Degenerative Scoliosis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Degenerative Scoliosis?
An orthopedic spine surgeon, a bone and spine doctor, or a neurosurgeon, a doctor who operates on the brain and spine, usually treats degenerative scoliosis. A physiatrist, a rehabilitation doctor, may guide non-surgery care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is degenerative scoliosis?
Scoliosis is a deformity, or abnormal curve, of the spine. Degenerative scoliosis, also called adult degenerative or de novo scoliosis, develops when parts of the spine slowly wear down. It usually involves the lumbar spine, the lower back.
Doctors measure a curve with the Cobb angle, a measurement taken from an x-ray. Adult scoliosis means a curve of more than 10 degrees.
It is different from adult idiopathic scoliosis. That type starts in the teen years and continues into adulthood.
Degenerative scoliosis affects men and women about equally and often starts around age 50. Studies report that it affects 32 to 68 percent of people over age 65.
Symptoms
Symptoms differ from person to person. Some people have no symptoms when the curve is mild. Symptoms can include:
- Back pain, the most common symptom.
- Leg pain, numbness, or weakness that is worse when standing or walking and better when sitting with support. Doctors call this neurogenic claudication.
- Pain and weakness that spread down the leg from a pinched nerve root (radiculopathy).
- Posture changes, such as the trunk shifting to one side or uneven shoulders and hips.
- Limits in daily activities.
Causes and who gets it
Doctors believe that disc wear starts the process. Discs are the cushions between spine bones. Over time, they lose height. Then they cannot steady the spine as well, and the facet joints, the small joints at the back of the spine, take extra load.
The overload is often uneven. This adds to the curve and makes narrowing of the spinal canal more likely.
Smoking, obesity, and inherited genes are linked to it.
Osteoporosis, or weak bones, was once thought to cause it. Most current studies do not support that idea. Weak bones may still speed up curve growth.
Curves under 30 degrees tend not to progress during adulthood. Curves between 30 and 50 degrees have a 70 to 80 percent risk of progression.
How doctors diagnose it
Doctors review your medical history, including any past spine surgery. The exam checks posture, such as uneven shoulders. It also checks for leg length differences.
A standing x-ray of the spine is the main test. Lying down reduces the size of the curve, so standing is needed.
An MRI shows the discs and any narrowing around the nerves. A CT scan shows bone details.
Treatment
Care without surgery is often tried first, even though strong evidence for it is limited.
Physical therapy uses exercises for core strength, flexibility, and posture. Low-impact exercise, such as swimming or cycling, can help keep you moving.
Pain relievers and anti-inflammatory drugs called NSAIDs are often used. Injections near the spinal nerves can give short to medium-term pain relief.
Doctors may suggest a brace to support the spine and ease pain.
Surgery is generally a last resort. It is considered for daily activity limits, pain, nerve symptoms, a curve that is clearly getting worse, or when other care has failed. Surgery is the standard for severe cases.
Options include spinal fusion, which joins spine bones. It uses rods and screws to line up the spine. Decompression alone may be used when nerve symptoms are the main problem.
Surgery has risks. One review found complications in 13.4 percent of cases, and other studies report up to 40 percent. Common problems include damage to the spinal cord covering, implant failure, wound infection, and nerve problems.
When to see a doctor
Tell a doctor if back pain or nerve symptoms limit your daily life.
Tell a doctor if you notice unexpected height loss or a spinal deformity, because these might be signs of a worsening condition.
Go to the emergency room right away if you have numbness in your private area, lose control of your bowel or bladder, or have leg weakness so severe that you cannot walk. These can be signs of acute cauda equina syndrome, which is a medical emergency.
Call 911 or go to the emergency room if you have a serious injury to your head or spine, or sudden, severe pain anywhere in the body.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms, order first x-rays, and help manage pain. They can also coordinate visits with spine specialists and physical therapists.
Common questions
Is degenerative scoliosis common in older adults?
Yes, it is common. Studies report that it affects 32 to 68 percent of people over age 65.
Does osteoporosis cause degenerative scoliosis?
No, most current studies do not support that. They suggest that osteoporosis is about as common in people with the curve as in the general population.
Does degenerative scoliosis always need surgery?
No, surgery is generally a last resort. Care without surgery works better for mild curves that are not getting worse and cause few symptoms.
Will my curve get worse?
It depends on the size of the curve. Curves under 30 degrees tend not to progress during adulthood. Curves between 30 and 50 degrees have a 70 to 80 percent risk of progression.
Sources
- PubMed Central (National Library of Medicine) - Adult Degenerative Scoliosis
- PubMed Central (National Library of Medicine) - A comprehensive review of adult scoliosis
- American Academy of Orthopaedic Surgeons (OrthoInfo) - Lumbar Spinal Stenosis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
