Most of us remember the scoliosis screenings from high school, as most scoliosis cases are typically caught by adolescence. Though the truth is some cases of scoliosis don’t present until later in adult life. Though the causes, symptoms, and treatments can be somewhat different from juvenile scoliosis.
What Is Adult Scoliosis?
Scoliosis is defined as an abnormal curvature of the spine that deviates from the natural, forward-and-backward curve to the spine. With many scoliosis cases, the spine can rotate which leads to the development of a side-to-side curve. Though the degree of deviation can vary from something as minor as 10 degrees to as much as drastic, severe as 100 degrees.
The vast majority of scoliosis cases occur in adolescents in the thoracic spine near the rib cage. Though adult-onset scoliosis is more common in the lumbar region of the lower spine and is often related to aging or gradual degeneration.
Most mild cases of scoliosis don’t require extensive treatment. Though with adult scoliosis the degree of the spinal curve may have gone undetected or has progressed with age. In cases like this, the treatment strategy may need to be geared towards relieving symptoms of discomfort, and might not necessarily require correcting the spinal curvature.
With many cases of adult scoliosis, the deviation in the curve of the spine is relatively painless and might be related to the normal age-related degeneration of the spine which leads to other symptoms.
What Are Common Symptoms Of Adult-Onset Scoliosis?
There are different types of adult-onset scoliosis, though most are related to degeneration in the spine, which causes a progressive deviation as you age. However, there are a few cases where pediatric scoliosis went undetected and managed to progress in adulthood. In some cases, adolescent scoliosis may develop symptoms with aging and require treatment.
Back pain is the most common symptom of adult scoliosis and is often related to arthritis and other degenerative conditions that affect the integrity of the spinal column. This includes arthritis in the affected spinal vertebrae. Other symptoms of adult-onset scoliosis can also include:
- The inability to stand upright
- Weakness of the core musculature
- Loss of conditioning in the core muscles
- Chronic leg pain leading to numbness
- Progressive weakness in lower extremities
- Gradual loss of height
- Alignment issues with the pelvis and hips
- Diagnosing Adult Scoliosis
There are multiple stages in the process of diagnosing and developing an effective treatment strategy for adult-onset scoliosis. This starts with your physician assessing potential risk factors such as a family history of scoliosis or other lifestyle factors that could contribute to a deviation in the natural curvature of the spine. This includes factoring in your age.
You should let your physician know about any pain, weakness, and numbness in your lower extremities. Also, note any bowel or bladder control problems you may have experienced recently.
At that point, a physical exam will be performed to assess the progression of the curve in your spine. Your physician might also test your reflexes, sensations and perform cursory muscle-strength checks.
The physical exam is usually followed up by an X-ray or other radiographic diagnostic imaging. Images will be gathered from different angles to assess the rotation of the spinal column, as well as the degree of deviation from front to back and side to side.
How Is Adult Scoliosis Treated?
Most adult-onset scoliosis cases can be managed without the use of invasive surgical techniques. This might include a treatment strategy that starts with over-the-counter pain medications, and core-strengthening exercises to strengthen your abdominal muscles and the reinforcing muscles in the back. In time, your physician might add flexibility exercises and other exercises to improve your core’s stability. If you smoke, you should make every effort to quit. Smoking has been shown to accelerate the degenerative process.
These measures will either be followed by or include some forms of physical therapy, to help both maintain your strength as well as relieve pain. This might include things like:
- Exercises to improve your overall posture
- Low-impact exercises, such as swimming
- Incorporating specific stretching exercises into your daily routine
- Increasing your overall activity level
If your discomfort and back pain symptoms do not improve with exercise and physical therapy, your physician might recommend an epidural injection around the spinal cord, or some other type of nerve-blocking injection. Though this is the last resort treatment for pain before embracing surgical intervention.
Surgical Treatment For Adult Scoliosis
There are some advanced or severe cases of adult-onset scoliosis that require surgical intervention. Though the type of procedure can vary depending on your symptoms and the overall deviation of the spine.
Pain that doesn’t improve with other treatment strategies as well as significant spinal imbalances is the top reason for surgical intervention. These methods are often based on maintaining or improving the overall quality of life.
Spinal Stabilization Surgery For Adult Scoliosis
Spinal stabilization surgery is the most common procedure used to fuse the bones of the spine. This calls for using bone grafts and then metallic implants to hold the spine in place. Recent advances in surgical technology and techniques in computer-assisted navigation systems make this a less invasive approach than in the past. This further helps with a faster recovery time.
Is Adult Scoliosis Preventable?
Most cases of adult scoliosis cannot be prevented, as most cases of “Idiopathic Scoliosis” have an unknown cause, and degenerative scoliosis happens slowly over time as the body ages. Though doing things like maintaining an active lifestyle and taking measures to maintain good core strength can help slow the onset of degenerative adult-onset scoliosis. It can also improve non-invasive treatment rates to prevent the need for surgical intervention.
While it is somewhat rare, adult scoliosis can be a serious health condition with symptoms that can affect your quality of life. If you’ve been experiencing symptoms of scoliosis, such as trouble standing, tingling, numbness, and weakness in the lower extremities, or you have a family history of adult scoliosis, you should strongly consider scheduling an appointment with your physician. With early intervention, physical therapy and increased activity can go a long way toward reducing degeneration and deviation in the curvature of the spine to prevent the need for invasive surgery.