Definition
Scoliosis is an abnormal curvature of the spine. It has a C or S shape instead of being a straight line from the neck to the buttocks.
Adult scoliosis may be a progression of childhood scoliosis or something that happens later in life.
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Causes
Idiopathic scoliosis is the most common form of this problem in adults. This means there is no known cause. It can result in premature aging of the spine. This can worsen the curvature.
Scoliosis that starts in adulthood may be from wear and tear injuries of the spine, also known as degenerative diseases.
Risk Factors
Scoliosis that starts in adulthood is more common in people who are 60 years of age and older. It may be present with other problems, such as:
- Degenerative disc disease
- Osteoporosis
- Compression fractures
- Prior spinal surgery
- Prior spinal trauma
- Spondylolisthesis—slipped vertebrae
- Infection
- Tumors
Symptoms
A person may have hips or shoulders that are not even. People with severe curves may lean forward or to one side to try to stand upright.
Other problems depend on where the curve is and its severity. Some people may not have problems. Others may have:
- Back pain or stiffness
- Numbness, weakness, or cramping in areas or limbs around the curvature
- Changes in bowel or bladder habits—if the curvature is in low back
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the spine.
Images of the spine may be needed. This can be done with:
Treatment
People without symptoms may not need treatment. They may only be watched for any changes.
For others, the goal of treatment is to ease symptoms and stop the curve from worsening. Choices are:
- Treating underlying causes
- Wearing a brace in the short term to ease pain
- Physical therapy to help with strength, flexibility, and range of motion to ease stress on the spine
- Medicines to ease pain and swelling, such as:
- Over the counter or prescription pain relievers
- Muscle relaxants
- Nerve block injections
People who are not helped by these methods may need surgery. A spinal fusion connects two or more bones of the spine with rods or metal plates. This can help straighten and ease pressure on the spine.
RESOURCES
Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org
Scoliosis Research Society http://www.srs.org
CANADIAN RESOURCES
Canadian Spine Society http://www.spinecanada.ca
Health Canada https://www.canada.ca
References
Chronic low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-low-back-pain. Accessed February 2, 2021.
Qaseem A, Wilt TJ, et al, Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530.
Scoliosis in adults. Hospital for Special Surgery website. Available at: https://www.hss.edu/conditions%5Fscoliosis-adults-overview.asp. Accessed February 2, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
- Review Date: 12/2020
- Update Date: 02/02/2021