Scoliosis is an abnormal curvature of the spine. Instead of a straight line from the neck to the buttocks, the spine has a C- or S-shape.
Adult scoliosis is a spinal curvature that exists or develops after someone is done growing (around 18 years old). Adult scoliosis may be a progression of childhood scoliosis or a scoliosis that develops later in life.
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Idiopathic scoliosis is the most common form of scoliosis that continues into adulthood. Idiopathic means there is no clear cause of the scoliosis. Idiopathic scoliosis that is not diagnosed or treated in childhood can continue into adulthood. The scoliosis can also cause premature aging of the spine, which worsens the curvature. This is more likely with curves greater than 30 degrees.
Scoliosis that develops in adulthood may occur as the result of wear and tear injuries of the spine, also known as degenerative diseases.
Scoliosis that develops in adulthood occurs more often in people aged 60 years and older. It may occur with one or more of the following:
- Degenerative disc disease
- Compression fractures of the spine
- Previous spinal surgery
- Previous spinal trauma or injury
- Spondylolisthesis—slipped vertebrae
The risk of progression of any scoliosis is related to the degree of the curve. For example, someone with a 50-degree curve is at a much higher risk of progression than someone with a 30-degree curve.
The most common symptom is the appearance of asymmetry in the shoulders or hips. More severe curves may cause leaning forward or to 1 side in order to stand upright.
Other symptoms will depend on where the abnormal curvature is in the spine and the severity of the curves. Some may not have any symptoms. Progression of scoliosis or abnormal wear and tear on spine due to scoliosis may cause:
- Back pain or stiffness
- Numbness, weakness, or cramping in areas or limbs around the curvature
- Spinal imbalance
- Changes in bowel or bladder habits—if the curvature is in low back
You will be asked about your symptoms and medical history. A physical exam will be done. You will be asked to move or hold certain positions. An examination of the back and spine may include:
- Assessing posture and spinal curvature in an upright position
An assessment of your spine while you are bent forward to look for:
- Spinal curvature
- Rib hump
- Other abnormalities along the back
Not all curvature can be easily seen. Imaging tests may be needed to look at the spine and surrounding structures. Test options may include:
- Myelogram —an x-ray using a dye to highlight smaller structures like blood vessels
- MRI scan
- CT scan
Neurologic tests may also be done to look for problems with nerves near the curvature.
Scoliosis with mild symptoms that don’t limit daily activities may not require treatment. Monitoring can be used to watch for any changes in the spine or symptoms.
Scoliosis that is causing difficult symptoms or progressing may require treatment to help relieve symptoms. Options include:
Bracing for adults may be recommended to reduce pain, but only for a short time. Wearing a brace for a long time weakens the back muscles and doesn’t help the scoliosis.
Medication may be used to decrease pain and inflammation. Medication options may include:
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- Prescription pain medications
- Muscle relaxants
- Injected nerve blockers
Stretching and exercise help maintain flexibility, strength, and improve range of motion. Physical therapists may help design an exercise plan that reduces stress on the spine.
Surgery may be done to address other problems caused by the scoliosis. Surgical options may include:
- Decompression—to relieve pressure on the nerves
- Discectomy —removal of herniated intervertebral discs
- Removing bone spurs from the spine
- Laminectomy —removal of the lamina to improve movement
Rarely, surgery may be needed to correct the curvature. It may be recommended when:
- Other treatments fail
- Curvature progresses
- The spine becomes unstable
- There is a decline in quality of life
A spinal fusion connects 2 or more bones of the spine with rods or metal plates. The combined bones can help to straighten out an area of the spine to relieve some pressure.
There are no current guidelines for preventing scoliosis in adults. If you are at high risk for other spinal conditions, such as osteoporosis, talk to your doctor about preventive measures you can take.
Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org
Scoliosis Research Society http://www.srs.org
Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca
Health Canada https://www.canada.ca
Chronic low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116935/Chronic-low-back-pain . Updated June 30, 2017. Accessed November 15, 2017.
Scoliosis in adults. Hospital for Special Surgery website. Available at: https://www.hss.edu/conditions%5Fscoliosis-adults-overview.asp. Updated September 6, 2011. Accessed November 15, 2017.
Scoliosis in adults. Spine Universe website. Available at: http://www.spineuniverse.com/conditions/scoliosis/scoliosis-adults. Updated August 1, 2017. Accessed November 15, 2017.
- Reviewer: EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
- Review Date: 11/2018
- Update Date: 12/15/2015