Treating curvature of the spine as an adult often involves pain relief medications, exercise, or spinal injections to soothe symptoms. Surgery may only be necessary for adults with severe curvature or back pain.
Doctors use the term scoliosis or hyperkyphosis to describe curvature of the spine. Scoliosis is a sideways curve when viewed from the front or back. Hyperkyphosis occurs when a person’s spine rounds or hunches forward more than it should, and is common in older adults.
Most people with spinal curvature receive a diagnosis when they experience a growth spurt during adolescence, but either condition can develop during adulthood.
This may be due to childhood scoliosis that triggers symptoms during adulthood or scoliosis that develops later in life due to the breakdown of spinal joints and the discs between vertebrae. Back and leg pain are common symptoms of adult scoliosis, and kyphosis can also cause back pain and posture problems.
Adult spine curvature treatments aim to address pain and restore function. Options may involve physical therapy, medications, and in more severe cases, surgery.
Staying active can help keep the back mobile. The type of exercise matters less than the act of exercise for managing pain due to the curvature of the spine. This can also support healthy body weight management, which may reduce pressure on the spine. Enjoyable, safe, and sustainable activities can help adults with scoliosis maintain an active lifestyle.
According to the American Academy of Orthopaedic Surgeons, some people with spine curvature may find that yoga and Pilates help to improve comfort, although research has not shown that they reduce curvature or prevent it from worsening.
Some people also visit physical therapists to learn exercises for scoliosis that may support pain relief. No reliable evidence suggests that physical therapy can straighten the spine’s curvature, but it can provide much-needed relief.
A 2022 study also found that three months of a specialized exercise and posture training program for hyperkyphosis prevented the condition from getting worse with age.
One approach to physical therapy for scoliosis is the Schroth method. This is a series of postural, breathing, and muscle and nerve-stimulating exercises that a physical therapist tailors to an individual’s specific spinal curvature. However, more research is still necessary to understand how effective the Schroth method is, particularly in adults.
Despite this, a physical therapist can still play a role in scoliosis management, as can a physician or scoliosis specialist. They can also help advise people with scoliosis looking to start a particular form of exercise on its safety.
Epidural spinal injections can help
Scoliosis and hyperkyphosis change the spine’s shape, meaning they can increase pressure on or pinch the nerves running down the spine. This can lead to radicular pain, tingling, and numbness. In kyphosis, this may also contribute to balance issues and challenges in controlling the bladder or bowels.
These injections may include steroid medications or local anesthesia. However, these are short-term solutions that last for several weeks or months.
Back braces for spine curvature are usually only helpful for preventing the curve from growing as the spine develops.
As adults with scoliosis have a fully developed spine, many will not need to wear a back brace. Some people may use one as an alternative to surgery if a person’s overall health prevents them from receiving surgery. In older individuals with hyperkyphosis, a back brace may support improved posture and increase spine strength along with exercises.
People may need to wear a back brace if they undergo spinal fusion surgery for spine curvature. This can support the spine while it heals.
Mild to severe back pain can result from curvature of the spine, and people may wish to use pain relief medications to improve comfort and function.
First, doctors recommend trying over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs). These are effective for many people with back pain due to spine curvature, but might not be suitable for everyone. A person can discuss options with a pharmacist.
If these are not effective, a person can consult a primary care physician about prescription pain medications, which tend to be stronger. They can also make a referral to a specialist pain management clinic if the pain is constant or severe.
Certain complementary treatments can support reduced back pain, including:
- chiropractic treatment
- massage treatment
- acupuncture
Surgery is only rarely necessary for adults with spine curvature. However, it may be helpful for people whose curve meets the following criteria:
- It is severe.
- It causes ongoing pain that does not respond to medication.
- It interferes with other crucial functions, such as breathing.
- Not having surgery risks further harmful changes to the spinal structure.
- It presses against or irritates nerves along the spine.
A doctor most often recommends spinal fusion to treat either scoliosis or hyperkyphosis. During this procedure, a surgeon makes a cut in the back, then straightens the curve using metal rods and fixes them in place with hooks and screws.
They will then fuse the spine in place using bone grafts that require either bone donations or bone from elsewhere in the body. For example, the surgeon may take bone from the pelvis. They aim to reduce the curve by half of its original severity. However, the procedure does not often completely straighten the spine.
Spinal fusion is a major procedure that requires up to one week in hospital after the procedure. Returning to normal activities including work is possible after four to six weeks, and people can play sports again around a year after the procedure.
Fusing the vertebrae together limits movements in those bones, but this may improve back pain. People often have enough mobility in the remaining joints of the back to live an active, full life and participate in sports. However, exercises that require enhanced flexibility may take up to a year to feel comfortable again.
If spine curvature causes nerve pressure or pinching, a surgeon may carry out spinal decompression. This can involve the removal of bone or damaged discs that may be pressing against a nerve. Spinal fusion may also follow a decompression.
Spinal surgery comes with significant risks, including wound infection, blood clots, and occasional nerve damage in the spine that can lead to numbness, weakness, or paralysis. It may also not fully relieve the pain, especially if the pain centers around the back rather than the legs.
It is advisable for a person to consult a spinal health specialist about the benefits and risks of surgery for their particular curvature.
Several treatments are available for curvature of the spine in adults, including physical activity, physical therapy, and some complementary treatments for pain relief. Pain relief medications, such as NSAIDs, may also improve comfort, and a doctor can prescribe stronger pain relief if necessary.
Spinal injections may help reduce nerve pressure and irritation due to a curved spine. In other cases, spinal fusion or decompression surgery may be an option for people who have severe curvature or persistent back pain. A person can discuss all options with a physician or orthopedic specialist.
Garg S, et al. (2024). Nonsurgical treatment options for scoliosis. https://orthoinfo.aaos.org/en/treatment/nonsurgical-treatment-options-for-scoliosis/
Katzman, W. B., et al. (2021). Long-term efficacy of treatment effects after a kyphosis exercise and posture training intervention in older community-dwelling adults: a cohort study. https://pmc.ncbi.nlm.nih.gov/articles/PMC7876164/
Kyphosis: Overview. (2022). https://www.nhs.uk/conditions/kyphosis/
Kyphosis (roundback) of the spine. (2020). https://orthoinfo.aaos.org/en/diseases–conditions/kyphosis-roundback-of-the-spine/
Lumbar decompression surgery: Overview. (2022). https://www.nhs.uk/conditions/lumbar-decompression-surgery/
Patel, K., et al. (2024). Epidural steroid injections.
Schreiber, S., et al. (2023). Schroth physiotherapeutic scoliosis-specific exercise (PSSE) trials—systematic review of methods and recommendations for future research. https://pmc.ncbi.nlm.nih.gov/articles/PMC10297476/
Scoliosis: Treatment in adults. (2023). https://www.nhs.uk/conditions/scoliosis/treatment-in-adults/
Surgical treatment for scoliosis. (2024). https://orthoinfo.aaos.org/en/treatment/surgical-treatment-for-scoliosis/