What is the typical conservative management approach for adult scoliosis?

• A. Physical therapy focusing on core stabilization, posture, and activity modification; observation for mild curves.
• B. Bracing for all adults.
• C. Immediate surgical fusion.
• D. No treatment ever.

Answer: (A)

The idea behind conservative management for adults with scoliosis is to relieve pain and improve function without surgery. A typical plan focuses on nonoperative care: a physical therapy program that strengthens the core, improves spinal stability, and trains proper posture, along with guidance on activity modification to reduce stresses on the spine. For mild curves, simply observing over time is reasonable because many of these curves progress slowly and symptoms can improve with targeted exercise and lifestyle adjustments. Bracing isn’t routinely used in adults because the spine is often already fixed and braces don’t reliably alter the deformity or pain in mature spines. Immediate fusion or surgery isn’t the go-to first step, and “no treatment ever” isn’t appropriate because there are often modifiable pain and function issues that conservative care can address.