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Back pain and menopause: why posture changes after 50 and how to protect your spine

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We often tend to think of scoliosis as a condition linked exclusively to adolescence, those growing years when parents constantly reminded us to “stand up straight”. However, there is a lesser-known yet very common reality: scoliosis that appears or worsens in adulthood, often during a delicate stage such as menopause. If, after the age of 50, you have started to notice persistent lower back pain or changes in your posture, you are not alone. Understanding what happens to our spine is the first step towards continuing to move freely and confidently.

“De novo” scoliosis: a new challenge after 50

There are two ways scoliosis may present in adults. Some people have lived with a spinal curve since their youth, which may become symptomatic again over time.
For many others, however, what doctors call “de novo” scoliosis develops. As the name suggests, this is a completely new curvature that appears in people who previously had a well-aligned spine. It is not caused by abnormal bone growth, but by the natural wear and tear of the structures that support the back. In most cases, this form affects the lower back (lumbar or thoracolumbar region) and presents with gradual postural changes associated with pain.

At the root of the condition are asymmetrical degenerative changes: the intervertebral discs thin unevenly, the joints between the vertebrae lose stability, and muscles and ligaments become less efficient. This creates an “asymmetrical load”: the spine tilts, weight distribution becomes uneven, and a vicious cycle begins, accelerating degeneration and progression of the curve. Over time, these changes may also lead to a reduction in the normal lumbar curvature (lordosis) and, in some cases, to small vertebral slippages or narrowing of the spinal canal.

Why women in particular? The role of menopause

Statistics speak clearly: adult scoliosis affects women more frequently and increases with age. It is estimated that prevalence rises from around 13% in people under 60 to over 30% after the age of 60, with even higher rates among older populations. With the onset of menopause, the body undergoes a true hormonal revolution that affects bone mineral density (osteoporosis), ligament elasticity, and muscle tissue quality. But it is not only a matter of more fragile bones.
The higher prevalence in women appears to result from a complex combination of factors: disc degeneration, osteoarthritis, ligament laxity, and muscular changes, which together make the spine more vulnerable to these small structural “failures”.

What can you do today for your back?

The good news is that we are not passive spectators when it comes to the health of our spine.

Stay active

Exercise is your greatest ally. Intense activity is not necessary: the important thing is to counteract sedentary habits and loss of muscle mass (sarcopenia). Strong muscles support the spine like a true “natural corset”.

Self-correction exercises

If scoliosis causes asymmetries or pain, modern physiotherapy offers very effective tools. Specific exercises teach the body to regain balance and improve posture actively. In particular, SEAS self-correction exercises have been shown to be effective in improving or slowing the progression of adult scoliosis.

Listen to your body’s signals

Do not ignore persistent pain, tingling in the legs, or difficulty walking for long periods. In more advanced cases, symptoms related to nerve involvement may appear, such as radiating pain (radiculopathy) or reduced walking tolerance (claudication). In these situations, it is important to consult a specialist. By carrying out daily home exercises aimed at improving trunk support, it is possible to reduce the impact of spinal degeneration on both pain and quality of life.

Scoliosis: situations to beware of in adulthood

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The importance of keeping scoliosis under control through regular specialist check-ups is well known, and this is also true in adulthood when the condition can continue to evolve, albeit slowly and gradually (by half/one degree per year according to the literature).

Although curves measuring less than 30° are unlikely to progress (and a progression becomes less and less likely the further below this threshold the measurement is), curves greater than 50° will often worsen in adulthood. Accordingly, the frequency of medical check-ups is decided by the specialist on the basis of the individual patient’s clinical situation.

Idiopathic scoliosis – the form most frequently found in children and adolescents – affects females in particular. It is important to remember that there are certain times in the life of an adult woman when her body undergoes major transformations that make it necessary for her to take particular care of her back.

The first is pregnancy: it was once thought that scoliosis was most at risk of worsening during pregnancy, due to the body’s production of the hormone relaxin in preparation for childbirth; it was thought that this hormone, in addition to softening the ligaments of the pelvis ready for delivery, also had the same effect on the ligaments that help to support the spine, thereby temporarily reducing the level of trunk support.
Now, however, it is understood that the postnatal period and early months in the child’s life are the trickiest time for the mother. Indeed, in the first year of life, babies often need to be held or carried, and in the space of just a few months, they become considerably heavier. Furthermore, as they learn to walk, the mother often finds herself having to adopt a forward bent position. Obviously, all this can have a negative effect on the back, affecting posture and giving rise to pain. At the first sign of back support problems (pain, difficulty getting through the day, frequently needing to lie down), women with scoliosis, particularly if it is a severe form, would be well advised to do specific self-correction exercises prescribed by an expert physiotherapist; these exercises strengthen the back and help it to support the spine.

Finally, in menopause and beyond, the clinical situation is at increased risk of sudden worsening.
The body changes and the aging process, which accelerates with the onset of the menopause, can cause a worsening of existing curves and even the appearance of new ones, so-called de novo scoliosis. 

Although men are less often affected by idiopathic scoliosis and are of course spared the major physical and hormonal changes that women go through, they are just as likely as women to experience aging-related scoliosis.
This form can cause postural imbalances severe enough to leave the affected individual with marked forward and/or lateral flexion of the trunk.
In this stage of life, a specialist medical examination is warranted in the presence of the following: onset of pain, an increasingly bent posture, worsening of postural asymmetries, loss of height, and difficulty supporting the trunk, relieved only when lying down.