What Causes Adult Degenerative Scoliosis?

As you age, your facet joints and intervertebral discs degenerate naturally, due to regular wear and tear.

There is no one cause of adult degenerative scoliosis, but factors that increase your likelihood of developing it include:

• Increasing age, especially being over 50
• Gender – women are more likely to get scoliosis
• Family history of scoliosis
• Genetic defects in the spine
• Previous back injuries
• Previous back surgeries
• Osteoporosis
• Being overweight
• Bad posture
• Long-term, repetitive strain on your back or neck, such as carrying a heavy backpack, bag or purse on one shoulder for many years

It is possible that you may have had pre-existing scoliosis as an adolescent or even a child that was never symptomatic, and therefore never caught, that is now progressing as an adult.

What are the Signs and Symptoms of Adult Degenerative Scoliosis?

Quite often, it is possible to have a scoliosis curve of the back and not have any symptoms. Symptoms usually appear gradually, and vary from person to person.

Symptoms can be similar to those of low back osteoarthritis or degenerative disc disease because they are all part of the same degenerative process. 

Depending on the severity, adult degenerative scoliosis symptoms can include:

• Dull ache or stiffness that comes and goes, usually in the low back
• Pain that is worse in the morning, at the end of the day, or after strenuous activity
• Sitting feels better than standing (as sitting takes the weight off the facet joints)
• Sharp leg pain that occurs while walking but goes away with rest
• You become shorter or have a leg length difference
• One shoulder looks higher or more prominent than the other
• One side of the hip is higher than the other (which can affect your gait)
• Your waist looks flat on one side
• Your ribs look higher on one side when bending at the waist
• Your head does not look centred on your body

In more severe cases of adult degenerative scoliosis, people may experience:

• Heart and lung damage making it difficult to breathe (as the rib cage twists and reduces space for your organs)
• Chronic back pain if the curve worsens (which is unlikely)
• Loss of coordination in your leg muscles
• Loss of bladder and bowel control due to pressure on the spinal cord

Pain is not caused by the curve of the spine due to the scoliosis, but rather by inflammation in the facet joints, or nerve impingement. 

As the spine degenerates, it may cause the spinal canal to narrow (spinal stenosis), putting pressure on the spinal nerves, resulting in weakness, tingling, numbness, or sharp, shock-like pain in your back that can radiate down into your legs (sciatica). Pain may be felt in one leg but not the other.

How is Adult Degenerative Scoliosis Treated?

How adult degenerative scoliosis is treated varies depending on the cause, severity, and likelihood of progression. Most of the time it can be treated at home or with physiotherapy.

Treatment for adult degenerative scoliosis can include:

• Physiotherapy
• Medications when needed, including:
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen, or medications used to treat inflammation from arthritis, like Celebrex
  • Corticosteroid injections to reduce inflammation and relieve pain
• Surgery – surgery is rare, but if it is necessary after other less invasive treatments have not helped the pain, physiotherapy is an important part of rehabilitation

Medications cannot be continued long-term, but can be used initially to reduce pain and inflammation so a physiotherapy exercise program can be started that will offer long-term benefits and relief. 

Since the curve is not able to be corrected like it is during childhood or adolescence, the main goal of treatment is to reduce pain and maintain quality of life.

Physiotherapy for Adult Degenerative Scoliosis

Physiotherapy is a drug-free and non-surgical treatment that focuses on reducing pain, regaining strength, preventing progression, and increasing mobility, function, and quality of life. 

Depending on your individual needs, physiotherapy for adult degenerative scoliosis can include:

• Heat and cold therapy following the PRICE protocol
• Stretching, strengthening, and range of motion exercises
• Stability and endurance exercises
• Hydrotherapy
• Activity modification and functional retraining
• Bracing
• Orthotics to add support and absorb the shock from your regular activities
• Patient education so you feel in control of your condition
• Postural and ergonomic education
• Cross-disciplinary pain-relieving therapies such as: 
  • Interferential current therapy (IFC) or TENS therapy
  • Therapeutic ultrasound
  • Manual therapy (joint and soft tissue mobilizations)
  • Acupuncture
  • Massage therapy
  • Chiropractic
  • Occupational therapy

Are you seeking physiotherapy for adult degenerative scoliosis? Book an assessment today.

Can Adult Degenerative Scoliosis Go Away On Its Own?

Unfortunately, no. There is no cure for adult degenerative scoliosis, but with proper treatment, it can be managed effectively.

If you have adult degenerative scoliosis, there are things you can do to make daily living easier, including:

• Minimizing activities that put stress on your back, like bending and lifting, or carrying heavy things
• Switching from high-intensity activities like jogging, to low-intensity activities like walking
• Using a properly supportive pillow and mattress
• Wearing a back brace (which aims to reduce pain but will not correct the curve)
• Using an ergonomic chair at work and home
• Applying heat and cold therapy

Can You Prevent Adult Degenerative Scoliosis?

Usually scoliosis is not something that can be prevented, but as adult degenerative scoliosis is caused by the spine degenerating due to age.

There are some steps you can take to try to prevent or reduce your chance of developing it, including:

• Exercising regularly, including stretching exercises such as yoga or tai chi (at least 30 minutes every day)
• Eating a non-inflammatory diet (avoiding sugar, and processed and refined foods)
• Drinking enough water (8 glasses a day)
• Maintaining a healthy weight (which reduces stress on the facet joints)
• Practicing good posture
• Wearing orthotics and proper, supportive shoes
• Using an ergonomic chair if you work at a desk
• Moving around more – don’t sit in one position for long periods of time every day
• Lightening the load of your purse or bag, or at least alternating shoulders so you don’t favour one shoulder over the other

Book a Physiotherapist Consult for Adult Degenerative Scoliosis Today

Concerned about symptoms of adult degenerative scoliosis? Book an assessment with a physiotherapist today.