Scoliosis Treatment: Scoliosis is a curve of the spine of 10 degrees. Adult scoliosis is defined as a curve in the spine of 10 degrees or greater in a person eighteen years or older. Adult scoliosis is separated into 2 categories:
Adult Idiopathic Scoliosis: Individuals have had scoliosis since childhood or as teenagers and have grown into adulthood. We do not know the cause of idiopathic scoliosis, but there is a lot of genetic work going on to find an answer to this question.
Adult “De Novo” or Degenerative Scoliosis: This type develops in adulthood. Degenerative scoliosis develops from disc degeneration. As the disc degenerates, it loses height. And if one side of the disc degenerates faster than the other, the disc starts to tilt. More pressure is placed on one side of the spine as it tilts, and gravity causes the spine to bend and curve. The more discs that degenerate, the more the spine begins to curve.
The seriousness of the problem can result in stiffness, back pain, posture issues, and quite a few different back problems.
Since both these states have the capability to become progressively worse over time, immediate therapy should be sought to stop the evolution of an observable hump or deformity.
Adults with scoliosis, whether idiopathic or degenerative, can have similar and overlapping symptoms. Scoliosis can have a variety of other symptoms that are generally related to degeneration of the spine.
Both types of adult scoliosis can progress over time. If the curves reach 30 to 40 degrees, the deformity may be noticed by a hump or prominence in the spine area. Curves that reach 50 degrees or greater may progress far quicker than those less than 50 degrees.
Adults with large curves may have back pain symptoms, and if it progresses above 80 degrees, they may complain of shortness of breath with activity. The shortness of breath is due to the effect on lung function. Rarely does adult scoliosis alone cause paralysis or other severe neurologic problems. Still, it can be associated with lumbar stenosis (the spinal canal or tube begins to narrow, where the nerves rest), resulting in nerve irritation, leg pain, and possibly weakness. Patients can also develop a posture that is pitched forward and be unable to stand up straight. This can occur with scoliosis and with age as the discs degenerate.
Scoliosis can be diagnosed with a clinical exam, but x-rays are necessary to evaluate the magnitude and type of scoliosis fully. For a proper scoliosis evaluation, whole spine x-rays are needed. An MRI may also be recommended if there are symptoms of leg pain associated with stenosis or concern about possible spinal cord compression or abnormalities.
To diagnose scoliosis, we begin with symptoms and health history. We are going to ask about experiences, gather information, i.e., severity and duration.
From there, imaging tests may be ordered to assist us in the evaluation. A spine x-ray will allow us to establish the type of scoliosis present and assess the curvature’s intensity.
Scoliosis treatment for adults is individualized and based on the specific symptoms and age of the patient. Some patients have scoliosis with minor symptoms and can live with it without treatment. Patients with predominant symptoms of back pain would typically be treated with physical therapy. Patients with back pain and leg pain may benefit from injection treatment to help relieve the leg pain. If lumbar stenosis (narrowing of the spinal canal) is present and unresponsive to non-surgical treatment, decompression( removal of bone and ligaments pressing on the nerves) may be recommended.
The fusion is recommended to prevent the curve from progressing when the spine is destabilized by the bone removal necessary to decompress the nerves. Fusions are usually accompanied by a metal rod and screw placed into the spine to help correct and stabilize scoliosis and help the bones heal/fuse. The length of the fusion, or the number of spine levels, depends on the type of scoliosis and the area of the spine involved. If the scoliosis is greater than 30 degrees, a fusion procedure will most likely be recommended along with the decompression. Adult scoliosis surgery’s primary goal is to remove the pressure on the nerves, and second to keep scoliosis from progressing.
If you are experiencing symptoms like stiffness and pain, chiropractic treatment can help alleviate your distress and restore your wellbeing. We’ve achieved great success using customized chiropractic treatments to assist our patients. Our specialist, Dr. Alex Jimenez D.C., uses a different therapeutic strategy while physicians rely on pain medication or surgery.
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