Degenerative scoliosis in adults can be extremely painful and cause pain that is in the lower back or possibly radiates down through the buttock region into the legs. How does it occur and what are the treatments for adult degenerative scoliosis?
There are two ways that a person in their adult years develops degenerative scoliosis. The first is if the individual had scoliosis as an adolescent. Studies have shown that if a person has adolescent scoliosis in excess of 35 to 40°, then through adulthood it can worsen at a rate of 1° per year.
This may not sound like a lot, but over a period of 30 years, a person may end up with in excess of a 70° curvature. As scoliosis is typically a three-dimensional curvature problem, the end result may be that the individual tilts off to one side, and also tilts significantly forward.
The second way that a person develops degenerative scoliosis as an adult is through severe arthritis. Anyone who has arthritis in one knee that is much worse than the other knows that arthritis is not often symmetric. What can happen in the spine is that one side can be much more arthritic than the other and the person can start to develop breakdown of that side and a curvature can start to develop.
As the breakdown continues, biomechanics kick in as the angles get severe and can actually make the situation much worse. As the spine continues to angle, nerves that are on the concave side of the curve start to get pinched and that is where the individual can have pain radiating down the buttock and the leg from that compression. so in essence the back pain occurs from the arthritis that has made the curvature worsen, and the leg pain occurs
from nerve pinching which is termed spinal stenosis.
What nonsurgical treatment is available for degenerative scoliosis?
Unlike adolescent scoliosis, bracing is of no help for adult scoliosis. Typically the curve is not flexible as arthritis has caused it to worsen and it is what is called a structural problem. So bracing does nothing to correct the abnormal curvature. One treatment that can help significantly is physical therapy. This can strengthen up the muscles around the spine along with a person’s core muscles including abdominals. Similar to physical therapy for extremity arthritis, this can help decrease pain and take some pressure off of the arthritic spinal joints. chiropractic treatment can also help relieve some pain in the back and also from the spinal stenosis. It can help improve blood flow and bring more oxygen in to help with pain control.
Pain medication can be very helpful for degenerative scoliosis pain. Typically from mild to moderate pain over-the-counter medications such as ibuprofen and Tylenol are sufficient. For acute flare-ups, short-term narcotic medication may be very helpful as well. Chronic narcotic medication is not the best idea for the treatment of degenerative scoliosis pain, however, if the person is in severe pain and not a surgical candidate then it may be necessary.
Pain management procedures for the pain from degenerative scoliosis are the best treatment going. Due to the fact that multiple levels are afflicted with arthritis and in pain, injections in or around the arthritic facet joints can significantly reduce the pain level a person is experiencing.
Medial branch blocks around the arthritic facet joints can provide pain relief for months, and if the pain returns a radiofrequency ablation at multiple painful levels can diminish the pain for over a year.
Surgery for degenerative scoliosis is a very big decision, as any procedure entails significant risks. It’s a very different procedure then a fusion for adolescent scoliosis, as the individual is not as able to withstand a lot of the fluid shifts and blood loss involved with the procedure. Most adult scoliosis procedures are either staged or last a very long time, and if surgery can be avoided with effective pain management that is best.
If you’re suffering from painful scoliosis, let Arizona Pain Specialists help you. The practice has multiple locations with Award-winning, Board-certified Arizona pain management doctors and chiropractors who are experts in the management of painful scoliosis.
Call 602-507-6550 for more information and scheduling with the best pain management doctors in Arizona.