Treating Scoliosis
Stretching and strengthening exercises to help with scoliosis and sideways curvature of the spine.
by Brad Walker | Updated April 20, 2025
When viewed from the back the spine should form a straight line. However, when the normal curvature is interrupted the spinal cord is stretched and can lead to further complications, including muscle imbalances, chronic joint pain, injuries, and other misalignment issues.
Females are more commonly affected by scoliosis. Although males can have scoliosis, progressive scoliosis requiring treatment is ten times more common in adolescent girls than boys.
What is Scoliosis?
The vertebrae of the spine are designed to fit together to form a straight line when viewed from the front or back. Any deviation from this line places extra stress on some of the bony processes, intervertebral discs, and muscles. A right or left curvature of the spine is called scoliosis, which may also be accompanied by a rotational curving of the spine.
This condition should not be confused with lordosis (an excessive inward, concave, curvature of the lumbar or cervical spines), or kyphosis (abnormal outward, or convex, curvature of the spine, in the thoracic region).
Anatomy
The spine, also referred to as the vertebral column or backbone, is the bony structure that protects the spinal cord, forms a base for other bones to connect to, and forms the central structure of the skeletal system. The spinal cord runs through the spinal canal formed by the vertebrae of the spine.
Scoliosis involves the vertebrae, the intervertebral discs, the ligaments and tendons that connect to the spine, and the muscles that surrounds and supports the spine. It can also affect the skeletal structures that are connected to the spine, such as the hips, shoulders, scapula, and ribs.
When the spinal column is curved, it can change the pull of the muscles on the various structures and cause misalignment in the hips and shoulders, and cause a shrinking of the intercostal spaces of the ribs, reducing total chest cavity volume.
Types of Scoliosis
Scoliosis can be classified as: idiopathic, congenital, neuromuscular, or degenerative.
- Idiopathic scoliosis is the diagnosis when all other causes are excluded. About 80% of cases are considered idiopathic. Adolescent idiopathic scoliosis is the most common type of scoliosis and is usually diagnosed during puberty.
- Congenital scoliosis results from malformed ribs or vertebrae prior to birth. Congenital scoliosis occurs because one area of the spinal column lengthens or grows at a slower rate than the rest.
- Neuromuscular scoliosis is the result of an underlying neuromuscular condition, like cerebral palsy, spinal cord trauma, muscular dystrophy, spinal muscular atrophy, and spina bifida.
- Degenerative scoliosis is diagnosed in adults over 65, and is attributed to wear and tear from age. The spine naturally degenerates with age, and in some more than others. Occasionally, these age-related changes are significant enough to affect postural alignment.
Scoliosis can affect either the thoracic or lumbar regions of the spine, or both.
What Causes Scoliosis?
Scoliosis has many causes. It can be a condition in itself or may be the symptom of another condition. It can be a congenital birth defect, it can be a genetic condition passed on from the parents, it may be a result of a neuromuscular issue, or it could be the result of a limb length difference. Scoliosis may also be caused by cerebral palsy, spina bifida, muscular dystrophy, spinal muscular atrophy, or tumors. The most common cases of scoliosis, however, are idiopathic. They have no known cause and occur in otherwise healthy individuals. It is important to note that scoliosis is not caused by poor posture, exercise, diet, or the use of back packs.
Signs and Symptoms?
Pain is not a common symptom in children with scoliosis, and if pain is noted there may be an underlying issue such as a tumor or injury. Adults may or may not have back pain with scoliosis. Fatigue may be experienced, especially during activities involving movement of the hips and spine. In severe cases of scoliosis, difficulty breathing may also be a symptom.
Common signs of scoliosis include:
- A difference in shoulder height.
- A more prominent shoulder blade on one side (it may appear to stick out more).
- The head may not be centered directly above the pelvis.
- The hips may appear off center and one side may be raised.
- The appearance of a body lean to one side.
- Rib cage abnormalities (there may be a hump in the rib cage, or one side may appear higher than the other).
- Asymmetric size and/or location of the breasts.
- Uneven spacing of the arms away from the body.
- An uneven waist.
Treating Scoliosis
Treatment for scoliosis falls into three basic categories: observation, bracing, and surgery. Minor curvatures, or those that develop later may fall under the observation category. A doctor may just keep an eye on the development to make sure the curvature does not get worse. Physical therapy and chiropractic treatment to stretch and strengthen the muscles may help keep misalignment issues from arising later. Adults may be given pain relievers and a specific exercise program to follow.
More severe curvatures, and especially those that continue to progress, may require bracing. Bracing is usually only used when the body is still growing, to prevent further curving of the spine. This treatment is applied until the growth of the spine has stopped. Children with a 25-40% curvature may receive help from a brace. Curvature beyond that, or in a mature spine, will not benefit from the brace.
The cases involving over 50% curvature or those cases in adults that continue to progress may require surgical intervention. This is commonly achieved through implants to support the spine or by fusing the vertebrae on the outside of the curve to prevent further curving. This is controversial in younger children because the fused bone will not grow, while the rest of the spinal column continues to grow.
Preventing Scoliosis
Scoliosis, due to the nature of the condition cannot truly be prevented, however once it is diagnosed, preventative steps can be taken to reduce the severity and prevent further curving of the spine.
- Avoiding activities that cause pain and pressure on the spine, especially around the area of the curvature will reduce the stress on the delicate spinal structure.
- If a brace is prescribed for the curvature, wearing it as directed will help prevent the spine from curving further.
- Warming up the muscles and joints in and around the back before starting any physical activity will help reduce the stress on the spine and intervertebral discs.
- Lifting with proper form and with controlled motions will reduce all back injuries and the stress placed on the spine.
- A strengthening program to condition and strengthen the muscles of the back, hips, shoulder girdle, and abdominals will help support the spine and balance the strength of the muscles.
- Stretching the muscles of the spinal column and keeping them flexible can reduce pain in adult sufferers and reduce the stress on the still growing body of children.
Research and References
- Alter, M. (2004) Science of Flexibility, 3rd Edition (ISBN: 978-0736048989)
- American Association of Neurological Surgeons. (ND). Scoliosis. Retrieved October 25, 2022, from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis.
- Beachle, T. Earle, R. (2008). Essentials of Strength Training and Conditioning, 3rd Edition (ISBN: 978-0736058032)
- Blanco, J. (June 15, 2015). What is Scoliosis?. Retrieved October 25, 2022, from https://www.hss.edu/playbook/what-is-scoliosis/.
- Janicki, J. Alman, B. (2007). Scoliosis: Review of diagnosis and treatment. Paediatrics Child Health, Nov;12(9):771-6.
- Martini, F. Tallitsch, R. Nath, J. (2009) Human Anatomy, 9th Edition (ISBN: 978-013432076X)
- Mayo Clinic Staff. (May 4, 2022). Scoliosis. Retrieved October 25, 2022, from https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716.
- Moninger, S. (November 9, 2021). 4 Types of Scoliosis and Their Interventions. Retrieved October 25, 2022, from https://www.btetechnologies.com/therapyspark/4-types-of-scoliosis-and-their-interventions/.
- Morningstar, M. (2011). Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis. Journal of Chiropractic Medicine, Sep;10(3):179-84.
- Tortora, G. Derrickson, B. (2009) Principles of Anatomy and Physiology, 14th Edition (ISBN: 978-1118866096)
- Walker, B. (2011). The Anatomy of Stretching, 2nd Edition (ISBN: 978-1583943717)
- Wikipedia contributors. (2022, October 25). Scoliosis, In Wikipedia, The Free Encyclopedia.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
