Q&A Topic: Painful Scoliosis Is Common in Adults. Stay Ahead of the Curve

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John Abrahams, MD, FAANS

Q. What is scoliosis, and what causes it?

A. You may remember being checked for scoliosis when you were a child. Typically done by the school nurse, a simple finger run down your spine was all it took to check for scoliosis, an abnormal side-to-side curvature of the spine. No one knows exactly what causes scoliosis. It could be partly genetic, but the actual cause of the disorder remains a mystery. For this reason, scoliosis is known as idiopathic, meaning of unknown origin. A spinal curve that existed in your youth may progress, or degenerative changes in your spine could lead to a de novo, or newly diagnosed, condition.

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Q. When should people seek treatment?

A. More than just a curvature of the spine, scoliosis changes the alignment of your body, throwing-off your equilibrium and causing pain. People with scoliosis may appear to be leaning to one side due to trunk imbalance. As your body contorts due to a worsening curve, pain becomes the major problem. While your back may look peculiar in the mirror, it’s usually the pain or the diminished quality of life that brings people into my office.

Q. Does it worsen with age?

A. As scoliosis patients become older, the likelihood of disability increases. Ranging from a dull back ache to excruciating sensations that shoot down the leg, pain can be constant, intermittent, moderate, or severe. Pain is not caused by the sideways curve of the spine, but from spinal joint inflammation or nerves in the back that have become compressed. If the spinal curve is severe, heart or lung function may also be compromised, making it difficult to even breathe. Once a curve starts, it can get worse and that’s when we start to see serious problems in adults.

Q. What are my options?

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A. A physical exam and a whole-spine, standing x-ray are necessary for diagnosis. Unlike childhood scoliosis when the treatment goal is to correct the curve, the aim of treating adult scoliosis is to address and treat the symptoms, not the curve. The good news? You probably won’t need surgery. Patients with minimal symptoms typically benefit from over the counter pain medication and lifestyle changes. Gaining weight – even a few pounds – puts more stress on your joints and your spine and can aggravate symptoms. Start by replacing soda and alcohol with water, choosing whole-grain bread instead of white, eating small amounts of dark chocolate instead of milk chocolate, and limiting your citrus intake. This will help reduce inflammation to support a healthy spine.

Q. My pain is progressing, what can I do?

A. If your scoliosis is severe and you’re experiencing difficulty breathing, loss of balance or motion, you may be a candidate for surgery. For some people, minimally-invasive decompression surgery is all that’s needed for relief. This is not the back surgery of thirty years ago. It’s likely that we can fix the problem and have you back home the same day with immediate pain relief. Others may need complete corrective surgery. Recovery could take anywhere from three months to a year, depending on the complexity of the surgery. It’s important to speak with your doctor if you’re experiencing debilitating symptoms. We’ll always do our best to develop a conservative plan that gets you back to your life as quickly as possible.

Northern Westchester Hospital
Chief, Neurosurgery
Co-Director, Orthopedic & Spine Institute, Spine Section
.Learn More About Dr. Abrahams

Read Past Topics from Dr. Abrahams:
Getting a Leg Up on Sciatica
Chronic Back Pain and Advanced Surgical Solutions
Dealing With A Pain In The Neck 
Arm Pain from a Pinched Nerve
Outpatient Spine Surgery 

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