Degenerative scoliosis describes a sideways curvature of the spine that results from the degeneration of the joints and discs in the spine. Also, this condition and the resulting problems of the spine usually occur gradually as a person ages.

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“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

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 are 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.


Doctor Patient appointment
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 laying down)
  • Pain in one or both legs
  • Numbness and/or weakness in one or both legs

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 are 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.

Learn more about braces used to treat back problems.


Epidural steroid injections can reduce inflammation, and facet-block injections can prevent pain signals from reaching the brain. These types of injections deliver the 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. Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Y. Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD are specially trained and have years of experience performing these types of complex spine surgeries.


Reba Dawson

Sadly, Reba’s curves were 65 degrees and causing bone on bone, and therefore, she was in constant pain. In view of this, she opted for surgery. Because of the skill of her surgeon, her pain was gone when she woke up from surgery. Fortunately, the pain never returned and she lives life to the fullest. In her youth, Reba was diagnosed with Scoliosis. As she got older, she learned that she had a double curve and in her 40s she started having a lot of pain. In 2017, she realized that the pain was taking over her life, day and night. Then she found Dr. Richard Hostin. And after that, she made an appointment and started her healing journey. So, “I’m pain-free and feeling amazing!”- Reba Dawson

“After surgery, patients are admitted 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.