Understanding Adult Scoliosis: Causes, Symptoms, and Treatments

Adult scoliosis is a complex spinal condition that affects more people than most might realize. Often associated with adolescents, scoliosis—characterized by an abnormal lateral curvature of the spine—can persist or develop in adulthood. While it might not receive as much attention as pediatric scoliosis, adult scoliosis can significantly impact quality of life, particularly as people age. Here are five surprising facts about adult scoliosis that highlight its prevalence, causes, and treatment options.

1. Adult Scoliosis Isn’t Always a Continuation of Adolescent Scoliosis

When most people think of scoliosis, they envision teenagers wearing braces to correct spinal curvature. However, adult scoliosis can arise from two primary causes, and not all cases are linked to adolescent-onset scoliosis.

Adolescent Idiopathic Scoliosis (AIS) That Persists into Adulthood
Some adults with scoliosis were diagnosed as teenagers but didn’t undergo treatment or experienced progression despite intervention. For these individuals, the spinal curve remains and may worsen over time due to age-related changes, such as spinal degeneration or osteoporosis.

De Novo (New-Onset) Scoliosis
Surprisingly, many adults develop scoliosis later in life without any history of spinal curvature as adolescents. This condition, known as degenerative scoliosis, is caused by wear-and-tear on the spine's discs and joints, leading to instability and curvature. This form of scoliosis is most common in people over 50 and is closely tied to the aging process.

Degenerative scoliosis is one of the leading causes of back pain in older adults. Unlike adolescent scoliosis, which often has no symptoms beyond the curvature, degenerative scoliosis can lead to nerve compression, back pain, and difficulty standing or walking for extended periods.

2. Symptoms Can Vary Widely—and Sometimes Mimic Other Conditions

One of the most surprising aspects of adult scoliosis is how its symptoms can differ widely from person to person. Unlike adolescents, who typically have no pain, adults with scoliosis often experience symptoms due to the structural and functional changes in their spine.

Common Symptoms Include:

Chronic back pain
As the spine curves and degenerates, it can place uneven pressure on the vertebrae and discs, leading to chronic discomfort.

Nerve-Related Symptoms
In many cases, the spinal curvature compresses nearby nerves, causing Sciatica-like symptoms such as tingling, numbness, or weakness in the legs.

Postural Changes
Adults with scoliosis may notice their torso leaning to one side, uneven shoulders, or one hip appearing higher than the other. These changes can affect balance and gait.

Confusion with Other Conditions

Because the symptoms of adult scoliosis—especially back pain and nerve issues—overlap with those of other conditions like herniated discs, arthritis, or spinal stenosis, it’s not uncommon for scoliosis to go undiagnosed for years. This underlines the importance of thorough medical evaluation and imaging studies for proper diagnosis.

3. It’s More Common Than You Think

Adult scoliosis is far from rare. While precise prevalence rates vary, studies estimate that nearly 30% of adults over age 50 have some degree of scoliosis. The condition becomes even more prevalent as people age, with estimates suggesting that up to 68% of adults over 65 exhibit signs of scoliosis.

Why is it so common? As the spine ages, degenerative processes such as disc thinning, ligament weakening, and vertebral collapse contribute to the development of scoliosis. Additionally, conditions like osteoporosis can weaken the bones, making them more susceptible to curvature.

Interestingly, the aging population and increased longevity mean that adult scoliosis is becoming a more significant healthcare concern. Orthopedic specialists and spine surgeons now see more patients seeking care for scoliosis than ever before.

4. Non-Surgical Treatments Are Often Effective

While many people associate scoliosis treatment with surgery, non-surgical options are often highly effective for managing adult scoliosis, especially in mild-to-moderate cases. Treatment typically focuses on relieving symptoms and improving quality of life rather than correcting the curve itself.

Non-Surgical Treatment Options:

Physical Therapy
Targeted exercises can strengthen the core and back muscles, improving posture and reducing pain. Many physical therapists also incorporate balance training to address gait issues.

Pain Management
Over-the-counter pain relievers, anti-inflammatory medications, and epidural steroid injections can help manage pain caused by nerve compression or inflammation.

Bracing
While bracing is more common in adolescents, some adults with scoliosis may benefit from a custom brace to stabilize the spine and reduce discomfort.

Alternative Therapies
Acupuncture, chiropractic care, and yoga are increasingly popular among adults with scoliosis. While evidence of their effectiveness varies, many patients report symptom relief.

For many adults, a combination of these therapies provides significant improvement, delaying or even eliminating the need for surgical intervention.

5. Surgical Advances Have Revolutionized Treatment

For adults with severe scoliosis or debilitating symptoms, surgery may become necessary. Advances in spinal surgery have made these procedures safer and more effective than ever before, with options tailored to individual needs.

Common Surgical Techniques:

Decompression Surgery
Focuses on relieving nerve compression by removing bone spurs or disc material that presses on the nerves.

Spinal Fusion
The most common surgery for scoliosis, spinal fusion involves fusing the affected vertebrae together to stabilize the spine and reduce curvature. Modern techniques allow for minimally invasive approaches, reducing recovery time.

Osteotomy
In severe cases, surgeons may reshape the bones to correct the curve and realign the spine.

Risks and Benefits:

While surgery carries risks such as infection, blood loss, or nerve damage, many patients experience dramatic improvements in pain, mobility, and posture. Importantly, modern surgical techniques focus not just on correcting the curve but also on maintaining spinal balance and functionality.

The Emotional and Social Impact of Adult Scoliosis

Beyond physical symptoms, adult scoliosis can have significant emotional and social effects. Chronic pain and visible postural changes can lead to self-consciousness, depression, and social withdrawal. Many adults feel a loss of independence due to limited mobility, further emphasizing the importance of comprehensive care that addresses both physical and emotional well-being.

Support groups, counseling, and education about the condition can help individuals navigate the challenges of living with scoliosis. Additionally, advancements in treatment mean that more people can lead active, fulfilling lives despite their diagnosis.

Conclusion

Adult scoliosis is a multifaceted condition that affects millions of people, often in unexpected ways. From its diverse causes and symptoms to the wide range of treatment options available, adult scoliosis underscores the importance of understanding and addressing spinal health as we age. Whether through non-surgical interventions or advanced surgical techniques, individuals with scoliosis have more options than ever before to manage their condition and improve their quality of life.