Scoliosis — a sideways curvature of the spine — usually begins in childhood or your early teen years. But you can develop or discover scoliosis as an adult, too. Here’s what you need to know about this condition.
What Is Scoliosis?
Scoliosis is an abnormal, sideways curving of the spine. The spine takes on a “C” or “S” shape, making your shoulders or waist look uneven. The curve can range from mild to severe.
According to the American Association of Neurological Surgeons, scoliosis affects 2% to 3% of the population. Doctors usually find it during growth spurts in adolescence. But scoliosis can also develop later in life from wear and tear on the spine caused by aging.
What Causes Scoliosis in Adults?
There are two types of adult scoliosis, and they have different causes. They are:
Adult idiopathic scoliosis
Adult idiopathic scoliosis is a continuation of adolescent idiopathic scoliosis. “Idiopathic” means there is no known cause. This spine curvature may persist through adulthood and worsen as a person ages.
An idiopathic scoliosis diagnosis may happen in adulthood because it went unnoticed or untreated in childhood. It’s most common in the upper and middle back. An adult of any age can have this type of scoliosis.
Adult degenerative scoliosis
This type of scoliosis happens as the disks of the spine fall apart. This could result from arthritis, osteoporosis, or spinal stenosis (narrowing the hole in the middle of the spine). It typically occurs in the lumbar region or lower back.
Adult degenerative scoliosis is most common in adults over 65.
Scoliosis Symptoms in Adults
Scoliosis symptoms in adults are due to pinched nerves and continual strain on the lower back and leg muscles. Typical symptoms include:
- Fatigue.
- Loss of height.
- Low back pain.
- Numbness and cramping in the legs.
- Shooting pain in the legs.
- Shortness of breath.
- Stiffness.
- Trouble walking.
- Uneven shoulders and hips.
“If a person is experiencing persistent pain for more than six weeks, that’s a major red flag,” says orthopaedic spine surgeon Naveed Nabizadeh, MD. “If neurologic symptoms such as numbness, tingling, or weakness in the lower extremities are present, they should consider seeking treatment.”
How Does a Doctor Diagnose Adult Scoliosis?
Doctors diagnose scoliosis in adults by:
- Asking about your medical history, including family history.
- Asking whether you’re feeling pain, and if so, where.
- Asking about problems with your bladder or bowels. This type of problem could mean nerve damage caused by scoliosis.
- Performing a physical exam to check the shape of your spine.
- Watching how your spine moves when you walk.
- Taking x-rays from the front and side of your spine.
Does Scoliosis Get Worse with Age?
If your doctor didn’t treat idiopathic scoliosis when you were a child or adolescent, it can worsen with age. If your spinal curvature as an adolescent was less than 30 degrees, it’s unlikely to deteriorate. If it was over 50 degrees, it’s likely to get worse.
“The risk of progression is much higher for those with curvatures greater than 50 degrees,” says Dr. Nabizadeh. “High magnitude curves may impact one’s sitting or standing balance, and large scoliosis curves might cause the manifestation of degenerative disc diseases in the lower ages with more pronounced symptoms.”
Degenerative scoliosis typically doesn’t begin till after age 65. Arthritis, osteoporosis, and spinal stenosis are possible factors in adult degenerative scoliosis.
Treatments for Adult Scoliosis
If your curvature doesn’t cause pain or loss of movement, it may not require treatment. Treatment for scoliosis in adults typically focuses on the symptoms. Treatment depends on your pain level and how much your problems interfere with your daily activities.
Treatment for adult scoliosis may include:
- Observation. Your doctor will see you every few years to see if your curvature has worsened.
- Physical therapy. Core exercises can strengthen the back and abdomen muscles and improve your flexibility. Low-impact workouts like swimming can also help. Your physical therapist may add yoga and stretching exercises to your routine.
- Medication. Your doctor may prescribe pain medications or recommend over-the-counter meds.
- Epidurals or nerve block injections can provide greater pain relief if necessary.
- Braces. In adults, braces are a short-term fix only. Wearing a back brace for too long can weaken core muscles and worsen symptoms.
- A plan to quit smoking. Smoking speeds up the degeneration of the spine.
- Surgery. Spinal surgery is usually the last resort for treating adult scoliosis. There are different surgical options, including minimally invasive spinal surgery. The goal is to stabilize the spine, help your balance, and relieve pressure on the nerves to diminish pain.
Everyone’s treatment may differ depending on their symptoms, but for those who undergo surgery, recovery can take as little as one to six months.
“Although everyone recovers differently, a typical patient will be able to leave the hospital a few days or so post-surgery,” says Dr. Nabizadeh. “After about two weeks, they can discontinue pain medication and should be able to return to school or work shortly thereafter. The return to activity should be gradual, but after six months of recovery, patients could resume full participation in all activities.”
Editor's Note: This article was originally published on , and was last reviewed on .