While scoliosis is more prevalent in children and adolescents, adults can also develop the progressive spinal condition. The two most common condition types to affect adults are idiopathic and degenerative, and thanks to what we have learned about the condition and treatment efficacy over the years, there are more treatment options available than ever before. While the nature of scoliosis necessitates a customized treatment approach, making each case different, some common treatment goals and options for adults with scoliosis include:
In addition to discussing the treatment options available to adults with scoliosis, we’ll be exploring the two most prevalent types of scoliosis in adults, plus addressing some common condition-related questions.
Scoliosis is an unnatural sideways curvature of the spine that includes rotation, making it a 3-dimensional condition, with a minimum Cobb angle of 10 degrees.
Cobb angle remains the gold standard for assessing scoliosis and is a measurement obtained via X-ray that involves drawing interesting lines from the tops and bottoms of the most-tilted vertebrae at the apex of the curve; this involves multiple vertebrae and places a condition on its severity scale of mild, moderate, severe, or very severe:
Condition severity is an important variable that guides the crafting of patient-specific treatment plans; another important factor is progression.
Scoliosis is a progressive condition, meaning it’s in its very nature to worsen over time, and while progression tends to slow in adulthood, once skeletal maturity has been reached, natural spinal degeneration, that can accompany aging, can lead to further progression over time.
In addition to condition severity and a patient’s progressive rate, characteristics that inform the crafting of patient-specific treatment plans include condition type (cause, if known) and curvature location/pattern.
While there are never treatment guarantees, when a customized and proactive treatment plan is applied, regardless of age, improvements can always be worked towards in terms of preserving the spine’s overall health, function, and improving daily life.
Different approaches to scoliosis treatment produce different results, so it’s important for patients to be fully informed on the treatment options available to them.
This not only helps ensure treatment expectations are aligned with the reality of their potential outcomes, but also that patients fully understand the process and goal of the chosen treatment approach.
There are two main approaches to scoliosis treatment, both with different treatment options and end goals: traditional and conservative.
When it comes to the traditional approach to scoliosis treatment in adults, this focuses mainly on pain management and stopping progression through spinal-fusion surgery.
Pain management can include bracing, pain medication, and anti-inflammatory steroid injections, but these are only treating a symptom of scoliosis, and not the scoliosis itself.
When it comes to traditional bracing, like the Boston brace, these braces are limited in their corrective potential as they only address the condition in 2 dimensions, squeezing the spine from the sides, so while it can help with pain management and controlling progression, it has little corrective potential, and the squeezing over time can actually weaken the spine and limit its function.
While no surgical procedure is without its share of risks, spinal fusion is a costly, lengthy, and invasive procedure that can carry some heavy potential complications and side effects.
As spinal fusion has preventing further progression as its main goal, achieving corrective results on a structural level, without surgery, is beyond the scope of traditional treatment.
While spinal fusion can most certainly straighten and stabilize a scoliotic spine, the way it achieves this, by fusing the most-tilted vertebrae of the curve into one solid bone is not the same as working towards correction on a structural level.
Part of the shortfalls of traditional treatment for scoliosis in adults is that it doesn’t address the condition’s true 3-dimensional nature, and is instead treating it as a 2-dimensional condition, limiting potential treatment efficacy.
Scoliosis doesn’t just mean a sideways curvature of the spine, it also includes rotation, meaning the spine twists from front to back, back to front, and for treatment to impact the whole spine, the condition has to be impacted in all dimensions, as it is with the conservative approach to scoliosis treatment in adults.
Here at the Scoliosis Reduction Center, my patients benefit from a conservative chiropractic-centered approach that combines multiple scoliosis-specific treatment disciplines.
As scoliosis is a structural condition, first and foremost, treatment aims to impact it on a structural level in the form of a curvature reduction. We also work towards stabilizing the spine and increasing core strength so the muscles surrounding the spine can provide it with optimal support.
Treatment at the Center is fully customized to address the specifics of each patient’s condition. I use chiropractic care, in-office therapy, custom-prescribed home exercises, and corrective bracing.
The bracing used in a conservative approach is corrective, and as the ScoliBrace addresses the condition’s 3-dimensional nature, when it’s combined with other scoliosis-specific treatment disciplines, it can help adults manage their pain, stabilize/support the spine, and achieve corrective results.
The goal of a conservative approach to treating adult scoliosis is to address the underlying cause of pain, which is the unbalanced spine that’s more prone to degenerative changes, by impacting the condition on a structural level.
As adult scoliosis tends to progress more slowly than with younger patients, our treatment options can help achieve curvature reductions over time, which reduce pain simultaneously, and prevent the need for invasive surgery.
My specific home-exercise program can help negate the slow progressive tendency of adult scoliosis and prevent the spine from deteriorating further, which can greatly impact quality of life.
Now that we have discussed the different adult scoliosis treatment options available, let’s move on to the two main types of scoliosis to affect adults: idiopathic and degenerative.
As mentioned, there are many different types of scoliosis a person can develop. The most prevalent form of scoliosis is idiopathic, meaning a condition is not associated with any single-known cause.
Idiopathic scoliosis accounts for 80 percent of known diagnosed scoliosis cases, with the remaining 20 percent consisting of condition types associated with known causes: neuromuscular, congenital, degenerative, and traumatic.
The condition’s most-prevalent type is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18, but this type also affects adults, if left untreated.
In most cases of AIS, especially mild ones, the condition isn’t known to be painful, or produce many functional deficits. In fact, as beneficial as early detection and proactive treatment can be, it can be hard to accomplish with AIS, which is why so many cases remain undiagnosed and untreated until adulthood.
Many of these undiagnosed and untreated cases progress into maturity, and once skeletal maturity has been reached, the condition can start producing more noticeable symptoms, such as postural changes and pain, that lead to a diagnosis and treatment.
The unfortunate reality, however, is that as scoliosis is progressive, had these patients been diagnosed and received treatment in adolescence, their spines would be in far better shape than they are by the time they come to see me; that being said, it’s never too late to seek out proactive treatment and work towards making improvements that can greatly impact daily life.
The most common symptom that brings adults in for a diagnosis and treatment is pain. In children and adolescents, the condition is not commonly painful, and this is due to growth and development.
In patients who are still growing and have not yet reached skeletal maturity, their spines are undergoing a constant lengthening motion, and this counteracts the compression caused by the scoliotic curve, known to be the source of most condition-related pain.
In adults whose spines have settled due to gravity and maturity, the compression caused by the uneven forces introduced by the condition can be felt in the spine and its surrounding muscles and nerves.
When nerves are compressed, this can lead to radiating pain felt throughout the body, including the legs and feet, and pain levels can range from mild and intermittent to chronic and debilitating.
Now that we have discussed the most common type of scoliosis to affect adults, let’s move onto the next most prevalent form of adult scoliosis: degenerative.
Degenerative scoliosis can be caused by natural spinal deterioration that accompanies aging and/or the presence of other spinal conditions such as osteoarthritis or osteoporosis.
Most commonly, it’s the spine’s intervertebral discs that are the first to feel the effects of deterioration.
As the intervertebral discs give the spine structure, added flexibility, and act as the body’s shock absorbers, when they start to degenerate, they lose height and fluid, compromising the spine’s ability to maintain its natural and healthy curvatures and alignment and leading to the development of a scoliotic curve.
So now that we have addressed the two main types of scoliosis to affect adults, let’s address a common query regarding whether or not scoliosis is curable.
When people ask if scoliosis can be corrected, I assume they mean cured. While we can achieve corrective results, in the form of a curvature reduction, in terms of being fully cured, scoliosis is incurable because it is a progressive structural condition.
When a person is diagnosed with scoliosis, regardless of age, they will have the condition throughout their lives; while this can sound bleak, I always remind patients that while we can’t cure scoliosis, it’s most certainly treatable and manageable.
If a treatment plan is considered successful, we have achieved a curvature reduction, stabilized the spine, managed progression, and increased core strength so the muscles surrounding the spine are better able to support it; while each case is different, to sustain those results, more work can need to be done in the form of continued chiropractic care, monitoring, and home exercises.
However, there are also numerous successful adults living with scoliosis who have gone on to fulfill their life’s dreams and ambitions; having scoliosis for life doesn’t mean that life has to have limitations.
Let’s move onto another common question regarding the condition’s progressive nature.
As explained, scoliosis is progressive, and as scoliosis is not a static condition, where it is at the time of diagnosis is not indicative of where it will stay.
If you recall the condition’s severity levels of mild, moderate, severe, and very severe, and the wide range of Cobb angle measurements, you can see how vastly the condition can differ from one patient to the next.
The natural progressive line is to increase in severity, especially if left untreated, or not treated proactively.
When it comes to adult scoliosis, it’s important to understand that although progression tends to slow once skeletal maturity has been reached, adults are then facing potential spinal degeneration related to aging, and that can increase progression, particularly if another spinal condition is present.
So, what happens if scoliosis is left untreated in adults? Again, while every case is different, generally, as adults age, their spines are more likely to experience deterioration; this can cause scoliosis to worsen more rapidly, increasing the chances of developing other spinal conditions, impacting its function, and making the spine more prone to injury.
Also keep in mind that even with a seemingly-slow progressive rate of 1 degree a year, over 10 years, the cumulative effect can add up to a significant curvature increase, and remember, as the condition becomes compressive once skeletal maturity has been reached, this means that related pain can also increase alongside curvature size.
Being as proactive with treatment as possible is important with progressive conditions because in order for treatment to be effective, it has to counteract the condition’s natural tendency to worsen over time.
When it comes to adults living with scoliosis, a focus of treatment is to protect and preserve the spine’s overall health and function, not only to impact the scoliosis, but to manage pain, prevent further spinal deterioration, and make improvements to daily life.
When it comes to a progressive condition like scoliosis, proactive treatment is always the best choice.
While there are different approaches to scoliosis treatment for adults, patients need to be fully informed as to what the approach entails throughout the treatment process, whether or not it's proactive, and the type of results it can deliver.
While the traditional approach to adult scoliosis treatment focuses on pain management through medication and preventing further progression through traditional bracing and spinal-fusion surgery, treating the condition as 2-dimensional and focusing on progression is not the same as delivering corrective results on a structural level.
For those choosing to forgo a surgical recommendation and/or are interested in a more natural and less-invasive treatment approach, a conservative chiropractic-centered approach can offer corrective results that preserve the spine’s overall health and function.
After all, a spine with a fused portion can be better in terms of alignment and stability, but it can also be less flexible and functional and more prone to injury.
Treatment that offers corrective potential by addressing the condition’s true 3-dimensional nature and integrating multiple scoliosis-specific treatment disciplines such as chiropractic care, in-office therapy, custom-prescribed home exercises, and corrective bracing, can help protect the adult spine from injury, developing other spinal conditions, further progression and deterioration.
Here at the Scoliosis Reduction Center, our results speak for themselves, and for those wanting to find out more information about scoliosis treatment in adults and different treatment options, don’t hesitate to reach out to us here.