Adult Degenerative Scoliosis

The Basics of Adult Degenerative Scoliosis

Scoliosis is a medical condition whereby a person’s spine bends forming an s-shape. There is typically also rotation, making it a three dimensional problem. Adult scoliosis is significantly different from what is seen in children.

degenerative scoliosisAfter skeletal maturity is reached, adults may develop scoliosis from two methods:

Progression of Adolescent Scoliosis

When an adolescent has scoliosis and becomes skeletally mature, the person stops growing. However, if the curve is over 40 degrees at that point, studies have shown the typical progression after that is about one degree per year. If it's less than that, the scoliosis often stays static.

One degree per year may not sound like much, but multiply that times forty years. Then a 40 degree curve becomes eighty and it may cause significant pain. Typically, pediatric scoliosis is not painful. In adults, it's usually painful and may cause both back and leg pain.

Completely New Adult Degenerative Scoliosis

This form of deformity in adults results from the deterioration of the spinal discs. This leads to arthritis in the joints of the spine.

Spinal degeneration is often not symmetric, which leads to potential curvature as one side deteriorates faster.

 What are the signs and symptoms of Adult Scoliosis?

Adult scoliosis has a number of symptoms and signs which occur mostly due to the wear and tear of the structures that support the spine. Examples of these symptoms are stiffness, degenerative scoliosis2regular low back pains, and aching. If the curvature is extreme, the individual may be tilted off to a side or forward. If severe enough, walking can be a chore and painful.

With the asymmetric spinal degeneration and resulting curvature, spinal nerve roots may get pinched. This occurs more often on the concave side of the curve due to the decreased space between the vertebrae. When nerve roots get pinched in this fashion, it is called spinal stenosis and may lead to significant buttock and thigh pain.

Normally, an evaluation of the spine by a qualified specialist should be undergone when a person develops this deformity. This evaluation and examination is always obtained by taking X-rays of the whole spine, performing an extensive physical examination and finding out the extent of pain.

If nerve roots are being pinched and leg pain is predominant, an MRI may be very helpful as well.

 What are the treatment options for Adult Scoliosis?

Non-operative treatment 

Physical Therapy - Conservative treatment involves a physical therapy program to patients who experience back pains and fatigue due to numbness and stiffness on the legs. This program involves stretching, strengthening and modalities including electrical stimulation along

[caption id="attachment_1108" align="alignright" width="300Epidural Injection Epidural Injection[/caption]

with ultrasound. It can be exceptionally helpful.

Medications - Examples of available pain medications include over the counter NSAIDS and Tylenol. Prescription pain medications that are available include:

  • Narcotics
  • Neurogenic Medications such as neurontin.
  • Muscle Relaxers
  • Topical pain creams

Interventional Procedures

Epidural Steroid Injections for the pinched nerves from spinal stenosis

Facet injections and medial branch blocks are excellent for the arthritic pain in the scoliotic spine. These may provide pain relief for weeks to months and can be repeated as needed.

[caption id="attachment_1107" align="alignleft" width="300Radiofrequency Ablation Radiofrequency Ablation[/caption]

Radiofrequency Ablation - If the pain relief from facet injections or medial branch blocks wears off, then an RFA may help for longer term pain relief. Having surgery for adult scoliosis is a big decision, so these procedures may help mitigate one's pain and prevent the need.

Surgical Treatment

Surgery for adult scoliosis is an absolute last resort. The procedures involve considerable time, rehab and potential complications (over 50%). So all aspects of conservative treatment should be attempted first.

In reality over 90% of those with adult degenerative scoliosis are able to successfully be treated nonoperatively. Pain relief can be achieved and patients can increase function dramatically!

The Board Certified Chicago pain management doctors at Premier Pain offer comprehensive nonsurgical treatment options for adult degenerative scoliosis. If you or a loved one is suffering from back and/or leg pain due to scoliosis, call PPS today!

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