Adult scoliosis and kyphosis are characterized by abnormal curvature of the spine. Depending on the severity of the condition, curves may be easily visible when the person stands straight. Mild scoliosis may go unnoticed, while more advanced scoliosis can create painful symptoms that reduce quality of life.
Wellness & Prevention
Adult scoliosis is also known as degenerative scoliosis, and is the second most common type of scoliosis. It occurs from traumatic injury, illness, thinning of the bones (osteoporosis) or major back surgery. In some cases, a person may have had scoliosis as a child that worsened during the adult years.
There is no known way to prevent adult scoliosis. The condition is caused by factors related to genetics and spinal development while growing. Preventive care includes regular screenings to detect scoliosis early. There is no evidence to support that exercise or back-strengthening exercises can prevent scoliosis. Early management of symptoms can result in the best possible outcome.
Many cases of adult scoliosis are not found until persistent back pain requires a visit to a doctor. In adults, symptoms may include pain in the legs as well as pain in the back. Full-length standing X-rays are the best way to confirm a scoliosis diagnosis. X-rays can also show how curved the spine is and if the curve has gotten worse since the last exam.
If scoliosis or kyphosis is suspected, your doctor will order further diagnostic tests. A full medical history will be taken, including questions about your family history. A detailed picture of the spine using one or more imaging tests can provide a better diagnosis. The most common imaging tests for diagnosis of scoliosis or kyphosis include the following:
- Spine X-rays can offer an image of the vertebrae so that doctors can measure the degree of curvature.
- An MRI scan provides a detailed picture of the spinal cord, cartilage and ligaments. An MRI can indicate if there are other conditions causing the curve in the spine, such as a tumor or cyst. It can also detect if the spinal cord is attached to the bony part of the spine.
- A bone age study uses X-rays of the wrists, hands or other parts of the body to study growth plates. This study can help doctors predict whether the curve will worsen and which treatments may help.
If a spinal curve is greater than 25 degrees, treatment may be recommended.
Treatment for adult scoliosis focuses on managing symptoms and restoring function. This is done through reducing existing curvature of the spine and slowing the progression of the disease. Unlike pediatric scoliosis, adults often have pre-existing conditions like normal spine wear and tear or arthritis that worsen the condition more quickly.
When deciding the best course of treatment for you, your doctor may consider the following:
- Your age
- Family history of scoliosis or kyphosis
- The type of scoliosis or kyphosis
- The degree and location of the curvature
Not all cases of adult scoliosis need invasive treatment. If symptoms are mild, they may be improved by nonsurgical care, such as regular exercise to strengthen core and back muscles or over-the-counter pain relievers. While braces can be helpful for temporary pain relief, they won’t help straighten the spine in adults. Long-term brace wearing can weaken core muscles. Injection therapy can also alleviate discomfort and help you comfortably participate in day-to-day activities.
If conservative treatments fail, surgery may be considered. Surgery can correct alignment and make the spine more stable to prevent curving again in the future. Sometimes, minimally invasive scoliosis surgery may be enough to decompress pressure on the spinal cord and provide relief. The surgical approach depends on your specific case of scoliosis or kyphosis, and may include a pedicle subtraction osteotomy (PSO), flatback syndrome correction, collapsing spine treatments, a laminectomy or revision surgery.
Scoliosis may not be life-threatening, but severe scoliosis can have a negative impact on everyday life. Many people with adult scoliosis can feel better with an appropriate physical therapy program or the right medications. Managing the symptoms of scoliosis is ongoing.
Those adults who need scoliosis surgery will require help and support while recovering. However, after recovery, many find that their symptoms are far better than before surgery.
Whether the condition is mild or advanced, continued visits with a doctor are an important part of scoliosis care. The goal of any scoliosis treatment is for better symptom prevention and a higher quality of life.