Adults with ASA may or may not have previously been diagnosed with adolescent scoliosis. ASA may be progressive or stable, depending on the individual case. In those with a previous diagnosis of AIS, monitoring progression is easy as comparison of current X-Rays to adolescent X-Rays can be done. In those where the scoliosis is discovered in adulthood, determining if the scoliosis is a pre-existing adolescent condition or a new onset of degenerative scoliosis can be difficult.
DDS usually develops in middle aged and older adults and is typically seen starting around 45 years of age onwards. As DDS is a result of degenerative instability, it is almost always progressive. However, the main complaint usually associated with DDS is lower back pain.
Although some forms of adult scoliosis can be progressive, the main complaint is usually lower back pain. Often this pain is severe and little relief has been found from usual medical and complementary care. A common misunderstanding still perpetuated by most health professionals is that scoliosis does not cause pain. This is not true. This notion has come about because the majority of children suffering from adolescent idiopathic scoliosis do not present with a primary complaint of pain and quite often even large deformities in children do not cause pain. However, in adults between the ages of 50 and 80 who suffer from chronic lower back pain, research shows that up 40% will have an adult scoliosis.
This misconception has led to a diagnostic and treatment approach that largely ignores the role of scoliosis in chronic lower pain in adults and, as a result, less than satisfactory outcomes for many of these patients.
The pain seen in adult scoliosis is not related to the size of the curve. Several good studies show there is little to no relationship between the size of the cuve and pain. i.e a 20 degree and a 55 degree curve have the same chance of causing pain in an adult. There are two key factors related to pain in adults.
1) Location of the curve. Almost all complaints of pain in adult scoliosis are of lower back pain. The majority of new DDS curve are lower back curves. It is rare for a single curve in the upper spine to cause lower back pain. However, in some cases patients with ASA who have an “S” shaped curve, the bottom half of the curve in the lower back may cause pain as an adult.
2) Balance of the spine. What is meant by “balance” is the forward/backwards, left right/shift of the spine that does not necessarily relate to the size of the curve. Most importantly adults with scoliosis who have a forward shifted posture, or those that are bent forward, will develop more pain than those in a neutral or backwards shifted posture.
We’d like to thank our patients for their permission to use their images and results in our case studies. These studies are not to be reproduced without written permission from ScoliCare.
Patient aged 7 years with scoliosis thoracic curve measured at 32° and lumbar curve measured at 27° In-brace correction achieved with a custom 3D designed scoliosis brace compared with a standard TLSO in a juvenile scoliosis patient Summary: This case demonstrates the effect of a custom 3D designed scoliosis orthosis…
78 year old female patient with progressive idiopathic scoliosis into adulthood. Summary: This case highlights improvements in pain, function and postural deformity in a 78-year-old patient using a custom 3D designed low profile scoliosis orthosis combined with physiotherapeutic scoliosis specific exercises. The patient presented with a 25 degree right-sided lumbar…
Female patient aged 3 years with an infantile scoliosis. Treatment of an infantile scoliosis using a custom 3D designed scoliosis brace. Summary: This case demonstrates the treatment of a moderate sized infantile scoliosis using a custom 3D designed rigid scoliosis orthosis in a 3-year-old female patient. The patient’s scoliosis had initially…
56 year old female patient with de novo degenerative scoliosis. Postural improvement, improved mobility and reduced pain in a female patient with de novo degenerative scoliosis using a 3D designed custom brace Summary: This case demonstrates the successful management of a patient with de novo degenerative scoliosis. The patient presented…
Female patient aged 14 years with a 71° thoracic curve and a 40° lumbar curve. Reduction of a severe scoliosis in a young female gymnast using a 3D designed scoliosis brace Summary: This case details the management of a young female gymnast with severe adolescent idiopathic scoliosis (AIS) using a…
Male patient aged 14 years with a right thoracic curve measured at 49 degrees. Reduction of a severe scoliosis using a custom 3D over-corrective scoliosis brace and scoliosis specific rehabilitation in a 14-year-old male Summary: This case demonstrates the management of a young male athlete with a severe scoliosis using…
Reduction of a Hyper-kyphosis in a 16-year-old female patient using a 3D designed kyphosis brace Case Background The patient presented to the ScoliCare clinic at 14 years of age with postural deformity and pain in the middle back. Examination Findings The patient was a pre-menarchal teenager who reported pain across…
