About 2% of people are affected with scoliosis which is a deformation of the spine which causes the normally straight spine to curve. It frequently occurs in families but often times its cause is unknown.
It frequently develops before puberty and goes unnoticed because it typically causes no pain in the adolescent. In adults, it is either caused by worsening of an adolescent curve or possibly from degenerative diseases of the spine like kyphosis, osteoporosis, or degenerative disc disease. With all of the baggy clothes most teenagers are wearing these days it’s no big surprise that scoliosis is often missed.
Pain is the biggest problem with adult scoliosis. Scoliosis can limit normal spinal movement and also bring on pain and even cause difficulty with breathing in severe cases due to abnormal rib cage pressure from the curve or severe kyphosis pressing on the lungs and not allowing normal lung expansion. This happens in extreme cases but can also press on one’s stomach and prevent the ability to eat properly.
Signs of scoliosis include uneven shoulder height, protrusion of shoulder blades, uneven waist, or elevated hips. Most people with scoliosis statistically never need treatment. Early detection is key, as medical observation is essential during growth to watch it for rapid exacerbation. Spinal bracing may prohibit the severe worsening.
In cases of significant exacerbation, surgery can repair the abnormal curve somewhat and stabilize it in addition to achieving pain relief. In kids, this is more for cosmetic reasons as scoliosis is not usually painful. In adults, it is just as much for pain relief due to the arthritis, degenerative disc disease, and spinal stenosis being experienced. If an adolescent achieves skeletal maturity with a curve over 40 degrees, chances are that curve will continue to progress into adulthood at a rate of 1 degree per year. One degree per year doesn’t sound like much but think about that over 30 years. Then the curve is at 70 degrees and counting, and the patient wishes he or she had done something about it much sooner.
Non-operative treatments for the pain of scoliosis include physical therapy, chiropractic, facet injections, epidural injections, spinal decompression therapy, radiofrequency ablation, and pain medications. Keep in mind that none of these options will reverse scoliosis, but simply manage symptoms. In adults, the surgery is an elective procedure, and entails significant risks so all attempts at non-operative treatment should be attempted prior to undergoing surgery.