The ways in which adolescent idiopathic scoliosis affects females as they age depends on the severity of the condition, rate of growth, and chosen treatment path. As adolescents with idiopathic scoliosis age, their condition changes mainly in terms of pain and progression.
As the most common form of scoliosis, adolescent idiopathic scoliosis (AIS) causes more spinal deformities in American adolescents than any other condition.
Despite its prevalence, many are surprised that 80 percent of diagnosed cases are defined as ‘idiopathic’. What that means is that the vast majority of diagnosed scoliosis cases have no known single cause. That’s not to say that the condition isn’t caused by a combination of variables, but that its causation can’t be tied to one specific source. Described as having multifactorial causation, we still have a lot to learn about which factors contribute to the development of the condition.
Within that group of people diagnosed with idiopathic scoliosis, the majority of those cases are adolescent. Individuals between the ages of 10 and 18 represent the largest group diagnosed with idiopathic scoliosis; AIS impacts 4-5 percent of adolescents.
While there are no major differences in how males and females experience adolescent idiopathic scoliosis in terms of symptoms, postural changes, and pain, there is a marked difference in which gender is more likely to develop the condition; for every four females that develop the condition, one male will.
When it comes to living with adolescent idiopathic scoliosis, in the vast majority of cases, there are no real markers or life changes that occur. In terms of physical changes to the body and posture, unless you’re an expert, these are hard to spot until the condition reaches a certain severity level.
In terms of physical limitations, most adolescents don’t have to make many changes to their physical activity levels. While safe sports and exercise routines need to be determined on a case-by-case basis and should be discussed with your doctor, active adolescents are more flexible, have better muscle strength, and are stronger and healthier overall; this helps the body better handle the challenges of living with scoliosis, not to mention the mental edge that active adolescent patients have over sedentary patients.
Certain sports are restricted, especially ones that favor the overuse of one side of the body, but overall, activity levels and sports that adolescents enjoy should be encouraged and continued throughout treatment and beyond. As our goal is to help our adolescent patients live their best lives, striking that perfect balance of appropriate activity levels is a key component of our treatment plans.
In terms of discomfort, adolescent idiopathic scoliosis is generally a painless condition. With approximately 20 percent of adolescents with scoliosis reporting muscle pain, the remaining 80 percent report no scoliosis-related pain.
For many, it’s difficult to understand how a condition that causes a spinal deformity can be painless; this is a result of the growth that characterizes the adolescent stage. With constant growth occurring, the adolescent’s spine is lengthening. That lengthening upward growth means an absence of compression.
In older patients with idiopathic scoliosis, growth has stopped. Once growth has stopped, the spine is no longer lengthening. The spine then starts to compress, putting pressure on the spine and surrounding nerves and tissues, causing pain and discomfort.
Whether a person is living with the extra challenge of a medical condition like scoliosis or not, we all make every-day decisions that affect how we age. From diet to lifestyle and disease prevention, no one is immune to the general effects of aging.
When it comes to living with adolescent scoliosis, there really is no difference in how the condition affects males and females as they age. The most important factors that determine how an adolescent ages with the condition is the severity of the condition, rate of growth, overall health, and what, if any, treatment path they choose.
As the number-one cause of progression is growth, you can see how a person’s experience with their condition would change as they progress from adolescence into adulthood. As a person with scoliosis ages, the condition is more likely to become painful. Generally speaking, the more severe a curvature is, the more likely it is to progress.
If an adolescent, male or female, chooses not to treat their condition, they are more likely to experience rapid progression and additional pain and complications as they age. While some conditions might progress extremely slowly, no abnormal spinal curvature is going to correct itself; only treatment can do that.
While the condition doesn’t have gender-specific symptoms, there are a few differences worth noting. The way scoliosis presents itself is the same in females and males, but with a 4:1 ratio, the condition itself is much more common in females.
While pain levels and postural changes are the same in both, girls are more likely to experience condition progression that necessitates treatment. In fact, in cases with curvatures of 30-plus degrees, females are 10 times more likely to experience progression.
Why is AIS More Common in Females?
The next natural question to ask is why is the condition so much more prevalent in females? While there are some theories in the medical community, again, with adolescent idiopathic scoliosis, the cause is unknown for both females and males.
One common theory attributes the higher rate of condition development in females to their growth patterns. As adolescent girls tend to grow and mature faster than boys, in light of how rapid growth spurts affect curvature progression, this theory makes sense and is generally accepted.
Here at the Scoliosis Reduction Center, our treatment approach is multifaceted. We are a unique facility because every member of my team has their own personal experience or scoliosis story. We wanted to give patients access to an alternative treatment approach that avoids spinal-fusion surgery by embracing different forms of functional patient-centered treatment options.
We combine scoliosis-specific chiropractic care, exercise, rehabilitation, therapy, custom 3-D bracing, and lifestyle guidance. Having all these disciplines represented in one convenient location means accessibility and options for our patients.
We work closely with each and every patient, and their caregivers, to design a treatment plan that addresses the age of the individual, condition severity, rate of growth, rate of progression, and sustainability.
As patients age, treatment is tweaked based on growth and progression. If an adolescent grows an inch, I want an X-ray done to see if that inch has affected progression. The more a person is growing, the more frequently X-rays and other monitoring techniques are employed.
As a patient ages and approaches the end of their growth stage, they move from the adolescent idiopathic scoliosis designation to an adult with idiopathic scoliosis. As growth slows down, monitoring slows down. The more successful a treatment plan is, the less of a need to monitor there is. That being said, the older a patient gets, the more likely they are to experience scoliosis-related pain, and then our treatment plan will widen to include pain management.
Once a curvature reduction is achieved, the goal with adult patients is to return their curvature to the degree it was when growth stopped, and this greatly reduces scoliosis-related pain and discomfort.
When people ask how adolescent idiopathic scoliosis affects females as they age, I feel the subject of pregnancy should be touched on.
When it comes to treating a pregnant patient, I wouldn’t necessarily change our treatment approach, but how I monitor that patient’s progression would change. Instead of X-rays, I would depend on posture and visual assessments.
When it comes to labor, one difference to consider with scoliosis patients involves administering an epidural for pain relief. Obviously, the patient’s curvature would have to be taken into account as the epidural involves the precise delivery of an injection into the spinal cord’s outer layer.
While there is no evidence that scoliosis affects pregnancy, patients have reported an increase in scoliosis-related back pain throughout the pregnancy and during labor.
As a female adolescent ages with scoliosis, it can also affect their menstrual cycle. The spine contains nerves that connect the brain to the body’s organs, which is why an abnormal curvature of the spine can impact so many of the body’s systems and functions. Spinal curvatures can impact, sleep, digestion, lung function, and even menstrual cycles can become less regular.
While the ‘idiopathic’ part of adolescent idiopathic scoliosis keeps the cause as equally mysterious for both females and males, the rate at which the condition progresses is different between boys and girls. Amongst my adolescent patients with a 30-plus degree curve, the girls are 10 times more likely to experience progression than the boys. Understood mainly as a result of how much faster girls grow and mature, girls with AIS are more likely than boys to experience progression to the point of needing treatment.
As my patients age, whether male or female, the condition changes based on the patient’s rate of growth. With less growth comes less risk of rapid progression and more pain due to the gravitational force of the spine’s compression. Additional factors such as how active the patient remains as they age and how healthy a lifestyle they live also impacts how the condition evolves with age. Patients who find that perfect activity-level balance and stay strong and active are better able to deal with the rigors of living with a progressive condition like scoliosis.
To return to the original question, as an adolescent girl with idiopathic scoliosis ages, the effects are much the same as boys would experience. While girls are more likely to develop the condition and experience progression, girls and boys who don’t treat their condition share the risks associated with allowing a curvature to develop unimpeded. My adolescent patients who start treatment as close to the time of initial diagnosis as possible experience the best success rates and minimize the chances of developing complications as they age.