Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 2 November 2026.
The school letter says her back needs checking. The X-ray says 18 degrees. The doctor says come back in six months. So for six months she carries the same bag on the same shoulder, and you watch her back when she walks ahead of you.
Or the curve is yours. You have known about it since secondary school, nobody has looked at it in twenty years, and now it aches by three in the afternoon. This page covers what physiotherapy can and cannot do for scoliosis, what the degrees mean, how to check at home, when a doctor comes first, and what to do while you wait for the next review.
Can physiotherapy help scoliosis?
Physiotherapy trains the strength, mobility and control around a scoliosis curve and works on the pain that comes with it. It does not straighten the spine. In teenagers wearing a brace, adding exercise may mean less curve progression. Exercise on its own has not been shown to change the curve. Bracing and surgery are your doctor’s decisions.1
Key takeaways
- Physiotherapy works on strength, mobility, control and pain around the curve. It does not straighten the spine.
- In teenagers in a brace, adding exercise may mean less curve progression. On its own, the evidence that exercise changes the curve is weak.
- In Singapore, curves under 20 degrees are usually observed, curves of 20 to 40 degrees in a fast-growing child are usually braced, and surgery is usually raised past 45 degrees in a growing spine.
- The less mature the skeleton, the greater the risk of progression. The growth years are when review dates matter most.
- Only an X-ray measures the degrees, and a doctor orders it. Physiotherapists do not.
First, the signs that mean a doctor, not this page
- Call 995 for breathlessness or chest pain.
- Go to the emergency department now for numbness between the legs or around the back passage, new trouble passing urine or stool, or leg weakness that is getting worse.
- See a doctor the same day for new weakness or clumsiness in the arms or legs, or back pain with a fever.
- See a doctor soon for back pain that stays in one spot and is constant or getting worse, pain at night that does not change with position, a curve you can see changing, or a curve in a child who has not started her periods yet, because she has more growing to do.2
Many teenagers with mild scoliosis have no pain. Pain that is constant, in one spot, or getting worse is worth a doctor’s look in its own right, because it can point to a cause other than ordinary scoliosis.2
How to tell if you have scoliosis
Stand behind the person with their top off or in a fitted top. Look for one shoulder higher than the other, one shoulder blade sticking out, one hip higher, or a waist crease deeper on one side. Then ask them to bend forward with arms hanging and look along the back from behind. A hump on one side of the ribs or lower back is the sign. That is the Adam’s forward bend test, and it is what school screening uses in Singapore.2
Screening has run in Singapore schools since 1982, for girls from Primary 5 to Secondary 2. If your child was flagged, or you see a hump at home, the next step is a doctor, who can order the X-ray. For a school-age child the Student Health Centre at the Health Promotion Board takes appointments.2,3 We can tell you what we see, but physiotherapists do not order X-rays, and only an X-ray gives you the degrees.
What the degrees mean
| Curve (Cobb angle) | What usually happens in Singapore | Who decides |
|---|---|---|
| Under 20 degrees | Observation, with clinical reviews about every 4 to 6 months. Exercises may be started | Your doctor |
| 20 to 40 degrees, growing fast | A brace, worn at least 18 hours a day. Sport is encouraged during bracing | Your spine specialist |
| Over 45 degrees, still growing | Surgery is usually raised | Your spine surgeon |
These figures are from SingHealth’s guidance for adolescent scoliosis.2 In adults the number matters less than the pain, the function and whether the curve is changing, and your doctor weighs all three.
The growth years are the clock. The less mature the skeleton, the greater the risk of a curve progressing, and progression is least common after a girl’s periods have started.2 That is why the review date is not one to move.
Six months until the next review
Watching a mild curve is the right call for many children. The doctor is answering the question that matters most: is it getting bigger?
It is the other questions that keep you up. She still slings the bag on the right. Her school skirt sits higher on one side, and you have stopped mentioning it. By the second hour of a three-hour paper she is leaning on one elbow. The PE teacher asks if she should sit out, and nobody has told you the answer. If the curve is yours, it is the bra strap that slides off one side, the trousers that always look uneven, the MC day when the back locks, and the belief that nothing can be done at your age because you were told at 14 that it was fine.
An X-ray measures the curve. It does not measure how strong each side of the trunk is, how far the spine turns each way, how long she can hold herself up before she leans, or what she does when nobody is correcting her. Many patients with scoliosis have never trained or strengthened the muscles around the spine. That part can be measured, and it can be worked on, whatever the X-ray says at the next review.
The review date is already on your calendar. Walk in with strength and movement measured, not only degrees.
What a physiotherapist does with it
Finding the real problem is half the battle. Treating it is the other half.
At the Assessment & Treatment, the physiotherapist reads your X-ray report and your doctor’s letter, then measures what the X-ray does not: how far the spine turns and bends to each side, trunk strength and endurance side to side, how the ribs move when you breathe, and how you sit, bend and carry. Most of the 45 minutes is then treatment: hands-on work where it is stiff or sore, and exercises set for the side and shape of your curve, checked in the room before they go home.
You leave knowing which stage you are in, what is limiting you, and a written plan your doctor can read. If you are in a brace, we work around the wearing hours your specialist set. If what we find needs a doctor, we tell you and write to them. All our physiotherapists see scoliosis. Every appointment is one to one with your physiotherapist, at five clinics: Orchard, Tampines, Serangoon, Tanjong Pagar and Jurong East. If you have been told to operate and want a fresh look first, that is a physiotherapy second opinion.
What the research says about exercise for scoliosis
We would rather you heard this from us.
| Question | What the Cochrane review found |
|---|---|
| Exercise alone, compared with no treatment, in teenagers | May make little to no difference to progression |
| Exercise added to a brace, in teenagers | Those exercising may have less curve progression |
| Does exercise reduce the need for surgery? | The review reports no finding on this |
| Overall certainty | Low to very low. 13 trials, 583 people |
That is the 2024 Cochrane review.1 So nobody can honestly promise you a smaller curve. What exercise is for is the rest of it: the strength, and the stamina to sit through a school day or a work day. A brace holds the spine from outside. It does not train what holds it from inside.
Exercises for scoliosis
Exercises for scoliosis are set for your curve, because a right-sided curve and a left-sided curve do not need the same thing. They usually include trunk and core endurance, strength work that favors the side that is behind, breathing into the stiff side of the ribs, and mobility for the spine.
Until someone has looked at yours: stay in sport and PE unless your doctor has said otherwise, carry the bag on both shoulders, and stand up from the desk or the school chair at every break.2
Pilates for scoliosis
Some of this work can be done on a Pilates reformer, where springs set the load. At our Jurong East clinic, Pilates for scoliosis is one to one with Jasmine Ang, who trained with the Australian Physiotherapy and Pilates Institute in Pilates for scoliosis. A 2021 meta-analysis of 10 trials found Pilates may help, but called the evidence poor quality, and a 2023 review called it very limited.4,5 It does not straighten the curve. With no pain or injury, a recent X-ray and a curve of 10 to 35 degrees, any age can start with Jasmine directly. With pain, an injury or past spinal surgery, a physiotherapist sees you first. Over 35 degrees, or with no X-ray, see your doctor first. Your doctor keeps checking the curve, and Pilates does not replace a brace.
Braces and surgery
We do not make or sell scoliosis braces. Your spine specialist prescribes the brace and refers you for it. If a brace is rubbing, or your child is not wearing it the hours she was told, tell the specialist before the next review, not at it.
Whether to operate is between you and your surgeon. After spinal surgery, physiotherapy follows your surgeon’s protocol through the four stages of The Phoenix Recovery Protocol. Physiotherapy after surgery sets out how those weeks run.
Types of scoliosis
| Type | What it is |
|---|---|
| Adolescent idiopathic | Develops between about 10 and 18 with no known cause. The most common type. A sideways curve of 10 degrees or more, usually with some rotation |
| Congenital | Present from birth, from vertebrae that formed differently. Followed closely as the child grows |
| Neuromuscular | Comes with a condition such as cerebral palsy, muscular dystrophy or spina bifida, and managed with that team |
| Degenerative (adult) | Appears from around 50 with wear in the discs and small joints. Pain and stiffness are often the main complaint |
In Singapore, about 1.37% of girls and 0.21% of boys aged 11 to 12 have adolescent idiopathic scoliosis, rising to 2.22% of girls and 0.66% of boys at 13 to 14.2
Questions about scoliosis physiotherapy
Can physiotherapy straighten scoliosis?
No. Physiotherapy does not straighten the spine. It trains the strength, mobility and control around the curve and works on the pain that comes with it. In teenagers wearing a brace, adding exercise may mean less curve progression. Bracing and surgery are decisions for your doctor.
How do I know if I have scoliosis?
Look for uneven shoulders, one shoulder blade sticking out, one hip higher, or a hump on one side of the back when bending forward. That is the Adam’s forward bend test. It tells you to get checked. A doctor confirms scoliosis with an X-ray, which gives the curve in degrees.
Is Pilates good for scoliosis?
It can be part of managing it, for trunk strength, mobility and control. It does not straighten the curve, and the research is limited. At Phoenix Rehab, reformer Clinical Pilates is at Jurong East. With no pain or injury, a recent X-ray and a curve of 10 to 35 degrees, you can start there directly. With pain or an injury, a physiotherapist sees you first. Over 35 degrees, or with no X-ray, see your doctor first.
Can my child still do sport with scoliosis?
Usually yes. SingHealth’s guidance encourages patients in a brace to continue all sporting activities. If your child’s doctor has given a specific restriction, follow that, and tell the physiotherapist which sport she plays.
Does Phoenix Rehab make scoliosis braces?
No. A spine specialist prescribes a scoliosis brace and refers you for it. Our physiotherapists work around the wearing hours your specialist has set.
Do I need a referral to see a physiotherapist for scoliosis?
No. You can book directly. Bring your X-ray report and any letter from your doctor. If you have never had the curve checked, see a doctor first, because physiotherapists do not order X-rays.
Eighteen degrees, six months to the next review, and nobody has measured anything but the curve? Get Assessed & Treated, and leave knowing which stage you are in, what is limiting you, and what to tell the doctor at the next review.
What our patients say
Google reviews from our clinics in Singapore.
Sources: 1. Romano M, et al. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev. 2024;2:CD007837. 2. SingHealth. Adolescent idiopathic scoliosis: primary care guidance. 3. Ministry of Education school letter on Health Promotion Board scoliosis screening, 2023. 4. Gou Y, et al. Medicine (Baltimore). 2021;100(39):e27254. 5. Kuru Colak T, et al. Spine Deform. 2023;11:797-804.
Where are you with this right now?
1. It is mild, stable and not bothering you
Many mild curves need nothing more than a doctor keeping an eye on them, and sport carries on. If the reviews are steady and you are moving freely, that is a good place to be. You do not need us for this, and we would rather say so.
2. It has stopped improving, or it was never looked at
The back aches by three in the afternoon. You lean on one elbow before the meeting is over. You were told it was fine at 14 and nobody has measured anything since.
The pain leaving is not the same as the capacity coming back, and a curve that has not changed on X-ray can still sit on a trunk that tires early. That is the gap worth measuring. If you have been working on it and it is no longer moving, the Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a spine does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See physiotherapy after surgery or the recovery programs.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
Where we are
Clinics across Singapore
ORCHARD
400 Orchard Road #12-12
Orchard Towers, S238875
NS22 Orchard MRT
Physiotherapy and hand therapy in Orchard →
WhatsApp 8800 1830TAMPINES
9 Tampines Grande #01-20
Asia Green, S528735
EW2DT32 Tampines MRT
Physiotherapy and hand therapy in Tampines →
WhatsApp 8780 9608SERANGOON
265 Serangoon Central Drive #04-269
S550265 · Lift C only
NE12CC13 Serangoon MRT
Physiotherapy and hand therapy in Serangoon →
WhatsApp 8892 4121TANJONG PAGAR
10 Anson Road #02-77A
International Plaza, S079903
EW15 Tanjong Pagar MRT
Physiotherapy and hand therapy in Tanjong Pagar →
WhatsApp 8227 7074JURONG EAST
2 Venture Drive #02-02
Vision Exchange, S608526
NS1EW24 Jurong East MRT
Physiotherapy and hand therapy in Jurong East →
WhatsApp 8242 7340