Adult Scoliosis Treatment in Phoenix
Adult scoliosis begins with degeneration of the discs of the spine, which then results in arthritis of the spinal joints. A person may or may not have had scoliosis as an adolescent. The arthritis does not occur symmetrically, and results in a spinal curve which may twist the spine 3 dimensionally. On an x-ray of a front and rear view of the body, the spine looks like an “S” or a “C” shape rather than a straight line. The condition is sometimes noticeable overtly, but sometimes it may not be. Scoliosis can make the waist or shoulders look uneven.
A spine curvature of an idiopathic (cause not known) nature, which began during teenage years, may progress during adult life. Adult idiopathic scoliosis can also be a continuation of adolescent idiopathic scoliosis. The curves may increase in size from 0.5 degrees to 2 degrees a year on average. While this may not sound like a lot, over a few decades it can add up considerably. Adolescents curves over 50 degrees are likely to get bigger into adulthood, but if it’s 30 degrees or under, the curvature usually won’t increase.
The vertebrae of the spine may be affected by another spinal condition that may be a secondary cause from scoliosis which develops in adulthood. Other conditions are:
- Osteoporosis (loss of bone mass)
- Disc Degeneration
It’s important to note that having scoliosis as an adolescent is not a prerequisite to having it as an adult.
Adult degenerative scoliosis affects many people. In a study of 1,149 x-rays, researchers found that 2% of the patients had adult scoliosis, which appeared to be more common among those ages 60 to 69 years of age.
Patients with adult degenerative scoliosis often experience both back and leg pain. The reason is the spinal arthritis causes back pain, while the spinal stenosis may lead to buttock and leg pain. Spinal stenosis is when nerves get pinched due to the spinal arthritis leading to bony and soft tissue overgrowth.
This is very different than adolescent scoliosis, where pain occurs in only 15% of patients and is usually not that severe. In adults, it can be incapacitating at times.
Seeing a doctor for scoliosis includes a physical examination, imaging tests, such as x-rays taken from side, and front views from which the degree of the curve is measured. Usually when adults see a doctor for this problem, the curve already exceeds 30 degrees. An MRI can help show the extent of spinal stenosis.
It should be noted that the severity of adult scoliosis on imaging studies does not correlate directly with the severity of symptoms. Even relatively minor looking arthritis on imaging studies may cause severe pain, and vice versa.
Most adults with scoliosis are able to be managed successfully without surgery. Most cases of adult scoliosis do well with treatments that may include:
- Over-the-counter pain relievers
- Short term narcotics for times of exacerbation
- Neurogenic medications for nerve related pain (e.g. Lyrica, Neurontin)
- Physical therapy to stretch and strengthen the muscles surrounding the spine.
- Epidurals or nerve block injections. Used for temporary relief if the patient has persistent leg pain and other symptoms due to arthritis and pinched nerves.
- Medial branch blocks and facet injections – excellent for relieving back pain due to arthritis pain.
- Radiofrequency Ablation – this is a procedure involving deadening of sensory nerves surrounding the arthritic joints. This can provide pain relief for over a year at a time!
Operative indications includes the following:
- Disabling back and/or leg pain and spinal imbalance.
- All reasonable conservative (non-operative) measures have failed.
- When a person’s functions are considerably restricted and a normal way of life is reduced in quality.
- All in all, it truly is a quality of life elective procedure similar to the decision to undergo a joint replacement.
All in all, adult degenerative scoliosis is a condition where both back and leg pain are common. Over 90% of individuals are able to avoid the need for surgery and obtain relief with the advanced nonoperative pain treatments administered by the Double Board Certified Phoenix pain management specialist at Pain and Spine Clinics. Dr. Ramin Abbasian is the Arizona pain doctor offering the customized treatment options.
Call Pain and Spine Clinics for the top adult degenerative scoliosis treatments in the Valley!