Scoliosis is often thought of as a condition that mainly affects younger people, and this is because its most prevalent form is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18; however, adults can also develop scoliosis. Keep reading to find out the most common condition types affecting adults.
The two most common types of adult scoliosis are idiopathic and degenerative; the former is the most common and is related to continuations of adolescent idiopathic scoliosis, and the latter involves spinal deterioration related to aging. Just like other forms, adult scoliosis can be highly treatable.
Scoliosis can develop at any age, although it is more prevalent in adolescents and children. Before we move on to the specifics of adult scoliosis, let’s take a minute to talk about the different types of scoliosis that can develop.
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One of the reasons it’s so important to customize scoliosis treatment plans is because not only is there a wide range of condition severity, but there are also different types of scoliosis that can develop, each with its own unique treatment needs.
While scoliosis can develop at any age, the condition is more commonly associated with children and adolescents; this is because its most prevalent form is adolescent idiopathic scoliosis (AIS) diagnosed between the ages of 10 and 18.
While there are benefits associated with early detection and proactive treatment, AIS can be difficult to spot in its early days; this is because mild forms don’t commonly produce noticeable symptoms, at least not to people who aren’t trained in how to recognize the condition’s early signs.
The ‘idiopathic’ designation means it is not clearly associated with a single-known cause and is, instead, considered to be multifactorial: caused by multiple variables that can change from patient to patient.
In fact, idiopathic scoliosis accounts for 80 percent of known diagnosed cases, and this includes adults.
The other 20 percent of known diagnosed cases are associated with known causes, and these types are neuromuscular, congenital, traumatic, and degenerative.
As the two most common types to affect adults are idiopathic and degenerative, these are the types we’ll focus on currently.
While adults can also develop neuromuscular or traumatic scoliosis, the two most common types of scoliosis to affect adults are idiopathic and degenerative.
Regardless of the nature of the condition or how it developed, cases of adult scoliosis, particularly in older adults, have different treatment needs than younger patients.
Idiopathic Adult Scoliosis
With idiopathic scoliosis in adults, we are talking about cases of adolescent idiopathic scoliosis that were undiagnosed and untreated during adolescence, and these individuals progressed into maturity with their condition; it’s common that AIS is not discovered until after skeletal maturity has been reached as that’s when the condition tends to become painful.
For children and adolescents, scoliosis is not commonly painful, and this is because they have not yet reached skeletal maturity. For patients still growing, their spines are undergoing a lengthening motion associated with growth, and this can counteract the condition’s main source of pain: compression of the spine and its surrounding muscles and nerves. Adults experience scoliosis-related pain more frequently than children and adolescents.
Once skeletal maturity has been reached and the spine has settled due to maturity and gravity, it’s vulnerable to the compressive force of the abnormal curvature, and this can cause varying levels of back pain and/or radiating pain, if nerves are affected.
It’s quite common to see cases of adolescent scoliosis in the adult because in addition to the condition not commonly being painful for adolescents and children, particularly in mild forms, the condition is also not known to cause noticeable functional deficits, and even postural changes associated with the condition, like uneven shoulders and hips, can also be very subtle and difficult to notice.
Most adults who come in to see me for a diagnosis and/or treatment are doing so because they are experiencing condition-related pain, often radiating pain felt in the legs and feet.
The unfortunate reality is that had these individuals been diagnosed and treated during adolescence, their spines would be in far better shape than by the time they come to see me; however, it is never too late to start treatment, and while there are never treatment guarantees, we can always work towards making improvements that can impact patients’ overall quality of life.
While idiopathic adult scoliosis is by far the most common type, adults can also develop degenerative scoliosis, which is related to spinal deterioration that can accompany aging.
As we age, the body experiences natural degeneration, and the spine is no exception.
In addition to spinal degeneration due to aging, the cumulative effect of certain lifestyle choices can add up to an unhealthy spine that is less capable of maintaining its natural and healthy curvatures.
Not maintaining a healthy weight, leading a sedentary lifestyle, not staying hydrated enough, and/or repeatedly lifting heavy objects incorrectly and straining the back can negatively impact the health of the spine over time.
So in addition to lifestyle choices, spinal deterioration can occur naturally as we age, and most commonly, this type of degeneration is going to involve the intervertebral discs.
Now, remember, the spine is naturally curved for a reason; its curves give it added strength, flexibility, and help it to evenly distribute and absorb weight and stress.
The components of the spine work together to maintain its natural curvatures, but when certain parts face degenerative changes, it can disrupt the spine’s biomechanics, impacting its overall health and function.
The spine is made up of bones called vertebrae, and in a healthy spine, they are stacked on top of one another in a neutral and healthy alignment. The vertebrae are separated by the spine’s intervertebral discs, and these discs perform many important functions.
The intervertebral discs are made up of two main parts: a tough and durable outer layer and a soft gel-like interior.
The discs act as the spine’s shock absorbers, helping to distribute stress that’s incurred during movement evenly throughout the spine. They also cushion the vertebrae so they don’t rub up against each other and generate friction.
The intervertebral discs, thanks to their soft gel-like interior, also facilitate vertebral flexibility, and their tough outer layer provides the spine with structure, holding everything together.
When the discs start to deteriorate due to age or the cumulative effect of certain lifestyle choices, they can dry out and lose height; this change can cause the spine to slip out of alignment, compromising its natural curvatures, and leading to the development of degenerative scoliosis.
In addition, the presence of other spinal conditions like osteoporosis, for example, which causes low bone mass, can lead to compression fractures of the spine and the development of degenerative scoliosis.
So now that we have explored the most common types of adult scoliosis, what are some common symptoms of scoliosis in adults?
While every case is different, adults who are diagnosed with scoliosis generally reach that point because they are experiencing one or more of the following symptoms.
Postural changes are one of the telltale signs of scoliosis as the uneven forces introduced by the spine’s abnormal sideways curvature, and rotation, can disrupt the body’s overall symmetry.
This can involve a pronounced lead to one side, uneven shoulder height, and/or the presence of a rib arch. Adults can notice one or more of these symptoms, and these postural changes tend to be more prominent when in a forward-bend position.
While we explored the topic of scoliosis-related pain earlier, again, this is often the main reason adults who had AIS finally get diagnosed and seek proactive treatment, and this is also the main difference between the adolescent version of the condition and the version experienced by adults.
As adults are vulnerable to compression caused by the scoliotic curve, this can be felt in the spine and its surrounding muscles and nerves.
Again, while every case is different, particularly in terms of condition severity ranging from mild to very severe, in the most severe cases of adult scoliosis, increasing pressure on the spinal cord can cause deficiencies in coordination, balance, and controlled use of the limbs, especially if left untreated.
So as we know that children and adolescents face potential rapid-phase progression because growth is the number-one trigger for progression, what about adults who are no longer growing? Do they still progress, and if so, at what rate?
At one time, it was taught that patients needn’t worry about scoliosis progression once skeletal maturity was reached, but we have since learned that this is not the case.
Idiopathic scoliosis can still progress during adulthood, and while adult progressive rates vary, they commonly range between .5 to 2 degrees a year.
As adults get older, these progressive rates tend to increase, largely because the spine is experiencing degeneration related to aging, particularly in cases of degenerative scoliosis, and particularly in cases where other spinal conditions, like osteoporosis, are present.
So while a rate of half a degree a year doesn’t seem significant, if left untreated, over 10 years, that would add up to a 5-degree increase in curvature size, and for those progressing at a rate of 2 degrees a year, over 10 years, they are looking at a curvature-degree increase of 20 degrees.
The larger the curve, the more rigid the spine tends to be, the more progression has occurred, and the more the body has adjusted to the curvature’s presence; this makes treatment more complicated, which is why it’s so beneficial to diagnose and treat scoliosis early on.
Speaking of treatment, what do treatment options for adult scoliosis look like?
As a leading scoliosis chiropractor, I have worked with patients of all ages and severity levels. Not only have I helped my young patients achieve corrective results in the form of curvature reductions, I have seen similar progress in my older patients as well.
There are two main scoliosis treatment approaches: conservative and traditional. It’s important to understand the differences between these approaches as they offer patients different potential outcomes.
Here at the Scoliosis Reduction Center, I offer patients a conservative chiropractic-centered treatment approach that prioritizes the spine’s overall health and function.
Treating adult scoliosis (and all types) requires commitment and hard work from the patients, and I work closely with each and every one to ensure they are engaged in the treatment process.
I also believe in an integrative approach that combines the benefits of multiple forms of treatment for the best results; here at the Center, this includes scoliosis-specific chiropractic care, in-office therapy, custom-prescribed home exercises, and corrective bracing.
As adults don’t tend to progress as rapidly as children and adolescents can, I can work towards curvature reductions and reducing condition-related pain simultaneously, which can prevent the need for surgery. In addition, the specific and customized home exercises I prescribe can help my adult patients negate the slow progressive nature of their condition, thus preventing further deterioration of the spine.
As I fully customize every treatment plan, if an adult patient, say with degenerative scoliosis, is experiencing increasing progression, I can adjust the treatment plan by apportioning the treatment disciplines accordingly, based on close observation of how the spine is responding to treatment.
My chiropractic-centered approach to scoliosis treatment is proactive and designed to help my adult patients achieve curvature reductions and stabilize the spine.
A big motivation behind achieving corrective results is avoiding spinal-fusion surgery, which is where many adults assume their treatment journey will end, and for those following the traditional approach of scoliosis treatment, this is a common scenario.
For adults following the traditional path of scoliosis treatment, this commonly leads to undergoing spinal-fusion surgery; this is because proactive treatment is not applied early on in the condition’s progressive line, even when early detection, at any age, has been achieved.
If an adult has a mild or moderate case of scoliosis, monitoring and bracing are the only forms of treatment that would be applied, prior to a recommendation for spinal-fusion surgery, but traditional braces do little in terms of correction as their main focus is on stopping progression and providing short-term pain relief for adults; as I’m certified in the use of ScoliBrace, I can use modern corrective bracing to complement other forms of treatment for optimal corrective results.
Once a condition progresses past the surgical-level threshold, often 40+ degrees, spinal-fusion is recommended as the best option for preventing further progression, but this is not the same as achieving corrective results in the form of curvature reductions and providing the spine with better stabilization: what we work towards here at the Center.
While spinal surgeons have their patients’ best interests at heart and any surgical procedure comes with its share of risks, spinal fusion is a lengthy and invasive procedure that has a long list of potential side effects and risk of complications.
In addition, some patients are disappointed with their level of spinal flexibility, back pain, and cosmetic results post-surgery.
When it comes to doctors who treat scoliosis in adults, as always, my top recommendation is to find a scoliosis specialist, due to the complex, highly-variable, and progressive nature of the condition.
My next piece of advice, regarding adult scoliosis, is to first try a conservative approach offered by a scoliosis chiropractor, like myself, before entertaining the thought of invasive surgery.
For those who have decided to try a more natural approach first, or who have decided to forego a spinal-fusion recommendation, there are other choices available, and I encourage patients to fully explore all treatment options available to them.
Once a spine is fused, it’s fused for good; there is no going back, and if the surgery is unsuccessful, there is no recourse, other than subsequent surgeries, which means facing the potential risks all over again.
When it comes to a conservative chiropractic-centered treatment approach, like the one offered here at the Scoliosis Reduction Center, regardless of age or condition severity, it’s never too late to work towards making improvements that can help patients live their best lives.
Seeking out proactive and effective treatment is essential as adult scoliosis, left undiagnosed and/or untreated, can lead to numerous problems with the neck, back, legs, and nerves.
If you or someone you care about is living with adult scoliosis and are unsure of how it should be treated, don’t hesitate to reach out to me at the Scoliosis Reduction Center for guidance and information.