While the majority of scoliosis cases are diagnosed during childhood, the actual rate of scoliosis increases among the aging population. While the symptoms of scoliosis and treatment needs differ in adults, early intervention is always the goal because as a progressive condition, most cases of scoliosis will get worse over time.
There are two main types of scoliosis to affect adults: idiopathic scoliosis and degenerative scoliosis. Idiopathic scoliosis has no known cause, but most cases of idiopathic scoliosis in adulthood are pre-existing from adolescence, and degenerative scoliosis is caused by degenerative changes in the spine causing increasing instability.
Scoliosis can affect babies, infants, juveniles, adolescents, adults, and the elderly.
Adult Scoliosis
Scoliosis causes the spine to develop an unhealthy sideways spinal curve with rotation, and as a complex 3-dimensional condition, treatment needs to be customized.
Two significant differences between childhood scoliosis and adult scoliosis are pain and progression.
Children can experience scoliosis pain, particularly muscle pain, and varying degrees of back pain, but pain isn’t considered a primary symptom of childhood scoliosis.
In young patients who are still growing, the spine is constantly being lengthened, and this counteracts the compressive force of the scoliosis, and while compression isn’t the only cause of scoliosis pain, it is a primary one.
In childhood scoliosis, the earliest telltale signs of scoliosis onset and progression is the development of asymmetrical posture, but in adults, it’s back and nerve pain that leads to most diagnoses.
Adult Scoliosis and Pain
Scoliosis pain can involve the back, the spine’s surrounding muscles, supportive structures, and radiating pain in the extremities due to nerve compression.
Compression is uneven pressure, and scoliosis becomes a compressive condition once skeletal maturity has been reached.
So while pain is a primary indicator of adult scoliosis, particularly in mild cases of childhood scoliosis, the signs can be subtle and difficult to recognize; this is why more patients are diagnosed with moderate scoliosis than mild scoliosis: the signs of mild scoliosis can go unnoticed until progression increases symptom severity, making them more noticeable.
Progression is also a significant difference between childhood and adult scoliosis, and this is because the main trigger for progression is growth, so what happens when growth stops?
Adult Scoliosis and Progression
Growth is the main trigger for scoliosis progression, which is why adolescents are the most at risk for rapid progression: puberty.
It’s important to understand, however, that adults still experience progression even though they have reached skeletal maturity.
In adults, daily stressors and age-related spinal degeneration can contribute to progression occurring over time, and while it might not seem like it, even incremental increases in curve-size of half a degree a year can add up.
So while adults aren’t as much at risk for rapid progression, they are more at risk for the uneven forces of scoliosis triggering the onset of spinal degeneration, and once the degenerative cycle has been initiated, it can be difficult to break; early intervention is key.
The most prevalent type of scoliosis in adults is idiopathic scoliosis, and idiopathic scoliosis has no known cause, but when it comes to idiopathic scoliosis in adulthood, we can say that lack of early detection and intervention of adolescent scoliosis are contributing factors.
Idiopathic Scoliosis in Adulthood
Adolescent idiopathic scoliosis commonly develops at the start of puberty in females and a little later in males, and is the most prevalent form of scoliosis overall.
As mentioned, the signs of childhood scoliosis can be subtle; scoliosis ranges widely in severity from mild to very severe cases.
Adolescents can experience postural changes even in mild cases, but the signs can be difficult to recognize without awareness, and adolescents aren’t always known for their transparency with sharing confusing bodily changes, even if noticed.
If adolescent idiopathic scoliosis goes undiagnosed and untreated during adolescence, as more growth occurs and skeletal maturity is reached, this is when symptoms, like pain, become overt and cause most adults to seek professional assessment.
The reality of these cases, however, is that usually significant progression has already occurred prior to the diagnosis, so the potential benefits of early intervention have passed, but it’s never too late to start treatment.
So the prevalence of idiopathic scoliosis in adulthood highlights the importance of early detection and intervention.
Scoliosis progression causes the spine to become increasingly rigid, making it less responsive to treatment, and harder to correct the spine’s unnatural curve and rotation.
Treatment for idiopathic scoliosis in adulthood is customized to address a patient’s symptoms, treatment goals, curve size, and rate of progression.
Treatment options for Idiopathic Scoliosis in Adulthood
Here at the Atl anta Scoliosis Center, adults with idiopathic scoliosis are comprehensively assessed, treatment plans are carefully crafted, and a variety of scoliosis-specific treatment disciplines are apportioned accordingly.
Through scoliosis-specific chiropractic care, vertebral subluxations are targeted as improvements to the spine’s structural position and alignment is restoring balance and stability to the spine.
Scoliosis-specific physical therapy works towards increasing the spine’s surrounding muscle strength and balance to take pressure off the spine by increasing its support.
A common effect of scoliosis is muscular imbalance, so targeted exercise can also help strengthen weakened muscles and relax overused muscles for uniform spinal support.
Corrective 3D bracing can further improve the spine’s position and provide short-term pain relief through stabilizing the spine.
Degenerative De Novo scoliosis
When scoliosis develops later in life, this is known as degenerative de novo scoliosis, and most often affects adults over the age of 45.
Degenerative de novo scoliosis develops in adulthood; it isn’t pre-existing so has different characteristics and treatment needs.
Degenerative scoliosis develops due to increasing instability in the spine caused by degenerative changes to spinal health and function.
Most spinal degeneration starts in the spinal discs, and as scoliosis develops and progresses, the spine’s unnatural curve and rotation are exposing the discs to uneven pressure, and postural deviation caused by scoliosis further increases the uneven pressure and distribution of body weight.
During movement, the spinal structures are being strained and are wearing unevenly, further contributing to the cycle of degeneration, poor posture, and unhealthy movement patterns.
When the spine is unstable, there is too much movement within the spine, putting older patients at risk for vertebral compression fractures and increasing disruptions to balance that can lead to a fall and serious injury; fall prevention is a primary focus of adult degenerative scoliosis treatment.
There is a certain amount of degeneration to be expected with age, but daily stressors also shape a person’s rate and level of natural age-related spinal degeneration such as poor posture, carrying excess weight, low activity levels, poor diet, and more.
Degenerative Scoliosis Treatment Options
When it comes to improving the health of degenerative scoliosis patients, improvements to the spine’s balance and stability are the focus.
Fall prevention is prioritized, and pain relief is key to improving overall quality of life.
Most cases of degenerative scoliosis are progressive and painful, and as the spine’s instability and imbalance is the underlying cause of back pain, improving the spine’s alignment and support is key.
Through scoliosis-specific physical therapy, improving posture and the spine’s surrounding muscle balance, endurance, and strength can be effective.
Scoliosis-specific chiropractic care can involve gentle adjustments to improve areas of vertebral subluxation and reduce uneven pressure on compressed nerves and discs.
Corrective bracing can improve posture and stability for short-term pain relief. As a leading cause of disability in adults, poor posture needs to be corrected.
improvements can always be worked towards, and even incremental changes to the spine’s alignment and balance can significantly improve quality of life and long-term spinal health.
Conclusion
The biggest risk of adult scoliosis is continued progression that compromises the spine’s stability, but treatment can help.
The two main types of scoliosis to affect adults include idiopathic scoliosis in adulthood, mainly involving cases of pre-existing adolescent scoliosis, and degenerative de novo scoliosis that develops later in life.
Idiopathic scoliosis has no single-known cause, and degenerative scoliosis is caused by degenerative changes to spinal health and function.
Spinal degeneration can take place slowly over time, and once the degenerative cycle is initiated, it can be difficult to stop, so recognizing its early signs is crucial; lower back pain, radiating pain, and a prominent lean to one side are scoliosis signs to watch for in adults.
Here at the Atl anta Scoliosis Center, patients of all ages benefit from customized proactive and comprehensive care plans that work towards long-term improvements to posture, spinal health, and function.
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