Scoliosis refers to a bending and twisting of the spine. In the adult spine, this curvature is usually due to wear and tear of the natural supports to the spine. These supports can be weakened by osteoarthritis and osteoporosis. When these supports fail, the spine begins to fall over, slip, and selectively rotates on the remaining structures.
As a result of the structures falling, people typically suffer from one of following three conditions:
1. Back Pain: Back pain can result from an instability or inappropriate motion of the joints in your spinal column, from painful arthritic joints in the spinal, and from painful worn out disks.
2. Leg Pain: Leg pain is usually caused by pressure on one of the nerve roots exiting your spine. Usually this pressure occurs at the foramen, the hole where the nerves leave the spell. With wear and tear, the facet joints, which are small joints in the spine, can get arthritic. This causes bone spurs to form inside the foramen and subsequently pinch a nerve. Wear and tear also causes the disk that acts as the shock absorber between two bones, to bulge or break and put additional pressure on the nerve. With inappropriate motion and curvature, the nerve can be pinched and cause leg pain.
3. Deformity: The third factor that causes problems with degenerative scoliosis is a deformity. When the spine rotates and starts to fall off, people begin to notice a change in their posture. Sometimes the presence of a rib prominence or a difference in one shoulder height can be readily noticed when this occurs. In some people, the deformity can become rapid and require prompt treatment.
What treatment exists for adult degenerative scoliosis?
Prevention is key. First of all, appropriate treatment for osteoporosis is vital in preventing adult degenerative scoliosis. Maintaining strong back and stomach muscles can help to stop this process from occurring or slow it down.
For symptomatic relief, one can take the following treatments:
Nonsteroidal Anti-inflammatory Medication: These medications can reduce pain and inflammation. It is important to remember that you need to discuss whether or not you are an appropriate candidate to take anti-inflammatory medications with your doctor. Some of these medications can be purchased over the counter such as ibuprofen, while others are given by prescriptions.
Epidural Steroid Injections: An epidural steroid injection can be given to reduce the pain when you suffer a flare from degenerative scoliosis. A steroid is a very powerful anti-inflammatory medication. While having an epidural steroid injection does not cure the problem, when coupled with an appropriate exercise program, it can sometimes result in excellent relief.
Exercises: An appropriate exercise program can be essential in treating adults with degenerative scoliosis. During physical therapy, the therapist will show you exercises to strengthen your back and stomach muscles and also teach you the biomechanically correct way to perform activities of daily living to decrease pain in your back.
Bracing: Back braces combined with physical therapy can sometimes be very beneficial in gaining relief.
Surgery: Surgery should be the last resort when treating adult degenerative scoliosis. Surgery is entertained for those who have failed conservative measures or for those who have suffered progressive changes in their curve. Often the goal of surgery is not to make the spain straight, but to keep the curve from getting worse.
This article is written for informational purposes only, and serves as no substitution for your visit with your doctor.
© 2012 Winifred D. Bragg, MD. All Rights reserved.