Scoliosis (Adult)

Adult scoliosis is an abnormal sideways curvature of the spine (often forming a "C" or "S" shape) occurring in skeletally mature individuals. It generally presents as either adult degenerative scoliosis—caused by the gradual wear and tear of facet joints and intervertebral discs—or adult idiopathic scoliosis, which began in earlier years and progresses into adulthood. 

Symptoms

• Persistent lower back pain, stiffness, or muscle fatigue 
• Visible spinal asymmetry, such as uneven shoulders, waist, or hips 
• Leaning forward or to one side while standing or walking 
• Sciatica, numbness, tingling, or weakness radiating into the buttocks and legs due to pinched spinal nerves
• Loss of height or progressive posture changes

Causes

• Degenerative Disc & Joint Disease: Natural aging and breakdown of the discs and facet joints leading to asymmetric spinal collapse. 
• Progression of Pre-existing Curves: Untreated or mild curvature from earlier life that gradually worsens over time.
• Secondary Causes: Prior spinal trauma, osteoporosis (leading to compression fractures), or previous spinal surgeries.

Risk Factors

• Advancing age and wear on spinal structures 
• Family history of spinal conditions 
• Osteopenia, osteoporosis, or low bone mineral density
• Repetitive physical strain or prior spinal trauma

Diagnosis

Spine specialists evaluate standing posture, gait, and nerve function through physical and neurological examinations. Advanced standing imaging—including full-spine X-rays, EOS imaging, CT scans, or MRIs—is used to measure the Cobb angle (degree of curvature) and check for spinal cord or nerve root compression. 

Treatment

• Physical Therapy & Core Strengthening: Targeted exercises to stabilize the spine, improve posture, and alleviate muscle strain. 
• Medication Management: Anti-inflammatory medications, analgesics, or nerve-pain agents to manage symptoms.
• Targeted Spinal Injections: Epidural steroid injections or facet joint blocks to relieve localized pain and nerve inflammation.
• Surgical Intervention: Decompression surgery to relieve pinched nerves, often combined with spinal fusion and realignment for severe curvature, instability, or debilitating pain unresponsive to conservative care.