What is adult-onset scoliosis?

Scoliosis is an abnormal sideways curvature of the spine, which if progresses, can lead to a twisted appearance of the body. One shoulder may seem higher than the other, the hips appear asymmetric, or one leg might seem longer.

Scoliosis can affect children or adults, and the type we are considering today is scoliosis that affects adults, typically in middle age or after, and it is common. It has been estimated to affect about one-third of adults, but one study of healthy adults with an average age of 70 showed that 68% of them met the definition of scoliosis.

An individual is said to have scoliosis if their spine has at least a 10% deviation from vertical. Our spine is made up of 33 disc-like vertebral bones that supports our heart, lungs, abdominal organs, and allows us to walk upright. Between these vertebral bones are sponge-like shock absorbers, or discs, that protect the vertebral bones and allow for movement.

But as we get older, the vertebral bones may become a bit softer (osteoporosis) and sometimes the bones can partially collapse, the shock absorber discs can break down, and we can suffer from inflammation and arthritis of the joints between the vertebral bones. Any of these factors can lead to the curvatures of scoliosis.

If the curvature worsens, the affected person can look crooked when seen from the front, and hunched over when seen from the side. Beyond these cosmetic problems, the affected person may develop low back pain as nerves and ligaments coming from the spine are stretched and pressed upon. Numbness and muscle weakness in the legs can develop. If scoliosis leads to a severe hunched appearance, the heart and lungs can be compressed.

Fortunately, a majority of people with adult onset scoliosis do not develop serious problems (beyond occasional pain), but what can be done to treat the condition, or even prevent it from progressing?


Preventing Scoliosis

First, don’t smoke. Amazingly, smoking can dramatically worsen scoliosis. Second, avoid obesity. You might imagine that the heavier you are, the greater the load and stress on the vertebral bones and spongy discs between the bones, making them more likely to fracture and malfunction.

The other important measure you can take is exercise to keep the “core” muscles of the body strong, and perform also “weight-bearing” exercises which helps strengthen the bones.

The “core” muscles are the superficial and deep muscles of the abdomen, pelvis, and lower back that act to support the spine. If these muscles are weak, the vertebral bones and discs are subject to more stress, and scoliosis and back pain become more likely. Strong core muscles help keep the spine straight, and your posture good.


Treating Scoliosis

 Most adults with scoliosis don’t require any active treatment beyond mild pain relievers when necessary. Most people will not become distorted or hunched over, or end up with disabling pain, but still, those outcomes are possible and it is wise to do what you can, if you have scoliosis, to minimize its progression and possibly reverse some of the curvature.

The same measures that help prevent scoliosis are used for treatment. Work on strengthening core muscles, improve flexibility, and perform regular weight-bearing exercises. It is wise to see a doctor such as an orthopedist or a physical therapy specialist to help diagnose and guide therapy. X-rays are usually needed for diagnosis, and periodically to check for any progression. Pilates may help.

Much of the therapy involves strengthening specific muscles to help counteract the curvatures. To learn which muscles to target, you need to consult a qualified specialist who can prescribe specific exercises for your case. Fortunately, surgical treatment is rarely needed, and reserved only for the most advanced cases that do not respond to more conservative management.

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