Scoliosis treatment: exercise, bracing and the monitoring decision

For curves of ten to twenty degrees, regular monitoring and a scoliosis-specific exercise programme are applied. The aim in this range is to track progression and improve trunk control.

Between twenty and forty degrees in someone still growing, bracing is considered. A brace does not correct the curve; it aims to halt progression, and its effectiveness in that aim is established.

Above forty-five degrees, surgical assessment arises. That decision is made not on the angle alone but on rate of progression, respiratory function and the person's symptoms together.

Scoliosis-specific exercise differs from general back exercise. Three-dimensional correction is worked in positions selected for the direction of the curve, combined with breathing, so the programme is built individually.

The programme increases the trunk muscles' capacity to balance asymmetric load. Even without changing the angle substantially, this reduces pain and improves daily function.

In adults the treatment goal is markedly different. As growth is complete the angle is not expected to change; the aim is pain management, endurance and preventing the secondary strains the curve produces.

There is no strong evidence that exercise corrects an established curve. Sharing this at the outset lets the patient begin the programme with the right expectation.

There is, by contrast, evidence that exercise slows progression, reduces pain and increases trunk endurance. These are measurable gains in daily life.

The programme depends on continuity. If stopped, endurance gained regresses within months, which makes the home programme more decisive than the number of clinic sessions.