Scoliosis is most frequently diagnosed in children, but it also affects adults. In fact, the actual rate of scoliosis increases among the aging population, and this is due to the development of degenerative scoliosis. The two main types of scoliosis to affect adults are idiopathic scoliosis and degenerative scoliosis.
Scoliosis is progressive, so treatment addresses an ongoing condition. When it comes to adult scoliosis, treatment focuses on pain relief, reducing the curve size to where it was prior to becoming painful, and restoring balance and stability to the spine.
Let's talk about the two main types of scoliosis to affect adults.
Adult scoliosis is diagnosed if an unnatural sideways-bending spinal curve with rotation develops in a patient who has reached skeletal maturity.
Although scoliosis is most often diagnosed during adolescence as adolescent idiopathic scoliosis, adults are also affected, and regardless of age, condition improvement can be worked towards.
The most common symptoms of scoliosis involve postural changes, mobility changes, and pain.
Postural changes are caused by the asymmetrical condition disrupting the body's overall symmetry, and in children, it's often uneven shoulders and hips that are the earliest warning signs.
As a patient's posture is disrupted, changes to balance, coordination, and gait can also occur, and in adults, a prominent lean to one side is common, and related postural changes are most visible when patients bend forward.
Symptoms of scoliosis are shaped by a number of factors including severity, type, curvature location and type, and as the condition ranges widely in severity, no two cases are the same, and treatment plans need to be individualized to address important patient/condition variables.
The more severe scoliosis is, the more noticeable its symptoms are going to be, and as progression occurs, symptoms become more overt and difficult to improve.
When it comes to diagnosing adult scoliosis, it's often pain that alerts adults they are in need of assessment.
The lack of pain in adolescent scoliosis factors into the prevalence of idiopathic scoliosis in adults.
As mentioned, the most prevalent type of scoliosis is adolescent idiopathic scoliosis diagnosed between the ages of 10 and 18, and if scoliosis develops during adolescence but isn't diagnosed or treated, it can become adult scoliosis.
This is a common scenario as idiopathic scoliosis is the most common type of adult scoliosis; in these cases, an adolescent is unaware of their condition, and it progresses with growth and time into adulthood.
When the lengthening motion of growth is no longer counteracting the compressive force of the unnatural spinal curve, scoliosis can become painful, and pain serves a vital purpose: it indicates something is wrong.
Scoliosis also ranges widely in severity from mild scoliosis to moderate scoliosis and severe scoliosis, and while mild, its symptoms can be subtle and difficult to detect, but once scoliosis become compressive and painful, it's less likely to go unnoticed.
So idiopathic scoliosis in adults is pre-existing, and in many of these cases, a significant amount of progression has already occurred.
Compression is uneven pressure and is the main cause of condition-related pain; it can cause muscle pain, back pain, and nerve pain, and for adults, it's most often pain that radiates into the extremities that leads to assessment and diagnosis.
After idiopathic scoliosis, the next most prevalent type of scoliosis to affect adults is degenerative scoliosis.
Idiopathic means cause unknown, and degenerative scoliosis is one of the three types of scoliosis associated with a known cause: age-related spinal degeneration.
Degenerative scoliosis is also known as de novo scoliosis because it develops in adulthood with no prior history, unlike idiopathic scoliosis in adults.
Degenerative changes in the spine can impact its ability to maintain its natural curves and alignment, and as it typically affects adults over the age of 45, the spine can become increasingly unstable, putting adults at risk of injury through a fall.
Because spinal degeneration is involved, degenerative scoliosis is almost always progressive and painful.
It's also more commonly diagnosed in females, and this is due to the changes in bone density and hormones related to menopause.
Degenerative changes usually start with the intervertebral discs; a disc sits between adjacent vertebral bodies providing cushioning, structural support, combining forces to facilitate flexibility, and acting as the spine's shock absorbers.
The discs are key to spinal health and function, but they are also generally the first spinal structures to feel degenerative changes, and when this happens, they can lose fluid, become desiccated, and change shape, and this can affect the position of adjacent vertebrae attached.
If an unnatural spinal curve develops in an older adult, it's likely that the spine will degenerate at a faster rate, becoming increasingly unbalanced, unstable, and painful.
But there are treatment options available to improve adult scoliosis, and the sooner treatment is started, the better.
Adult scoliosis treatment doesn't have the same focus of counteracting rapid progression that's in place in childhood scoliosis treatment because the progressive trigger of growth is no longer occurring.
Adult scoliosis focuses on pain relief, and while curvature reductions are a goal of treatment, reducing adult curves back to the size they were prior to becoming painful is more the focus.
Adult scoliosis treatment also focuses on reducing the risk of injury through a fall by improving the spine's stability and support.
Here at the CLEAR Scoliosis Institute, the treatment approach is proactive and conservative.
Corrective bracing can be used to improve the spine's stability and for short-term pain relief, but when it comes to long-term pain management, this is worked towards through chiropractic care and physical therapy.
Condition-specific chiropractic care can involve a series of precise and gentle manual adjustments that may improve the position of the curve's most-tilted vertebrae; if the spine's alignment is improved, its balance and stability are improved.
A misaligned spine can cause nerve pain due to nerve compression; improving the spine's alignment can also mean reducing pressure on the spinal nerves within to improve radiating nerve pain.
Physical therapy and the prescription of scoliosis-specific exercises can help by targeting the spine's surrounding muscle balance and strength. A spine that's surrounded by balanced and strong muscles is one that has optimal support and stability.
Rehabilitation can involve home exercises that patients are taught to hold treatment results and improve posture for long-term results.
Scoliosis is a complex and highly-prevalent spinal condition that affects approximately 7 million people in the United States alone.
While many consider scoliosis to largely be a childhood condition, the estimated rate of scoliosis in adolescents is between 2 and 4 percent, while studies of adult scoliosis show rates as high as 12 to 20 percent.
When it comes to the aging population (adults over the age of 60), the rate of scoliosis can be as high as 68 percent.
So adult scoliosis also needs to be taken seriously and treated proactively.
The two main types of scoliosis to affect adults are idiopathic scoliosis and degenerative scoliosis.
The symptoms of adult scoliosis include back pain, muscle pain, muscular imbalance, postural changes, a prominent lean to one side, and mobility changes.
As progression occurs, the size and rotation of the scoliosis is increasing, and this makes its effects more noticeable and difficult to improve and/or reverse; this is the benefit of starting treatment early before significant progression has occurred.
But regardless of severity or patient age, it's never too late to work towards improvement that can shape a patient's quality of life.
So can you correct scoliosis in adults? Corrective results are within reach, but adult scoliosis can also be more complex to treat, particularly in aging adults facing degenerative changes.
While significant curvature reductions capable of counteracting the trigger of growth are the focus of childhood scoliosis treatment, improving the spine's stability and balance is more the focus of adult scoliosis treatment.
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