13 movesA wall, A bandA 20-minute mat Pilates workout for complete beginners. It covers breathing, spine position and the foundation moves, each with an easier option.
20 minBeginner13 movesNo equipmentA 15-minute routine that moves your neck, upper back and lower back through bending, arching, side bending and twisting, then holds the spine steady.
15 minBeginner12 movesNo equipmentFour weeks of beginner Pilates: three short sessions a week, with easy walks in between. Do one-sided moves evenly.
See a GP if:
Teenagers with idiopathic scoliosis typically have no pain or nerve problems, so back pain, numbness, tingling or weakness in a teenager with scoliosis needs checking for another cause. Doctors usually order an MRI (magnetic resonance imaging) scan for significant pain, nerve signs or an unusual curve. Our scoliosis guide lists the signs to look out for.
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Call 999 (911 in the US) or go to A&E if you have back pain with any of these. Don't drive yourself.
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"If something hurts then stop", the charity says. Stop any move that brings on leg pain, numbness or tingling, and get it checked if it doesn't settle.
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Scoliosis Support & Research says Pilates won't reduce a curve or slow its growth, and the Scoliosis Research Society says curves can't be reversed without surgery. The Pilates trials are few and small, and in the only head-to-head trial, Schroth reduced the curve more.
Idiopathic scoliosis "is not thought to be linked to things such as bad posture, exercise or diet", the NHS says.
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The NHS says general exercise shouldn't be avoided unless your doctor advises it, and the Scoliosis Research Society encourages sport, even in a brace. SOSORT recommends carrying on with sport and PE.
In growing teenagers with moderate curves, a brace has the best evidence. A night brace did better than activity alone, and exercise designed for scoliosis didn't clearly beat activity alone.
The one simple one-sided exercise tested didn't change curves in a trial, and its originator says it can make upper-back curves worse. Do one-sided moves evenly unless a scoliosis-trained physiotherapist has prescribed something else.
Schroth is a method designed for scoliosis and taught one to one. Programmes that combine Schroth and Pilates have been tested only without a comparison group, and trials comparing or combining them are still running.
It's good exercise for people with scoliosis, but not a treatment for the curve. The UK charity Scoliosis Support & Research says Pilates can help posture, muscle tone, balance, joint mobility and back pain, but won't reduce or slow the growth of a curve. The trials of Pilates in scoliosis are few, small and low quality.
No. The Scoliosis Research Society says curves can't be reversed without surgery, and the Pilates trials that reported smaller curves were small and of low quality. In the only head-to-head trial, Schroth reduced the curve more than Pilates.
Yes, for most people. The NHS says general exercise shouldn't be avoided unless your doctor advises it, and the scoliosis charity lists Pilates among good exercise for the back. Don't push too hard, stop if something hurts, and check with your specialist or GP if you're unsure.
No study has tested this, so this is our suggestion: leave out the rolling moves and those that put weight on your neck, such as rolling like a ball, the roll-over and the jack knife. Keep twists and side bends small and comfortable, and do every one-sided move evenly on both sides. If a specialist has given you limits, follow them.
For the curve, it may be. One small trial in 24 girls found the curve fell more with 12 weeks of Schroth than with Pilates, though the evidence is very low certainty. Schroth is designed for scoliosis and taught one to one by trained therapists; Pilates is general fitness, and many Schroth therapists use both.
We found no trial of reformer Pilates for scoliosis, so the same principles apply as on the mat: even work on both sides, comfortable twists and side bends, and no rolling or weight on the neck. Choose a qualified teacher and tell them about your curve.
Yes, unless the specialist says otherwise: the NHS says children with scoliosis only need to avoid activities a specialist advises against, and the international scoliosis society, SOSORT, recommends carrying on with sport during brace treatment. Pilates doesn't replace a brace or check-ups, which have the strongest evidence.
Usually yes, once your surgical team agrees. Scoliosis Support & Research says regular sport is usually possible 3 to 6 months after surgery, with sports that jar or jolt the back avoided for a year or more. The fused section won't bend, so move from your hips and don't force it.
It may. In a small trial of 34 young people with scoliosis, 16 Pilates sessions eased pain more than no exercise, though the curve and quality of life didn't change. The scoliosis charity says Pilates, yoga and swimming can help with back pain.
Neither has been shown to change the curve, and we found no trial comparing them for scoliosis. The charity names both, with swimming, as good for keeping the back muscles strong, so choose the one you'll keep doing, and do it evenly on both sides.
Not unless a scoliosis-trained physiotherapist has prescribed it for your curve. The one simple one-sided exercise tested didn't change curves in a trial, and its originator says it can make upper-back curves worse.
Yes, as exercise for pain, strength and balance. The NHS says activities that strengthen and stretch your back may help reduce pain, though physiotherapy exercises are unlikely to change the curve. See a GP if your curve or posture changes.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
