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Curved back: Treatment options for adult scoliosis

A curved back is often called many names — some people will refer to it as a curve, a hump, an “S shape” or scoliosis, the technical term for a sideways curvature of the spine. Often times, different forms of spinal malalignment will be referred to simply as scoliosis and in most instances, there is a component of scoliosis. 

Here are the facts about adult scoliosis symptoms, types and next steps.

Scoliosis symptoms

For adults, there is usually a component of kyphosis, or inability to stand upright, along with the scoliosis. People with scoliosis also commonly experience degeneration, nerve pinching and possibly spinal instability.

These spinal problems can create a varying group of symptoms for each individual patient with scoliosis. Below are a few of the symptoms I commonly see in patients with scoliosis.

Visible curve

Most patients will experience an abnormal bump or standing position of the spine; however, in milder cases of scoliosis, this may not be evident except on X-rays. 

Back pain

Scoliosis often involves a degree of pain, which can vary in intensity from an occasional deep, dull ache to severe constant back pain. The pain is usually located at the apex of the curve and can radiate from there and into the buttocks. 

Related: 5 myths people believe about lower back pain

Leg symptoms

Leg symptoms are also common but not as common as back pain. The leg symptoms are similar to other spinal problems that cause nerve pinching; they are leg pain, either burning or electrical, numbness and sometimes weakness. 

Decreased activity

In addition to back and leg symptoms, patients suffering with scoliosis can have difficulty completing their activities of daily living such as leaving the house, cooking, cleaning and even simpler things such as walking and standing up out of a chair. 

Types of scoliosis

Although scoliosis types can be grouped and there is a common set of symptoms, each person with scoliosis has a unique experience and will require an individualized treatment path. The three main types of adult scoliosis are referred to as congenital, idiopathic and degenerative. 

Congenital scoliosis

Congenital scoliosis occurs when there is a malformation of the spinal bones causing an abnormal shape or even a partial fusion of the bones that then causes the spine to curve. 

Idiopathic scoliosis

This type of scoliosis is one of the most common forms and has an unknown etiology, although there is a genetic, inherited component. Idiopathic curves tend to fall into reproducible groups; there is also significant research that has been done and is currently underway that provide evidence help develop treatment plans for patients. 

Degenerative scoliosis

Degenerative scoliosis occurs when there is substantial degeneration of the spine causing either instability or abnormal alignment. Often times in adults, idiopathic and degenerative scoliosis are present at the same time, meaning degeneration within an idiopathic curve can cause increase in the curve size, pain and stenosis. 

Scoliosis treatment options

Over time, scoliosis can worsen and begin to impact your quality of life and activity level. However, with a personalized treatment plan, it is possible to find relief from scoliosis symptoms and get back to the activities you enjoy. 

It’s important to keep in mind that scoliosis treatment is not one-size-fits-all. Treatment of scoliosis, like most spine conditions, is based on the symptoms and the severity of your condition. If there are no or very mild symptoms, initial treatment may simply entail monitoring for curve progression.

Curve progression can occur with or without pain and if the progression is significant, it is generally an indication for surgical correction. Surgery can help prevent further curve increase and protect from potentially harmful effects on the internal organs, such as the heart and lungs. 

If your symptoms do begin to increase, anti-inflammatory medications, muscle relaxers and physical therapy for core strengthening can be helpful. Research shows that narcotic medication should be avoided if at all possible. The next tier of treatments often involves pain management through epidural steroid injections and facet injections and ablations. 

Ultimately, surgical correction is the definitive treatment for scoliosis if the two major indications — curve progression and significant symptoms — are present. The symptoms are generally back pain in the area of the spinal deformity and leg symptoms of pain, numbness and weakness. Surgery for scoliosis can be very involved, but the amount of improvement it can make for a person, both for symptom improvement and quality of life, is dramatic.

Scoliosis shouldn’t keep you from enjoying all life has to offer. If you’re experiencing scoliosis symptoms, find a scoliosis expert near you

About the author

Ioannis Avramis, MD
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Ioannis Avramis, MD, is an orthopedic spine surgeon on the medical staff at Baylor University Medical Center. Book an appointment with Dr. Avramis today.

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Curved back: Treatment options for adult scoliosis