Degenerative scoliosis, also known as adult onset scoliosis, is a condition that a curvature of the spine occurs due to wear and tear changes. In general, the curve of the spine is 10 degrees or more.
The condition is related to natural aging and is the most common type of scoliosis in adults. In most situations, degenerative scoliosis happens in the lumbar spine, the lower part of the back in the discs or the facets.
In the human body, we have all in all 33 bones, or vertebrae, in our back. As we grow old, the facet joints that connect the vertebrae start to degenerate. Since facet joints are responsible for keeping the spine stay flexible, degenerative scoliosis usually causes stiffness.
Basically, degenerative scoliosis is most commonly seen in elderly people and the disease is often related to osteoarthritis or osteoporosis. Osteoarthritis, or osteoporosis, is a type of arthritis that usually causes joint pain and stiffness.
According to statistics, degenerative scoliosis mostly happens in elder people, especially people who are over the age of 65. The risk of over-65-year-old people having the condition can be as high as 68%. On average, the prevalence of degenerative scoliosis can range from 6% to 68%. Since an aging population increases rapidly in the United States, degenerative scoliosis is also growing to become a health concern to many people.
At present, the cause of degenerative scoliosis remains a problem to solve. However, researches and studies have found that the condition has a close connection with natural aging, microtrauma and other activities that hurt the spinal area repeatedly. What’s more, severe falls or other accidents also may lead to degenerative scoliosis.
Generally speaking, people with degenerative scoliosis usually experience pain in the back, hip, buttocks, and legs. For different patients, the signs and symptoms of degenerative scoliosis may vary.
Common symptoms may include the following:
- Pain in parts of
- Muscle spasms
- Shooting pains
- Numbness in the
- Difficulty lifting
the front part of the foot
- Weakness and
- Trouble standing
Frequently, the symptoms may develop in a gradual way. As time goes by, the painful feeling may worsen bit by bit. Also, people with the condition may feel the pain especially stronger in the morning and night. During daily activities, the situation might become better.
When an individual goes to the hospital, the doctor usually takes a complete medical history and checks the individual’s symptoms first. During the physical examination, the doctor is likely to check the individual’s backbone, shoulder, and hips. If the individual is suspicious of having degenerative scoliosis, the doctor will then use imaging tests to help diagnose the condition.
Additional tests may include X-ray, Magnetic
resonance (MR) imaging, and Computed tomography (CT) scans. Besides, Magnetic
resonance imaging (MRI) scan may also be used to obtain information about the
nerves, disks, and soft tissue in the spine.
Based on the images of the individual’s potentially affected area, the doctor can give an accurate and detailed diagnosis.
Once the spine degenerates, there is no cure. However, non-surgical treatment and surgical treatment can both offer help to reduce the symptoms. The fundamental goal of non-surgical treatment is to alleviate the pain and help the patients to perform routine activities. In severe conditions, surgery may also be recommended by the doctor so that the pressure on the spinal cord can be relieved.
For patients with milder symptoms, the available
treatment options may include the following:
- Pain management.
In order to ease the pain, the doctor may prescribe some pain relievers for the patient with degenerative scoliosis. Nonsteroidal anti-inflammation drugs such as ibuprofen and acetaminophen can be helpful to reduce pain. Also, it is often recommended to avoid narcotic pain medication.
- Physical therapy.
For people with degenerative scoliosis, gaining more muscle strength and moving around can be beneficial to relieve the pain. So, a physical therapy that involves exercise and stretching programs can play a significant role in easing the pain as well as preventing the pain from recurring in the future. Some exercises may be done in a pool too.
The doctor may recommend wearing a brace in the back to restrict motion. Unlike the bracing for people with adolescent idiopathic scoliosis, the brace for degenerative scoliosis is only to relieve the pain and help the patient to engage in daily routine activities, instead of preventing the curve from progressing.
- Heat and/or cold therapy.
Heat packs can help to ease the inflammation that causes pain while cold packs can be soothing to the affected area.
- Epidural steroid injections.
These injections can reduce inflammation and ease the pain.
- Eat healthily.
There are many foods that have anti-inflammatory qualities, such as ginger and turmeric. Food with enough nutrition is also important. If necessary, nutritional supplements can also be taken. To ease the inflammation, it is also very crucial to keep the body hydrated.
- Keep a healthy weight.
Losing some weight can decrease the pressure for the spinal area. Manual manipulation by experienced chiropractic or osteopathic experts may help to adjust the spine too. But not all find manual manipulation effective.
Overall, non-surgical treatment can be done either alone or in combination. But, if the patient with degenerative scoliosis have developed spinal stenosis, the doctor may recommend surgery.
Usually, after the patient with degenerative
scoliosis receives the surgery, he or she will need 3 to 12 months to recover. The
main goal of the surgery is to relieve the pressure on the spinal cord and ease
the pain. There may be several surgical options available:
- Spinal fusion. In this
surgical procedure, the doctor may place metallic devices so as to improve spinal stability.
- Laminectomy. This surgery
is often performed to make room for the nerve roots that are compressed. By removing
the laminae, the nerve root will have enough room to function in a normal way.
- Minimally invasive
surgery. Thanks to the advances made in medical technology, minimally invasive options
that make only tiny incision are also available now.
Keywords: degenerative scoliosis; adult onset scoliosis.