“At Southwest Scoliosis and Spine Institute, we see adult patients in pain or embarrassed by the curves. Our expertise and experience with complex adult scoliosis make the difference in improving lives.”
Richard Hostin, MD
Degenerative Scoliosis occurs in adults and can cause a particularly debilitating condition, which produces terrible pain and progressive curvature of the spine. Untreated cases may manifest as a disfiguring S or C-shaped curve and often a large hump in the back. As they age, patients with this form of scoliosis have increasing difficulty exercising, and their lifestyles become changed and impacted by pain. As the disease progresses, some may experience difficulty breathing and walking.
When working to provide a diagnosis for a patient’s pain and discomfort, we closely examine each patient’s specific curvature and entire body. So we conduct a thorough physical examination of the back and extensive testing including specialized low-dose X-rays.
Definition of Degenerative Scoliosis
- Pure degenerative – Scoliosis patients who had straight spines earlier in life but developed curvatures from wear and tear of the aging spine.
- Old idiopathic curves with degenerations – Scoliosis patients who had curves in childhood that increased in curvature later in life.
- Secondary – Scoliosis patients who experienced curves caused by other conditions, such as tumors and fractures.
Upon looking for the cause of pain or discomfort, patients can have a range of symptoms — depending on what causes the condition. Some patients with this condition experience no symptoms, while others experience pain and disability. Degenerative scoliosis symptoms may include:
- Back pain that gets worse while standing (and may get better while lying down)
- Pain in one or both legs
- Numbness and/or weakness in one or both legs
Questions and Answers
What is Degenerative Scoliosis
Degenerative scoliosis, also known as adult-onset scoliosis, characterizes an abnormal sideways curvature of the spine that occurs in adulthood. Unlike adolescent idiopathic scoliosis, which typically develops during adolescence, the cause of degenerative scoliosis happens with the degeneration of the spinal discs and joints that occurs naturally with age. It often affects older individuals and doctors find it associated with osteoarthritis and spinal stenosis.
What are the Symptoms of Degenerative Scoliosis
The symptoms of degenerative scoliosis can vary from person to person. Common symptoms include back pain, stiffness, and a noticeable curvature of the spine. The pain may worsen with prolonged standing or walking and may be relieved by sitting or lying down. Some individuals may experience leg pain or numbness if the scoliosis is compressing nerve roots or the spinal cord. In severe cases, degenerative scoliosis can lead to spinal instability, balance problems, and difficulty with daily activities.
What are the Treatment Options for Degenerative Scoliosis
The treatment options for degenerative scoliosis depend on the severity of the curvature and the presence of symptoms. Non-surgical treatments such as pain medication, physical therapy, and exercise are often recommended initially to manage symptoms and improve mobility. In cases where conservative measures are not effective, surgical intervention may be considered. Surgery aims to correct the spinal curvature, stabilize the spine, and relieve pressure on nerves or the spinal cord. The specific surgical approach will depend on various factors, including the location and severity of the scoliosis, as well as the overall health and preferences of the individual.
Diagnosing Degenerative Scoliosis
The diagnosis of Degenerative Scoliosis occurs by combining a physical exam and specialized X-rays. During the physical exam, Dr. Hostin will look at the degree of rotation in the curvature of the spine, as well as other changes in other parts of the body, such as:
- Uneven shoulders
- Rib hump or asymmetry
- Low back hump or asymmetry
- Change in the shape of the waist
- Uneven pelvic bones or hips
Often, these changes do not get noticed while standing and only become visible when the person bends forward. Meanwhile, X-rays provide an important tool for pinpointing the shape and location of the curves, as well as for measuring the degree of the curvature. For instance, the Southwest Scoliosis and Spine Institute uses the revolutionary EOS X-ray imaging system, which allows us to quickly take full-body images of patients in multiple positions while having the lowest possible dose of radiation.
When Does Degenerative Scoliosis Become Serious?
If degenerative scoliosis causes the spinal cord or a nerve root to become impinged, either through stenosis (narrowing of the spinal canal) or severe bending of the spine, nerve function could become jeopardized. Initially, this often feels like a sharp or shock-like pain in the back that radiates down the buttock and/or into the leg, or as tingling or numbness that can radiate down into the leg. Doctors refer to this as sciatica or sciatic pain, and the medical term for this type of radiating pain is radiculopathy. While uncommon, this condition can cause weakness in the legs and/or problems with bladder and bowel control.
As a result of our experience, we use conservative treatments for degenerative scoliosis and they include medication, exercise, and bracing to support the spine.
If the doctor finds osteoporosis present, then treatment of this disease may also slow the progression of scoliosis. In addition, the current treatment includes increasing calcium and vitamin D intake and weight-bearing exercises.
Our doctors prescribe mild pain medicines to use as needed. Usually, we do not prescribe strong pain medications, such as narcotics. In many cases, we treat degenerative scoliosis by combining physical therapy and pain management. However, in cases where the patient’s curve progresses to the point that they feel pain or have difficulty breathing, doctors may recommend surgery as the best option.
Physical Therapy and Exercise
A physical therapist or another qualified medical professional can help develop an exercise and stretching routine to meet the patient’s specific needs. Physical therapy can help keep the soft tissues and joints limber as well as strengthen the targeted muscles. The doctor will likely prescribe anti-inflammatory drugs. Drugs like ibuprofen or medications that treat arthritis inflammation can help reduce pain and allow patients to continue physical therapy.
The goals of physical therapy are to help
- learn ways to manage the symptoms of the condition
- improve spine posture
- stabilize the spine
Exercise does not help to stop scoliosis. However, it can help by addressing pain, posture, and spine stability. Your doctor may schedule therapy sessions for four to six weeks.
The use of a spinal brace may provide some pain relief, but in adults, the brace will not cause the spine to straighten. Once you have reached skeletal maturity, bracing is used for pain relief rather than prevention. If the doctor finds a difference in the length of your legs (or if scoliosis causes you to walk somewhat crooked), special shoe inserts, called orthotics, or a simple shoe lift may reduce your back pain.
Epidural steroid injections can reduce inflammation, and facet-block injections can prevent pain signals from reaching the brain. These types of injections deliver anti-inflammatory medication directly to the affected area in the spine.
Degenerative Scoliosis Surgery
If the curve becomes severe and the patient feels a great deal of pain, the doctor may recommend surgery. Also, the most common type of surgery to address this condition is called spinal fusion. When performing this surgery, rods and screws are placed into the vertebrae to prevent the spinal curve from growing any further.
The Southwest Scoliosis and Spine Institute Specializes in helping patients with Scoliosis and complex Spine Conditions.
If you think you or a loved one might need surgery to correct scoliosis or any other kind of complex spine surgery, you should contact a surgeon who performs these kinds of complicated and specialized procedures all the time. Finally, the Southwest Scoliosis and Spine Institute’s board-certified, fellowship-trained orthopedic surgeons, Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD should be your first choice as they are scoliosis and spine doctors who very frequently are recommended by other doctors. They maintain the highest level of expertise and surgical skills necessary to handle the most complicated cases and achieve successful results.
In fact, they’ve performed more than 16,000 successful spine surgeries. Significantly, they have also helped more than 100,000 patients get back to living a normal, pain-free life. So, if doctors advise you that nothing can help, please call us at Southwest Scoliosis and Spine Institute, and we have offices in Dallas, Plano, and Frisco, Texas. Finally, with our skills, knowledge, abilities, expertise, and experience, we can offer hope, remove pain, and provide better health. If you need help, call us for an evaluation at 214-556-0555 or visit our contact page today!
“After surgery, patients go to the intensive care unit to obtain focused nursing care,” says Dr. Hostin. “It really is very comforting for both the patient and their family to know that there’s one nurse assigned to take care of the patient’s needs.”
If you experience pain from scoliosis, we can help. Call the Southwest Scoliosis and Spine Institute at 214-556-0555.