Scoliosis in Adults: Symptoms & Treatment Options
Scoliosis in Adults: Symptoms & Treatment Options
Believe it or not, a healthy spine contains a series of natural curves. In fact, there are three natural bends in the spine that enable it to withstand greater amounts of pressure. This is ideal because of the way our body moves as it negotiates ambulation and balance. These gentle curves provide a more even distribution of our weight. Unfortunately, there are plenty of medical conditions that affect the way our spine curves. (And, they all cause a slew of problems that only worsen if left unattended.)
Scoliosis is one such condition. In a normal spine, curvature should only be observable from the side (or lateral) view. With scoliosis, however, a sideways curvature of the spine is visible from both an anterior and posterior view. Usually, this condition manifests in childhood during periods of growth spurts. If left untreated, however, the problem may extend into adulthood. In rare cases, an injury or infection may cause the onset of scoliosis after the adolescent growth period. However, most of the time, this is not the case.
In the vast majority of instances, scoliotic curves are mild. In fact, there are many examples of patients who have scoliosis that exhibit no negative symptoms whatsoever. That being said, if left unchecked, there is a possibility that the curves may worsen. This isn’t always the case, however. Some scoliotic curves simply stop progressing after the period of adolescent growth has ceased. It is important to remember that severe scoliosis can be very painful and disabling. Therefore, if you believe that you or your child has scoliosis, you should seek out medical evaluation immediately.
Adult Scoliosis Causes, Risk Factors, & Complications
In adults, there are two general types of scoliosis. The most common type of the condition is adult idiopathic scoliosis. Idiopathic scoliosis simply means that there is no definitive cause of the condition. In contrast, one may also develop adult degenerative scoliosis. This form of the condition, as well as its underlying causes, are more understood. As the name suggests, this form of scoliosis stems from the degeneration of spinal anatomy, namely facet joints and intervertebral discs. These structures may degenerate because of age-related wear and tear or other progressive conditions such as osteoporosis.
As far as risk factors for the condition go, there are three that you should be aware of. As you may be able to guess, age is the number one risk factor for adult-onset scoliosis. This may trace back to the previous growth spurt stage during adolescence or the onset of age-related wear and tear. The other two risk factors for the condition include gender and family history. Women are much more likely to develop the condition than men, and in some cases, scoliosis runs in families (although it doesn’t necessarily have to).
While most cases of scoliosis are mild, severe manifestations of the condition may result in serious complications. In the absolute worst case scenario, the condition may lead to lung and heart damage as the rib cage presses against these structures. More commonly, however, complications include back problems and a cosmetic effect on appearance. Adults with scoliosis are much more likely to experience chronic lower back pain, while more severe cases may lead to noticeable body asymmetries.
Adult Scoliosis Symptoms & Diagnosis
For adults, symptoms of the condition are generally as follows:
- Pain: Adult scoliosis usually results in leg pain and discomfort in the lumbar spine. In some cases, pain may also present in the middle back. Usually, this pain has a gradual onset and becomes more intense in the morning, at night, or after strenuous activities.
- Problems Walking: Because the facet joints are responsible for most of the pain associated with the condition, walking tends to be much more difficult. These joints have much more pressure applied to them when we stand or walk. Many patients find that sitting down temporarily alleviates these issues.
- Physical Deformity: The worse your scoliosis curves get, the more observable they tend to become. Postural changes may include uneven shoulders, asymmetrical rib prominence, and an uneven waistline.
Because many cases of adult scoliosis do not exhibit symptoms, the vast majority of patients with the condition never get diagnosed. That being said, if you or your doctor suspects scoliosis, there are a number of ways to confirm a diagnosis:
- Patient History: Your doctor will always start by examining your full medical history, including pre-existing medical conditions and injuries. He or she will ask you questions about your current lifestyle and family history, as well as when your symptoms first arose.
- Physical Exam: If the previous questionnaire suggests adult scoliosis, then your doctor will likely perform a physical exam. A physical exam involves feeling suspect areas of the spine as well as observing the patient in different stances/postures. Additionally, your doctor will assess your strength, flexibility, and reflexes.
- Imaging Tests: To confirm your diagnosis, your doctor will order either an MRI, CT scan, or X-ray to observe degenerative changes in the spine.
Treatment Options For Adult Scoliosis
Thankfully, there are plenty of conservative and surgical treatment methods available for adult scoliosis. Usually, doctors will exhaust nonsurgical methods before opting for surgery. Conservative treatment options for adult scoliosis include:
- Physical Therapy: A physical therapist will be able to develop an exercise regimen that will suit the specific needs of your case. Certain low-impact exercises will keep your joints and soft tissues limber, while simultaneously strengthening muscles. You may also wish to consider trying yoga.
- Massage Therapy: Massage therapy may be useful for keeping the facet joints mobile and reducing pain in turn.
- Pain Medication: NSAIDs and acetaminophen are highly effective at treating pain for adult scoliosis. Epidural steroid injections present a viable alternative for reducing inflammation.
- Bracing: Proper use of an assistive device, such as a brace, will allow for postural improvements in the patient. Additionally, braces also prevent scoliotic curves from worsening.
If these methods don’t work for you, your doctor may recommend surgery. Here are some common procedures that surgeons use to correct adult scoliosis:
- Spinal Decompression Surgery: This procedure removes a vertebral portion or other offending structures to relieve pressure on nearby nerve roots or the spinal cord itself.
- Spinal Fusion Surgery: Usually, this procedure is performed in conjunction with decompression surgery. In more severe cases, it may be necessary to fuse bones together in order to maintain spinal stability. Usually, this process necessitates the need for screws, rods, or cages.
- Osteotomy: This procedure involves removing affected vertebrae in order to realign the spine back into a healthier position. The difference between this and decompression surgery is that the intent is to eliminate the curve itself.
Do you have a scoliotic curve that is causing you discomfort? If so, get in touch with Jason E. Lowenstein at (855) 220-5966. Dr. Lowenstein is a board-certified scoliosis surgeon and a leading expert in the field of spinal deformity care. He also acts as the medical director of spinal deformity at The Advanced Spine Center and is one of its founding members. Don’t leave your health up to just anybody. Contact scoliosis expert Dr. Lowenstein today!