We see two groups of people develop scoliosis. One is the younger group, usually, teenagers and even younger, where they develop it during their growing years.
The second group that we see affected by this are adults, usually in their forties, fifties, or sixties, where it just shows up and sometimes quite randomly.
The causes of scoliosis can be twofold.
In kids, we likely think it’s more of a genetic cause where as the child is growing, for whatever reason, the expression of the genes they’re born with leads them to have a curved spine.
In adults, things are a little bit different because what usually happens as we age is arthritis. It sets in and you can get this degenerative cascade where the joints in the spine actually deteriorate. The discs collapse, and when they collapse, you can get a curvature of the spine that we call scoliosis.
As you can imagine, if you have a tumor in one area that’s causing the spine to twist, or maybe an infection that gets into the disc or the bone, it can cause a collapse that leads to the spine to curve.
Other things can include getting into a car wreck and breaking your bone. It can all lead to deformation of the normal spine, which is supposed to be straight, but then ends up being curved.
Ironically in kids, there are usually no symptoms. It’s usually picked up by them looking in the mirror and feeling that things are just a little bit off. In adults, it’s usually pain that leads them to seek help.
Diagnosis happens in one of two ways. The first one is clinical. We’d like to see our patients in person and evaluate their spines. When you lean forward, we can actually see the tilt in your back and then measure the scoliosis with something called a scoliometer. The degree of curvature then prompts us to use the second way that we diagnose it, which is an X-ray. This is a traditional X-ray that we typically use to diagnose it.
At Scripps, we now have access to a state-of-the-art new X-ray machine that allows us to take these X-rays at a fraction of the radiation dose, and also to evaluate the spine as it relates to the entire body. We can measure the degree of curvature and where it’s located, and then be able to more appropriately recommend management.
In kids, we do know the use of brace wear, especially when the degree of the scoliosis is a little bit smaller, can actually help the scoliosis from getting worse.
In adults, we’re on a different cascade because it’s the spine that’s degenerating that is leading to the problem. Anything that we can do to promote our spine health will hopefully stop that progression from happening.
Having a curve is actually quite normal as we age. What you want to do is keep the pain at a minimum, and that’s the type of progression that we would like to prevent.
The way we treat scoliosis in kids differs from the way we treat it in adults.
In kids, while they’re still growing, we have the opportunity to use a brace that can actually help the spine straighten as the child is growing.
Adults are done growing, so it doesn’t work the same way. A brace wear actually doesn’t help very much. We try all kinds of nonsurgical management. However, for patients that have scoliosis-related pain, that can include things like chiropractic care or acupuncture or physical therapy, all which can be effective in trying to help and promote pain reduction.
If you’re having symptoms that are going into the legs, like nerve pain or sciatica, often times we’ll use nerve blocks or epidural injections to try to help with the pain that’s associated with the nerves. When all these things don’t work, sometimes we have to use surgery to help the problem.
It really is dependent on how big the surgery needs to be. There’s less invasive surgery, minimally invasive surgery, that sometimes is applicable in these cases. Sometimes patients need a bigger operation to straighten out the spine.
Recovery can range anywhere from a couple weeks to several months, even up to six months.
Think about a seven-day week. If you are plagued by pain for more than four days a week, that tells me that your back is really limiting you more times than it’s not, so that’s a good time to go seek help.
Certainly if you have symptoms of shooting pains down your legs or sciatica or other nerve type of pinching, then you want to be evaluated. There could be other reasons for it, for that to be happening. But certainly if pain is becoming a factor in your quality of life, then I would definitely recommend seeing someone for help.
I think a lot of patients feel a lot of anxiety around their spine, especially if they’re having pain in the back or pain in the chest that’s coming from the spine from scoliosis.
I encourage you to take ownership of your back. Exercise, eat well, stay healthy. Chances are, if you really take care of your body, then you won’t need anything that’s more aggressive as far as treatment. You’ll be able to get through life hopefully in a relatively pain-free fashion.
Lightly edited for clarity.
Watch the San Diego Health video with host Susan Taylor and Dr. Mundis discussing symptoms and treatments for scoliosis.