Aesthetics Of Scoliosis In Adults
While pain, disability, and the progression of your curves are the most serious and urgent results of adult scoliosis, the way that you look when you go about your daily life is a very real and important consideration for scoliosis sufferers.
In addition to worrying about the possibility of your condition deteriorating over time and resulting in pain, you sometimes feel self-conscious because of the way your scoliosis makes you look.
I hated the way I was different. My friends were always asking me if I was in pain because my hip was sticking out to the side when I walked. Yes, I was in some pain, but I didnt want anyone to notice, but they all did.
So many scoliosis sufferers can relate to this feeling of being different from everyone else. Even if you are experiencing no pain, your scoliosis appears as a disability in the eyes of people you see at work, at the supermarket, in interviews, at gatherings with friends, and everywhere you go.
The good news is that treatment for your scoliosis can stabilize, and possibly even modestly reduce your scoliosis and allow you to experience less pain, disability, progression, and self-consciousness.
Research shows that even if the curve can only be modestly reduced, significant postural improvement is still very possible!
Katherine was suffering from back pain for 40 years. She went to many different physical therapists, chiropractors and doctors to no avail. The pain worsened and began to spread to her shoulder:
Progression Of Scoliosis In Adults
Even worse than the severe pain or limiting disability that can occur for scoliosis sufferers is the feeling of utter helplessness to do anything about it. When you do not receive treatment for scoliosis and simply watch and wait, you are vulnerable to the likely outcome that your curve will get much worse over time.
The above series of X-rays shows the progression of an untreated child from ages 9 to 13. You can see that this patients upper curve progressed 45 degrees and the lower curve progressed 37 degrees in just 4 years. In an adult, the curve progression is typically much slower.
Research shows that the curve progression in an adult will vary between 0.5 to 3.0 degrees per year, depending on the shape of the curve, overall curve size, and the age of the scoliosis onset.
It was previously thought that progression only happens for people with more extreme curves of more than 30 or 40 degrees. But more recent studies on scoliosis have proven that scoliosis curves can and often do progress drastically and in a shorter period of time, especially as you get older.
A 2003 study found that 36% of adolescents with scoliosis had progressed by more than 10° after 22 years.
Damon was diagnosed in 10th grade. After X-rays and visits to specialists no treatment was prescribed because his scoliosis wasnt bad enough. He went to a chiropractor and acupuncturist but all it did was lessen some pain and discomfort while providing no visible changes:
Adult Scoliosis Can Be A Pain In The Back And Legs
Just like the padding in our knees wears downover time, so can the cushioning in our spines. In some adults, this can resultin a side-to-side curvature of the spine a condition called adultdegenerative scoliosis.
Adult scoliosis is different from idiopathicscoliosis, which typically affects children and teens. Idiopathic scoliosis candevelop without an apparent cause and accounts for approximately 80% of scoliosiscases in the U.S.
Adult degenerative scoliosis is awear-and-tear breakdown of the spinal discs and joints that results in shiftingand twisting of the vertebrae. As the degeneration progresses, the spine canbecome more out of balance, resulting in back and leg pain. As adults livelonger, more active lives, were seeing an increase in cases of adult scoliosis.
According to The Burden of MusculoskeletalDiseases in the United States, approximately 5.88 million adults in the U.S. have adultscoliosis, though some estimates suggest that number could be as high as 141million because rates of the disease are not well reported.
Adult degenerative scoliosis is a wear-and-tear breakdown of the spinal discs and joints that results in shifting and twisting of the vertebrae. As the degeneration progresses, the spine can become more out of balance, resulting in back and leg pain. As adults live longer, more active lives, were seeing an increase in cases of adult scoliosis.
Carlos Bagley, M.D.
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When Scoliosis Surgery Can Help
If nonsurgical treatments provide no relief and you have a spinal imbalance with disabling back or leg pain, scoliosis surgery may be an option:
- Laminectomy, also called decompression surgery, removes some or all of the lamina part of the vertebra to relieve pressure on the spinal cord
- Microdiscectomy , a minimally invasive surgery to relieve pressure on the nerves
- Spinal fusion permanently joins two vertebras with bone or synthetic graft material
- Osteotomy realigns spinal segments
- Vertebral column resection realigns the spine when an osteotomy or other surgeries dont correct the scoliosis
Recovery depends on your condition and type of surgery, though it can take up to a year to fully recover. You should not lift heavy objects and minimize bending for the first 612 weeks.
Which Type Of Scoliosis Do I Have
Here are 2 quick tests on how to determine which type of Scoliosis you have.
a)Forward Bend Test
- Stand with your feet together.
- Keep knees completely straight.
- Take note of the severity of your Scoliosis.
- Position 2:
- Bend forwards at the waist until your torso is horizontal.
Results:
- Structural Scoliosis: Nil change in the alignment of the spine.
- Functional Scoliosis: Partial/Full correction in the alignment of the spine.
b)Side Bend Test
- Stand up right.
- Side bend away from the side of the concave curve.
Results: If the curvature of the spine partially or completely reverses, then you have a Functional Scoliosis.)
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The Top 5 Benefits Of The Strauss Method
The Strauss Method has given scoliosis sufferers freedom, quality of life, and peace of mind. You wont believe the additional benefits that come with slowing your progression and decreasing your pain. You have the opportunity to non-invasively improve your condition and your life. What would you give to have hope that your condition will not get worse, but instead will improve?
Disability Related To Scoliosis In Adults
Another terrible consequence of untreated scoliosis is disability. You lose your freedom to do the things that you love to do and can become less and less independent. Some severe scoliosis sufferers cannot even stand or walk because their condition is so degenerative. This is known as postural collapse and occurs in adults due to the relentless effect of gravity on the scoliotic spine.
As scoliosis patients become older, the likelihood of disability increases. Without treatment, disability from scoliosis can cause you to be confined to bed, unable to move without the aid of someone else, and completely without freedom to do the things that you enjoy.
One Strauss Scoliosis Correction patient had such severe scoliosis that she could not walk and was confined to her bed. She was without any freedom and independence. But after just 6 weeks, she was able to walk and move again without any pain or discomfort:
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Scoliosis Pain And Trigger Points
The most common type of pain in adults with scoliosis is due to their posture shifting forward. This change in balance causes development of painful nodules called trigger points to form along the back. These trigger points are very responsive to the specific exercises shown below.
To treat the pain of this forward shifted posture, you must both release the trigger points along the mid to lower back muscle attachment points as well as strengthen the back muscles to lift the posture.
Trigger Points from scoliosis occur over the top of the back of the pelvis and extend up to the middle back. They feel like areas of tense knots in these muscles. They are always painful to deep pressure and in sensitive people, even a light touch can provoke strong pain. Often trigger points can send pain radiating from the back to the flanks, abdomen, buttocks or groin.
CAUTION: We only discuss two of the more common scoliosis patterns. If you are not absolutely certain that your spine matches one of these patterns, DO NOT use these exercises and instead seek out a scoliosis expert to guide you. You can contact us anytime for a free assessment.
Does The Severity Of Pain Vary
Scoliosis pain symptoms vary widely, and the amount of pain isnt necessarily related to the severity of spinal curvature. Mild cases can be painful while severe scoliosis patients dont have pain at all. Although, generally speaking, the larger the misalignment, the greater intensity of pain. For adolescents, it can sometimes be more painful if the torso and shoulders are shifted over the hips, due to the increased burden upon the muscles on one side of the body. Adults typically experience more pain if they have a forward head posture.
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Muscle Degeneration At The Local Level
An August 2021 paper in the Global Spine Journal investigated the effect of paraspinal muscle degeneration in degenerative lumbar scoliosis cases where patients had corrective surgery. In this study:
- 98 degenerative lumbar scoliosis patients were examined through an average 38.3 months follow-up after corrective surgery.
- The T1 pelvic angle, lumbar lordosis, and pelvic incidence were measured preoperatively, immediately postoperatively, and at last follow-up.
- Patients were divided into the lumbar lordosis maintenance group and the lumbar lordosis loss group .
- Explanatory note. Lumbar Lordosis Loss or Flat Back Syndrome has been described for decades. In 1988 Dr. Michael O. LaGrone wrote in the journal The Orthopedic clinics of North America: Symptomatic loss of lumbar lordosis is a disabling complication of scoliosis surgery. This so-called flat-back syndrome is characterized by an inability to stand erect and by upper back pain. Distraction instrumentation extending into the lower lumbar spine or sacrum is the most frequently identified etiologic factor responsible for loss of lordosis.
Pain Management For Scoliosis
Most patients with scoliosis have mild forms of the condition that are easily treatable with conservative treatment. For these individuals, there are many options for managing pain and improving posture.
According to Drs. Chi and Kang, its best to exhaust the following non-surgical, conservative treatments before consulting with a surgeon.
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How To Analyze Your Scoliosis On X
X-Ray Analysis
1. Your Alignment vs Ideal Alignment
- Draw a vertical line that is the mid point between the 2 hip joints.
2. Pelvic Tilt
- Draw a line between the waist heights.
3.Leg Length Discrepancy
- Draw a line between the top of the hip bones.
4. Identify the Convexity and Concavity curves
5.Determine the Cobbs angle
Instructions:
- > 45 degrees: Severe
Note:
** The following Scoliosis exercises are best suited for those who have a curve of < 20 degrees.
** The exercises will still help for those who have a curve of > 20 degrees, however, other factors such as spinal rotation and rib position will likely need to be addressed as well.
** For angles > 40 degrees, surgical interventions may need to be considered.
Scoliosis Exercises For Long
While simple stretches such as these can temporarily relieve scoliosis pain, they are not a long-term treatment.
There are, however, scoliosis exercises that achieve long-term results by retraining the brain to counteract the spines abnormal curvature.
The key is to use involuntary exercises movements the body makes automatically in response to certain stimuli. For example, the ScoliSMART Activity Suit places small amounts of weight on the head, torso, and pelvis that trick the brain into perceiving a different balancing point for that part of your childs body. The brain sends out an automatic response to re-balance the body, which in turn causes the entire spine to realign.
Clinical studies have proven ScoliSMARTs scoliosis exercise program effective at stopping scoliosis progression and reducing spinal curvature, all without the trauma and risks of bracing or surgery.
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What Causes Scoliosis Pain
Typically, the pain you experience with adult onset scoliosis is the result of pressure on your spinal disks, pressure on facet joints, and muscle pain. But scoliosis can cause pain for other reasons.
The curvature of the spine can stretch or irritate nerves. It can also strain joints, causing them to become inflamed.
Scoliosis also affects your posture, which leads to muscles tightening or becoming tired, causing pain.
In children, the spinal curve can increase without treatment.
Which Sports And Activities Are Safe For Scoliosis
A scoliosis diagnosis doesnt have to mean giving up the activities you enjoy! Collisions sports and those with highly repetitive motions are more risky when it comes to spinal trauma, but a doctor or physical therapist with expertise in scoliosis can help you assess your case specifically. Swimming, road biking, dance, yoga, short distance hiking and running, and low-impact exercises and activities are all good options! Learn more in our big list of scoliosis workout question and answers.
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What Treatment Options Are Available
Treatment options and outcomes for adultscoliosis have improved significantly over the years. Just a few decades ago,we could successfully treat scoliosis only in children and teens. Today, weknow that multimodal treatment a team approach and combinations of therapy is the best way to treat adult scoliosis and prevent recurrence of symptoms.
While back braces might be effective for scoliosis in children, its not a primary treatment for adults. Sometimes we recommend bracing to stabilize the spine during acute episodes of pain. But long-term bracing can do more harm than good in adults. It can weaken back muscles because they dont have to work to support the torso, putting additional stress on the discs in the spine and speeding up degeneration.
Physical therapy is the first-line treatment for adult scoliosis, which sometimes surprises patients if their backs or legs hurt during activity. A physical therapist can help patients develop proper back mechanics to minimize stress on the spine when lifting, bending, and exercising.
We also recommend other non-surgical approaches, such as acupuncture or dry needling and anti-inflammatory injections to help manage symptoms. Some patients benefit from getting epidural steroid injections to reduce the inflammation affecting the nerves and reduce sciatica pain.
The Universal Guide To Lower Back Pain: Everything You Ever Wanted To Know Straight From The Experts
In This Article: | | | | | | | | | |
If youve ever had lower back pain stop you from doing what you want, youre not alone. Lower back pain is one of the most common medical problems in the world. It is a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Diseasea significant study published in the Lancet medical journallower back pain is also a leading cause of disability.
While severe lower back pain can cause worry, pain severity is not always an indication something is seriously wrong. Photo Source: Shutterstock.
You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.
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Where Does The Pain Come From
When it comes to living with scoliosis, there are two anatomical explanations for pain.
- Musculoskeletal pain is related to how the skeleton changes with scoliosis like straining and overworking muscles and is very common with idiopathic scoliosis.
- Nerve pain is often experienced by people with degenerative scoliosis. As a spinal disc deteriorates, the body has trouble holding itself up, which can start to pinch nerves and cause sharp, radiating pains or numbness in the neck and lower back.
Conservative Care Treatment Options
Many people will be able to manage their scoliosis-related problems with conservative care. It is likely that many people reading this article have been doing these treatments for years already and they are exploring other ways to achieve pain relief and some degree in the improvement of function.
A June 2020 paper in the journal Pain Medicine evaluated the effectiveness of nonsurgical treatments in symptomatic adult degenerative scoliosis. The researchers reviewed six previously published studies which included outcome studies specifically on injections, bracing, or yoga and multiple treatment programs. The conclusion the study team reached was: Literature describing the effectiveness of nonoperative treatments in symptomatic adult degenerative scoliosis is scarce. The quantity and quality of the evidence regarding injections, bracing, and yoga are insufficient to advise for or against the use of these methods to improve outcomes in symptomatic adult degenerative scoliosis. For these and other nonoperative treatment forms, further research is needed. Many of you may have found long or short-term relief in some of these treatments. Perhaps you are looking for more of the same type of treatment or these treatments no longer provide comfort.
What are we seeing in this image?
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