Posture guide
Scoliosis is a sideways curve of the spine with a twist, measured on an X-ray as more than 10 degrees. It affects about 2 to 3 in 100 young people, usually starts between 10 and 15, and in most cases the cause is unknown; it isn't caused by posture, school bags or sport. Many curves stay small and need only check-ups. Growing children with bigger curves may need a brace, which has the strongest evidence, and large curves sometimes need surgery.
Exercise can't straighten a curve. Scoliosis-specific physiotherapy, such as Schroth, may reduce a curve by a few degrees in small trials, but it didn't beat ordinary activity in the largest trial of moderate curves, and expert bodies disagree about it. General exercise and sport are safe and encouraged at every age, and in adults exercise helps pain and function.
This guide is general education: a curve in a growing child needs a GP and a specialist team, and exercise doesn't replace a brace or check-ups. It covers the evidence, everyday moves with 3D demos (none of them Schroth or a treatment for the curve) and the signs that need a doctor.
A sideways curve of the spine with a twist, measured on an X-ray as more than 10 degrees. It affects about 2 to 3 in 100 teenagers, and in about 8 in 10 cases the cause is unknown. It isn't caused by posture, heavy bags, sport or sleeping position, and it can't be prevented.
Below about 25 to 30 degrees, growing children usually have check-ups with X-rays every 4 to 6 months. A brace is used for curves of about 25 to 45 degrees while a child is still growing, and surgery is usually considered above 45 to 50 degrees.
In the BrAIST trial (Bracing in Adolescent Idiopathic Scoliosis Trial), 72% of braced teenagers kept their curve below 50 degrees, against 48% of those who were only watched, and more hours in the brace gave better results.
In a 2024 Cochrane review, programmes such as Schroth reduced curves by about 3.6 degrees compared with no treatment, with very low certainty, which is within the 5 degrees that X-ray measurements can vary. In the largest trial of moderate curves, they did no better than ordinary physical activity.
SOSORT (the Society on Scoliosis Orthopaedic and Rehabilitation Treatment, which focuses on non-surgical care) recommends these exercises as the first step. The Scoliosis Research Society's patient pages list observation, bracing and surgery as the treatments and say exercise has a role alongside bracing. The NHS says it isn't clear that they help.
Most people with scoliosis can do most activities, including sport, and children can carry on with sport in a brace. In adults, exercise is mainly for pain and function: the NHS says physiotherapy exercises are unlikely to improve the curve but may help pain.
Scoliosis is a three-dimensional twist of the spine that shows as a sideways curve. It is defined on a standing X-ray as a Cobb angle (the angle of the curve on the X-ray) of more than 10 degrees, with the vertebrae rotated. Curves of 0 to 10 degrees are called postural asymmetry, not scoliosis.
A functional curve, for example from standing with one knee bent, goes away when the position changes. A structural curve doesn't.
About 8 in 10 cases are idiopathic, meaning the cause is unknown; adolescent idiopathic scoliosis, which appears from about 10 to 18, is the most common kind. Other types come from vertebrae that formed differently before birth (congenital), from conditions such as cerebral palsy or muscular dystrophy (neuromuscular), or, in older adults, from wear of the discs and joints (degenerative).
About 2 to 3% of young people have it, with studies ranging from under 1% to about 5%. Small curves are only slightly more common in girls, but curves over 40 degrees are about 7 times as common in girls as in boys. About 30% of teenagers with idiopathic scoliosis have a family history of it.
One shoulder higher than the other, a shoulder blade that sticks out, leaning to one side, one hip higher or sticking out, the ribs sticking out on one side (most obvious when bending forward), or clothes not fitting well. The Scoliosis Research Society suggests looking at a child's back in a swimsuit, especially during growth spurts between 10 and 15, and if a parent or sibling has scoliosis.
A doctor looks at your back as you bend forward and may measure the twist with a scoliometer. Diagnosis and curve size need a standing X-ray; an MRI (magnetic resonance imaging) scan is used only for nerve signs, significant pain or an unusual curve. In one study, parents trained with a 4-minute video measured the twist reliably with a phone app, but the route for a worry is still a GP.
About two-thirds of curves in teenagers get bigger before growth ends, more often upper-back curves, bigger curves and curves in children with more growing left to do. Girls usually grow until about 14 and boys until about 16. Most curves then stay about the same, though some, especially those over 60 degrees, keep slowly increasing in adulthood.
'Scoliosis usually does not cause pain', says the Scoliosis Research Society, and most back pain in teenagers comes from other things. In 2,442 children with idiopathic scoliosis, 23% had back pain when first seen, and 9% of those with pain turned out to have another cause, such as a stress fracture. Curve size doesn't track pain, so a child with scoliosis and back pain should be checked properly.
The UK doesn't screen teenagers for scoliosis, because there isn't enough evidence that finding it earlier improves outcomes, and the US Preventive Services Task Force found the evidence insufficient. The Scoliosis Research Society recommends checking girls at 10 and 12 and boys once at 12 or 13, while noting 'a great deal of controversy'.
Treatment depends on age, the size of the curve and how likely it is to get worse. For curves under about 25 to 30 degrees in a growing child, the usual approach is observation: clinic visits and X-rays every 4 to 6 months during growth, and less often later. Many curves never pass this size.
In BrAIST, 242 teenagers with curves that usually lead to a brace either wore one or were watched. 72% of those braced reached the end of growth with curves under 50 degrees, against 48% of those watched; among those randomly allocated it was 75% against 42%, and the trial stopped early because bracing worked. Wearing the brace under 6 hours a day gave about the same result as no brace, and over 13 hours a day gave success in 90% or more.
The NHS says a brace is usually worn for 23 hours a day; SOSORT advises at least 18 hours a day at the start. A brace aims to stop the curve getting bigger, not to straighten it.
In the CONTRAIS trial (Conservative Treatment for Adolescent Idiopathic Scoliosis), 135 young people aged 9 to 17 had curves of 25 to 40 degrees. A night-time brace plus physical activity stopped curves progressing by more than 6 degrees in 76%, against 53% with physical activity alone.
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In two long-term studies (339 people), those who had been braced reported a more negative experience of treatment and of their body appearance than people who had surgery or no treatment. In CONTRAIS, 12 patients had 16 brace-related problems, mostly skin and pressure problems. Because of uncertainty about how well braces work, the NHS notes that not all specialists recommend them.
For curves usually over 45 to 50 degrees, surgery straightens and fuses the curved section with rods, screws and bone graft (spinal fusion); younger children may have growing rods. The Scoliosis Research Society describes 3 to 6 days in hospital, school after 3 to 4 weeks and full activity at about 6 months. Risks include bleeding, infection, problems with the metalwork and, rarely, nerve damage.
Physiotherapeutic scoliosis-specific exercise (PSSE) teaches you to correct your own curve in three dimensions, hold the corrected position, use it in daily life, and understand your condition. Schroth uses aids such as cushions and is usually practised for about an hour a day after an intensive course. SEAS (Scientific Exercise Approach to Scoliosis) uses self-correction without aids, for about 15 minutes a day, with a physiotherapy session once a month.
SOSORT says these programmes should be tailored to your curve and taught one to one by a therapist trained in the method. That is why this guide doesn't try to teach them with a 3D figure.
A 2024 Cochrane review found 13 trials with 583 people, aged 12 to 15 on average. Compared with no treatment, exercise reduced curves by about 3.6 degrees (2 studies, 52 people; very uncertain), within the 5 degrees that X-ray measurements can vary. Added to a brace, it gave about 2.2 degrees more than a brace alone (low certainty).
Compared with general exercise, it probably reduced the twist of the trunk a little, and quality of life was slightly better. No study looked at harms. The 2012 version of the review found too little good evidence to recommend these exercises.
Schroth added to usual care made curves 3.5 degrees smaller than usual care alone after 6 months (50 teenagers) and improved back-muscle endurance. Schroth supervised in a clinic made curves 2.5 degrees smaller, while the same exercises done at home without supervision did no better than no treatment (45 teenagers). In 110 teenagers with mild curves, self-correction and task-based exercise reduced curves by more than 5 degrees, and the effect lasted at least a year after treatment ended.
These were small trials, and the teenagers knew which treatment they were having.
In CONTRAIS, 135 young people with curves of 25 to 40 degrees had scoliosis-specific exercise (3 individual sessions over 3 months, then 30 minutes a day at home) or a night brace, each on top of 60 minutes of daily physical activity, or the activity alone. Curves avoided progressing by more than 6 degrees in 58% with exercise and 53% with activity alone, a difference that could easily be chance. Two years later, 9 people in each group had had surgery. Differences in trunk twist, appearance and quality of life were small and unlikely to matter.
SOSORT's 2016 guidelines recommend scoliosis-specific exercise as the first step to stop a curve getting worse and to avoid a brace, and alongside a brace. The Scoliosis Research Society lists observation, bracing and surgery as the treatments; its patient pages say 'exercise does have a role in the treatment of scoliosis, along with more conventional treatments like bracing' and suggest discussing specific exercises with your doctor.
We found no formal statement from the Scoliosis Research Society on these exercises, so this summary comes from its patient pages and from trial authors' descriptions of North American care, which has used observation and bracing but not exercise; it may not reflect the society's latest view. The NHS says it isn't clear whether specific exercises or physiotherapy improve scoliosis, and they are not recommended by all specialists. The CONTRAIS trial and the 2024 Cochrane review both came after SOSORT's guidelines, and both support caution.
In the one small trial comparing them, exercise alone allowed about 2.7 degrees more progression than a brace, with very uncertain evidence, and in CONTRAIS the night brace did better than exercise. Bracing has the strongest evidence for growing children with moderate curves.
Holding a side plank on one side reduced curves by 32% in an uncontrolled series of 25 people, but not at all in a randomised trial of 64 teenagers, in which only about a third kept it up. Its originator says it suits lower-back curves only and may exaggerate upper-back ones, so the side and the curve type matter. Pilates has only a few small, low-quality studies in scoliosis.
If your child's specialist team offers scoliosis-specific physiotherapy, it may help a little, especially with a brace; in the largest trial it caused only 3 minor problems. It doesn't replace a brace when one is recommended, and it can't straighten a curve. This is our editorial summary of the evidence above.
Treatment for adults is mainly about pain. The NHS suggests any exercise that keeps your back moving, chosen because you enjoy it, and says physiotherapy exercises 'are unlikely to improve the curvature of your spine, but may help with your pain'. Check a new programme with a GP, specialist or physiotherapist. Steroid injections can ease nerve pain for a while, braces are occasionally used, and most adults don't need surgery.
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In 130 adults (average age 52) with curves under 35 degrees, 20 weeks of self-correction, task-based exercise and cognitive behavioural therapy reduced disability by 12 points more than general physiotherapy on the Oswestry questionnaire (a 0 to 100 disability score), and the benefit lasted at least 12 months. The curve differed by 4 degrees, too little to matter, and side effects were short flare-ups of pain.
Reviews rate the evidence for non-surgical treatments of adult scoliosis as low. In one series of people with degenerative scoliosis, a brace slowed progression from about 1.5 to 0.24 degrees a year.
Most curves stay about the same after growth stops. Some large curves, especially over 60 degrees, and degenerative curves in older adults can slowly increase. Specialists writing for the US National Scoliosis Foundation say exercise and sport have no effect on curves that haven't been fused, while stronger back muscles, flexible hips and aerobic fitness help pain and daily life.
In 117 people with untreated idiopathic scoliosis followed for 50 years, 61% had long-term back pain against 35% of people without scoliosis, but it was mostly mild or moderate. Breathlessness was linked to curves over 80 degrees in the upper back, and survival, function and work were similar to people without scoliosis.
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In older adults, new back pain with height loss or a change in posture can be a spinal fracture from osteoporosis. See a GP, and use the osteoporosis guide for safe exercise.
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The NHS says 'most people with scoliosis are able to live normal lives and can do most activities, including exercise and sports', and that general exercise shouldn't be avoided unless your doctor advises it. The Scoliosis Research Society says to keep doing the sports you love, even in a brace, unless you're in pain or your doctor says otherwise, and that 'keeping your core trunk strong is good for your back'.
The NHS guidelines apply: children and young people an average of at least 60 minutes of activity a day, and adults 150 minutes of moderate activity a week, with muscle-strengthening activity on at least 2 days.
SOSORT advises keeping up physical education at school throughout treatment, unless a specialist sets limits, and carrying on with sport in a brace, with care in contact or very dynamic sports. The NHS says the brace usually comes off only for baths, showers, swimming and contact sports.
SOSORT suggests avoiding competitive sports that strongly bend and twist the spine; this is expert opinion rather than trial evidence. Scoliosis is more common in rhythmic gymnasts and ballet dancers, but whether the sport plays any part is unknown, and there is no evidence that swimming causes it.
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Follow your surgeon's timeline; the Scoliosis Research Society describes full activity at about 6 months. Exercise and recreational sport shouldn't harm a solid fusion, and flexible hips help make up for the movement the fused section has lost.
Corrective exercises copied from videos can't be matched to your curve without an X-ray and an assessment, and the one simple one-sided exercise tested didn't change curves in a trial. Do general exercise the same on both sides, and leave curve-specific work to a specialist physiotherapist (our editorial advice).
Ordinary strength and fitness moves, done the same on both sides: the same reps and the same hold time each side. They are not Schroth or any scoliosis-specific exercise, and they don't treat the curve. Build up to the NHS activity amounts. With a brace, after surgery, or with a curve your team is watching, follow their advice first.
3D demoTreadmill walkingBeginner · Cardio machine
3D demoSit to stand from a chairBeginner · A bench or box
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoStep-upBeginner · A step
3D demoGlute bridgeBeginner · No equipment
3D demoBand rowBeginner · A band + An anchor point
3D demoIncline push-upBeginner · A bench or box
3D demoFarmer's carryBeginner · A dumbbell + A kettlebell
3D demoDead bugBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoHalf-kneeling Pallof pressBeginner · A band + An anchor point
3D demoForearm plankIntermediate · No equipment
3D demoCat-cowBeginner · No equipmentFor adults with degenerative scoliosis, who are often older: one-leg stands, 3 holds of 20 to 30 seconds each leg next to a counter; heel-to-toe standing for 20 seconds, then 3 walks of 15 steps; 5 to 8 slow breaths into the sides of the ribs (editorial starting points). Breathing practice is for comfort, not treatment.
General fitness, not scoliosis treatment. Do one-sided moves equally on both sides. If you are older and have lost height or developed a new stoop, have your bones checked first.
A gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallA 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.
15 minBeginner6 movesNo equipmentA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallStrength and balance in one session: squats, Romanian deadlifts, push-ups, rows, step-ups, back extensions, carries and single-leg balance.
45 minBeginner14 movesA wall, A dumbbellA 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.
20 minBeginner11 movesA bench or box, Something with weightA 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 equipmentGeneral plans for building strength and fitness, not scoliosis treatment.
Your first four weeks: two, then three short strength sessions a week at home plus walks, building gently to a full routine.
2 training days20 minBeginner3 days a weekA weekly plan for women over 50: strength, bone-loading and balance on 3 days plus walking, built on UK osteoporosis consensus advice.
3 training days45 minBeginnerIt's unlikely that anything is seriously wrong, but get it checked if:
Back pain in a child with scoliosis needs checking for other causes, especially with:
At any age, for back pain with weakness or numbness in both legs, loss of feeling around the genitals or anus, or new problems controlling the bladder or bowels. In the US, call 911.
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See a GP if your curve or posture is changing, for pain that doesn't settle, for nerve pain down the legs, or for height loss, which can be a spinal fracture from osteoporosis. Surgery is considered for severe or worsening curves, severe pain despite other treatment, or squashed nerves.
Breathlessness is uncommon and linked to very large upper-back curves, over 80 degrees. The Scoliosis Research Society says curves rarely press on the heart or lungs, and shortness of breath needs checking.
They don't. Idiopathic scoliosis isn't thought to be linked to posture, exercise or diet, and it can't be prevented. A heavy backpack 'is not good for your back or posture in general', but 'it will not worsen scoliosis'.
Curves 'can't be reversed without surgery', says the Scoliosis Research Society. Specific exercise changed curves by a few degrees at most in small trials, within measurement error, and not at all in moderate curves in the largest trial.
In the one trial comparing them, exercise alone allowed about 2.7 degrees more progression than a brace, and in CONTRAIS scoliosis-specific exercise didn't prevent progression in 25 to 40 degree curves. Bracing has the strongest evidence.
General exercise and sport are safe and encouraged, including in a brace, and exercise doesn't change curves that haven't been fused.
It usually doesn't in teenagers, and untreated adults had more back pain than others but mostly mild or moderate, with normal function. Pain in a child with scoliosis needs checking for another cause.
The NHS says there is little reliable evidence that chiropractic or osteopathy corrects a curve or stops it getting worse.
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No. Exercise can't straighten a scoliosis curve: specialist exercises changed curves by a few degrees at most in small trials, about the size of measurement error, and didn't beat ordinary activity in moderate curves. Bracing during growth and, for large curves, surgery are the treatments that change the course of a curve.
A scoliosis-specific physiotherapy method: you learn to correct your posture in three dimensions, hold it and use it in daily life, usually after an intensive course and with up to an hour a day of practice. It has to be tailored to your curve by a trained therapist. A 50-person trial found curves 3.5 degrees smaller after 6 months, while the largest trial comparing scoliosis-specific exercise with ordinary activity found no real difference.
It may help a little, especially alongside a brace, and trials reported few problems. It isn't a substitute for a brace when one is recommended. Ask your child's scoliosis team: SOSORT, the Scoliosis Research Society and the NHS differ on how strongly to recommend it.
Almost any exercise you enjoy, such as walking, swimming, strength training, Pilates or yoga, done equally on both sides. The NHS and the Scoliosis Research Society encourage exercise and sport, including with a brace. Corrective exercises for your particular curve should come from a specialist physiotherapist.
Most people don't need to avoid any. SOSORT suggests care with contact or very dynamic sports while wearing a brace, and avoiding competitive sports that strongly bend and twist the spine if the curve is at high risk of getting worse. After surgery, follow your surgeon's timeline.
Generally yes. The Scoliosis Research Society encourages sport and a strong trunk, and specialists say exercise doesn't change curves that haven't been fused. Build up gradually, and check first if you wear a brace, have had recent surgery or have severe pain.
Yes, for pain and function rather than the curve. The NHS says physiotherapy exercises are unlikely to improve the curvature but may help pain. In one trial, adults on a specific exercise programme had 12 points less disability than with general physiotherapy.
Most curves stay about the same after growth stops. Some large curves, especially over 60 degrees, and degenerative curves in older adults can slowly get bigger, by about 1.5 degrees a year in one series. See a GP if your curve or posture changes.
In teenagers it usually doesn't, and most teenage back pain has other causes. Adults with scoliosis report more back pain, but in a 50-year study it was mostly mild or moderate and people functioned well. A child with a painful curve should be checked for other causes.
In about 8 in 10 cases the cause is unknown. It sometimes runs in families: about 30% of teenagers with it have a family history. It isn't caused by posture, heavy bags, sport, diet or sleeping position, and it can't be prevented.
The UK doesn't screen, because there isn't enough evidence that finding it earlier improves outcomes, and the US task force found the evidence insufficient. The Scoliosis Research Society recommends checks at 10 and 12 for girls and at 12 or 13 for boys. If you notice uneven shoulders, a rib hump or a lean, see a GP.
The NHS says there's little reliable evidence that either corrects a curve or stops it getting worse. For a growing child, follow the specialist team's plan of check-ups, and a brace if one is recommended.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Get a curve or hunch that is new or getting worse checked, above all in a growing child or after a fall, and get urgent help for numbness or weakness in the legs or a change in bladder or bowel control. Health disclaimer.
