Scoliosis, a condition that causes the spine to curve, is often thought of as something that only happens in children. While it is frequently diagnosed in children, it can also happen in adults. It is estimated that 60 percent of patients over the age of 60 have mild degenerative scoliosis.
When scoliosis begins or is discovered after puberty, it is called “adult scoliosis” because the curve is found after complete skeletal growth. Scoliosis is an abnormal curvature of the spine (backbone) in which the spine rotates and develops a side-to-side curve. In adults, the main concern is typically in the lumbar or lower spine as it is most susceptible to the changes seen with aging or degeneration.
The cause of adult scoliosis varies depending on the type of scoliosis. The most common form of adult scoliosis is degenerative where the spine curves as you age. In this form, degeneration or aging of the discs and joints in the spine occurs asymmetrically, causing tilting and even slipping between the vertebrae. This form of scoliosis primarily affects the lumbar spine.
For some adults, the curve may be a remnant of childhood scoliosis or be a case of pediatric scoliosis that was undiscovered until adulthood. More commonly, though, adult scoliosis happens as the result of the spinal wear and tear that comes with aging, usually in combination with another condition that affects the spine, such as arthritis or osteoporosis. It is usually the arthritis or osteoporosis symptoms that cause discomfort and disability that lead people to seek medical care.
Most cases of adult scoliosis don’t cause symptoms, though pain may develop. Symptoms may include low back pain, numbness and pain that radiates down one leg, leg weakness or a stooped posture. Back pain occurs for many reasons such as arthritis, inability to stand upright, or weakness of the core musculature and loss of conditioning. Leg pain, numbness, weakness may develop if there is pressure on the nerves in the lumbar spine. Arthritis and osteoporosis are often the culprits because they can weaken the spine.
In adults, the degree of the spinal curve may or may not determine treatment. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. The goal is always to decrease pain and improve function. Though scoliosis itself is painless, the normal age-related degeneration of the spine may lead to symptoms. These symptoms are treated the same, whether there is scoliosis or not. Changes in the appearance of the body are also possible depending on the degree of the spinal curve. When symptoms become bothersome or limiting, then treatment is recommended.
Typically, the first step in treatment involves physical therapy along with stretching and making dietary and nutritional changes. Weight-bearing exercises, such as walking, can help maintain bone mass and ease scoliosis symptoms. If another medical condition, such as osteoporosis, is contributing to scoliosis, then that issue must also be treated to help keep the spine curve from getting worse. If the pain lasts despite treatment, or if scoliosis symptoms are so severe that they limit mobility, then surgery may be appropriate.
The majority of cases of adult scoliosis can be managed non-operatively through regular observation by a doctor, over-the-counter pain medications, and core-strengthening exercises to strengthen your abdomen and back and to improve flexibility. Surgery may be suggested for spinal imbalance, to improve quality of life or when back and leg pain becomes severe and does not respond to conservative treatment.
For patients suffering from an overly tilted or arthritic spine, surgery can be effective at relieving symptoms. Surgical intervention usually involves a spinal fusion, which essentially takes vertebra that are moving and flexible, and turns them into one longer vertebrae. The fused vertebrae helps straighten the spine and prevents the curve from getting worse. The surgery can be quite prolonged and often takes six hours or more to complete. The length of hospital stay required after surgery is typically three to five days. Advances in surgical techniques and computer-assisted navigation systems make less invasive approaches possible, and recovery time quicker.
Adult scoliosis is unpreventable. Therefore, it is important to maintain a regular low-impact aerobics and core strengthening exercise program. If you suspect you could have adult scoliosis, your healthcare provider can help you assess your symptoms. Is it time to schedule your annual wellness check? Find a provider.