Adult Scoliosis


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Understanding Adult Scoliosis

The term adult scoliosis refers to an abnormal curvature of the spine after one has finished growing. Scoliosis can be a curvature to the right or left and sometimes can include a rotational component to the spine. With these structural changes over time patients often will notice appearance changes including possibly one shoulder higher than another, ribs more prominent on one side, or possibly asymmetric skin folds.

solutions being pipetted into various test tubes
solutions being pipetted into various test tubes


Due to the degeneration of discs and spinal anatomy, patients may also experience symptoms associated with stenosis or narrowing around the spinal canal or nerves.

Common symptoms include:

  • Mid or low back pain
  • Arm or leg pain, numbness, or tingling
  • Concerns about appearance – loss of height, change in posture, or change in fit of clothing

Of note, there are some symptoms where we recommend more urgent evaluation which may be associated with spinal stenosis including progressive weakness, loss of bowel or bladder function, and loss of bowel or bladder control. These symptoms warrant prompt evaluation and management.

When to Seek Treatment

If you’re noticing symptoms associated with Scoliosis and suspect a spinal issue, it’s crucial to consider consulting a board-certified spinal specialist. Reach out promptly to a certified spine surgeon for an accurate diagnosis and timely treatment. Early intervention can significantly improve your overall well-being and provide a broader range of treatment options, which may decrease as symptoms persist. The key to a successful and speedy recovery lies in addressing the root of the pain with your spine specialist as soon as symptoms arise.

While many people experience day-to-day back or neck pain, dismissing it as soreness, this may not be the case for everyone. If your pain persists for more than 10 days, it should be taken more seriously. Evaluate such prolonged pain with a spine surgeon to identify the root issue and determine the appropriate treatment. Additionally, be attentive to other signs related to back or neck pain that should not be ignored, including pain accompanied by fever, pain associated with loss of bladder control, and weakness/tingling/numbness in your arms or legs.

It’s important to note that these are general guidelines based on our expertise in spine care over the past three decades, recognizing that each patient’s symptoms may be unique.

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Common Causes

There are many different types of scoliosis, but the two most common forms of adult scoliosis are worsening of a scoliosis known from adolescence or degenerative scoliosis. In degenerative adult scoliosis asymmetric degeneration of the discs or joints in a patient’s back can lead to unbalanced loading of the spine. This unbalanced loading can worsen a curvature or degree of scoliosis.

Adolescent idiopathic scoliosis is very common, for those patients with known scoliosis we recommend close monitoring over time. Often patients with adult degenerative scoliosis do not know they have scoliosis until their initial examination with x-rays.

Diagnosing Adult Scoliosis

When a patient comes to our office we do a full physical exam to not only check their muscle strength and deep tendon reflexes but also evaluate for some of the previously mentioned exam findings associated with scoliosis. We are assessing for changes in patients height over time, overall alignment, asymmetric skin folds which would indicate a curvature being present or possible asymmetry in shoulder or pelvic height.

Imaging is required to confirm the diagnosis of scoliosis and we utilize full scoliosis x-ray imaging so we can visualize the cervical, thoracic, and lumbar spine. We wish to visualize any structural instability, curvatures, or rotation of the spine. Scoliosis is confirmed when radiographs show a curvature of 10 degrees or higher, this measurement is called a Cobb angle.

solutions being pipetted into various test tubes
solutions being pipetted into various test tubes

Treatment Options

We do recommend for scoliosis patients to be monitored by a scoliosis spinal specialist. We anticipate due to natural aging and gravity’s effect on our spine, scoliosis curvatures to worsen over time. If symptoms are mild we may often continue to monitor their curvature or possibly treat with a number of different non-operative modalities. Non-operative treatments often include use of physical therapy or athletic training to strengthen the core muscles supporting our spine. Often if symptoms are significant we will also prescribe medications or order injections. For significant scoliosis or scoliosis that has worsened to where patients have noteworthy symptoms that are interfering with their life, surgical intervention may be discussed.

The goal of spinal deformity surgery in the setting of adult scoliosis is to provide patients with relief of their pain and neurologic symptoms while restoring their overall spinal alignment. Improvement in overall spinal alignment is shown to improve not only long term quality of life but also improve a patient’s self-image.

Physical Therapy →

Spinal Injections →

Correction Surgery →

Frequently Asked Questions about Adult Scoliosis

Please provide any previous imaging studies (x-ray, MRI, or CT scans) or imaging reports available so we can evaluate your scoliosis progression. Please bring any previous office visit records or if you did have treatment for your scoliosis any available operative or injection records.

No, we try to maintain a patient’s range of motion and quality of life for as long as possible prior to moving forward with surgery. The decision to move forward with surgery is after multiple in-depth conversations between you and your spinal specialist as well as review of imaging studies, trial of non-operative treatments, and discussion over quality of life.

As an adult we are skeletally mature, meaning our bones are no longer growing. Therefore, any brace commonly seen for use in adolescent scoliosis will not change the condition of adult scoliosis. We often will use a brace if the patient has had scoliosis surgery to help with post-operative pain.

Often we follow our patient’s for a prolonged period of time before jointly making the decision to move forward with spinal surgery to treat scoliosis. At that point, patients will have failed a multitude of non-operative treatments including injections, medications, and therapy. We discuss quality of life and post-operative goals for the patient. Another example where a patient may be a surgical candidate but may not have significant pain is in those with severe spinal curvatures. Our role at the Virginia Spine Institute is to help you understand all your options, guide you through this process, and answer any questions you may have.

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