Scoliosis is an abnormal curvature of the spine. Instead of a straight line from the neck to the buttocks, the spine has a C- or S-shape.
Adult scoliosis is a spinal curvature that exists or develops after someone is done growing (around 18 years old). Adult scoliosis may be a progression of childhood scoliosis or a scoliosis that develops later in life.
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Idiopathic scoliosis is the most common form of scoliosis that continues into adulthood. Idiopathic means there is no clear cause of the scoliosis. Idiopathic scoliosis that is not diagnosed or treated in childhood can continue into adulthood. The scoliosis can also cause premature aging of the spine, which worsens the curvature. This is more likely with curves greater than 30 degrees.
Scoliosis that develops in adulthood may occur as the result of wear and tear injuries of the spine, also known as degenerative diseases.
Scoliosis that develops in adulthood occurs more often in people aged 60 years and older. It may occur with one or more of the following:
- Degenerative disk disease
- Compression fractures of the spine
- Previous spinal surgery
- Previous spinal trauma or injury
- Spondylolisthesis—slipped vertebrae
The risk of progression of any scoliosis is related to the degree of the curve. For example, someone with a 50-degree curve is at a much higher risk of progression that someone with a 30-degree curve.
The most common symptom is the appearance of asymmetry in the shoulders or hips. More severe curves may cause leaning forward or to one side in order to stand upright.
Other symptoms will depend on where the abnormal curvature is in the spine and the severity of the curves. Some may not have any symptoms. Progression of scoliosis or abnormal wear and tear on spine due to scoliosis may cause:
- Back pain or stiffness
- Numbness, weakness, or cramping in areas or limbs around the curvature
- Spinal imbalance
- Changes in bowel or bladder habits – if the curvature is in low back
Your doctor will ask about your symptoms and medical history. A physical exam will be done and the doctor will ask you to move or hold certain positions. An examination of the back and spine may include:
- Assessing posture and spinal curvature in an upright position
- An assessment of your spine while you are bent forward to look for:
- Spinal curvature
- Rib hump
- Other abnormalities along the back
Not all curvature can be easily seen. Your doctor may ask for imaging tests for a better detailed look at the spine and surrounding structures. Test options may include:
- Myelogram—an x-ray using a dye to highlight smaller structures like blood vessels
- MRI scan
- CT scan
Neurologic tests may also be done to look for problems with nerves near the curvature.
Scoliosis with mild symptoms that doesn’t limit daily activities may not require treatment. Your doctor may simply monitor you for any changes in your spine or symptoms.
Scoliosis that is causing difficult symptoms or progressing may require treatment to help relieve symptoms. Options include:
Bracing for adults may be recommended to reduce pain, but only for a short time. Wearing a brace for a long time weakens the back muscles and doesn’t help the scoliosis.
Medication may be used to decrease pain and inflammation. Medication options may include:
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)
- Prescription pain medications
- Muscle relaxers
- Injected nerve blockers
Stretching and exercise helps maintain flexibility, strength, and improves range of motion. Physical therapy may help design an exercise plan that reduces stress on your spine.
Surgery may be done to address other problems caused by the scoliosis. Surgical options may include:
- Decompression—to relieve pressure on the nerves
- Discectomy—removal of herniated intervertebral disks
- Removing bone spurs from the spine
- Laminectomy—removal of the lamina to improve movement
Rarely, surgery may be needed to correct the curvature. It may be recommended when:
- Other treatments fail
- Curvature progresses
- The spine becomes unstable
- There is a decline in quality of life
A spinal fusion connects two or more bones of the spine with rods or metal plates. The combined bones can help to straighten out an area of the spine to relieve some pressure.
There are no current guidelines for preventing scoliosis in adults. If you at high risk for other spinal conditions, such as osteoporosis, talk to your doctor about preventive measures you can take.
- Teresa Briedwell
- Reviewed: 12/2013
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