Idiopathic Scoliosis in Adults (Cause, Diagnosis, Treatment)

Idiopathic scoliosis basically refers to scoliosis for which the cause is unknown. To understand what exactly idiopathic scoliosis is and how it occurs, read further. 

Basically, every individual has a bind or a curve in the spine that is referred to as the lordotic curve which occurs near the neck. Similarly, the upper and the middle portion of the back often referred to as the thoracic regions of the spine bend outwards gently in a curve that is referred to as the kyphotic curve. Your lower portion of the back also has a curve, termed as a lordotic curve. 

When you have a healthy spine or a spinal column, the spine does not bend more than the degree that is considered normal for each of these regions. There is also no bending on either of the sides, i.e., the sideways bend is usually at 0 degrees. For those who have scoliosis, it may not be possible to adjudge whether the individual has scoliosis just by looking at them, especially if the scoliosis is in its nascent stages. Imaging studies such as PET scan or an MRI may be required. Once such imaging is taken, a very evident C shaped or an S-shaped bend is visible in the spines of those who suffer from scoliosis. 

While many people think that scoliosis does not have to be treated, the consequences of leaving scoliosis untreated can be far-reaching. For instance, in terms of health, the bend of the spine can even cause distress to the heart or lungs, lead to aesthetic abnormalities and other conditions associated with a bent spine. Therefore, it is important to identify and treat scoliosis at the earliest. 

Idiopathic Scoliosis in adults

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Mostly, scoliosis begins to occur during teenage when the body is undergoing changes due to puberty. If such scoliosis is left untreated for a significant period of time, it can lead to scoliosis in the same adults as well. The problem with idiopathic scoliosis is that there is a likelihood of the bend increasing every year by a little bit. There are multiple reasons as to why this may occur, such as degeneration of the spinal column, and narrowing thereof, bone conditions such as osteoporosis and arthritis. Unfortunately, scoliosis can lead to a number of painful symptoms such as back pain, especially in the lower parts of your back, lack of flexibility, pain due to compressed nerves, tiredness, lack of energy, tingling sensations, and numbing of various parts of the body. If you find any of this happening to you, it might be helpful for you to check out as to whether you have scoliosis. 

What causes idiopathic scoliosis?

The meaning of idiopathic scoliosis itself is that the reason for which it occurs is unknown. While it is not identified as a genetic disorder, those people who have family members with scoliosis may be at a higher risk to develop the condition themselves as well. While genetics may not play a positive role in as to whether or not you develop scoliosis, genetics could play a role in how it plays out – such as how your condition progresses, at what age it occurs, the degree of the spinal curvature, etc. 

Diagnosis and treatment

While many people are often under the misconception that scoliosis need not or cannot be treated, nothing can be further from the truth. Here are some of the ways that a diagnosis of scoliosis is made, and the various treatment options available to people. 

Diagnosis methods

  • Postural Screening Exam: One of the first things to get affected due to an increasing spinal curvature is your posture. If you find yourself tilting to one side more than the other, or find that one leg is longer than the other, these may be signs that you have developed scoliosis. Physicians keep track of all of these factors while making a diagnosis. 
  • Spinal Exam: Usually, Adam’s forward bend test is used in combination with a scoliometer to check the posture and how symmetrical the trunk of your body is. Depending on this examination, the physician usually determines if further intervention is required or not. 
  • Standing X-ray: Standing X-rays are usually prescribed to patients with scoliosis to diagnose the condition through the Cobb method. It can demonstrate how bent the spine is, whether there is a side to side bend, etc. 
  • Magnetic Resonance Imaging (MRI): If your doctor finds issues with the X-ray or believes that further imaging studies may be required to make a correct diagnosis of your scoliosis, he or she may prescribe an MRI. 

Treatment Methods

Usually, a holistic treatment plan that involves both symptomatic management (such as pain management) as well as treating the actual condition is prescribed. If you have any psychological issues arising from chronic scoliosis, a psychologist may also be recommended. 

  • Observation: For those patients who do not have a great deal of spinal curvature, the best course of action may be to just wait and watch and observe the condition. 
  • Physiotherapeutic scoliosis-specific exercises (PSSE): Various exercises exist in order to give you some extra flexibility and fix the bend of your spine. Usually, these exercises are performed in sets, and the sessions are weekly once or twice, depending on the severity of your condition. 
  • Special inpatient rehabilitation (SIR): If your doctor deems fit, they may admit you in the hospital for a period of a few weeks where specific rehabilitation exercises are prescribed for your scoliosis. 
  • Bracing: Various braces, whether soft or otherwise may be prescribed. While there is not sufficient evidence as to the actual difference that braces make, they may be prescribed conjointly with other forms of treatment. 
  • Nerve blocks and epidurals: One of the most painful complaints that most people suffering from scoliosis have is that the compression or the bending of the spine causes pinched nerves. This is similar to those suffering from carpal tunnel syndrome, and various types of treatment including pain management techniques such as in the form of an epidural may be prescribed. 

Alternative treatments

Various alternative forms of treatment such as physical therapy, aqua therapy, and yoga practice may also be recommended to those suffering from scoliosis. However, there is currently very limited backing as to the clinical effectiveness of such options. 

Surgery

Surgery is sometimes prescribed as a last resort option to those where no other form of intervention works. Usually, surgery is only prescribed to those with a spinal curvature of over 45 degrees. Surgery usually makes use of screws and rods and uses these implants to stabilize the spine and prevent the curve from degenerating. It must be remembered that while surgery is not usually recommended for children and young adults, it can be even more risky for older individuals due to the possibility of comorbid conditions existing. 

  • Microdecompression: Given that a lot of pain from scoliosis is due to pinched nerves and compression of the nerves, microdecompression attempts to fix this symptomatic pain that arises from scoliosis. 
  • Surgical stabilization: As discussed earlier, if the situation may require, physicians may recommend a surgical approach to treat scoliosis until your spine fuses.
  • Fusion: This can be done with your own bone or with a synthetic bone to force your spine into the position that it must be in. 
  • Osteotomy: This refers to removing segments of the spine and realigning them to correct scoliosis. 
  • Vertebral column resection: this refers to resecting parts of your spinal column. This is a risky procedure and usually is done as a last resort option only. 

Takeaway

Therefore, while many people are under the misconception that scoliosis cannot or need not be treated, this is certainly not true. Depending on how severe the conditions of your scoliosis is, when it occurred, how severe the bend is, what the degree of progress is, a suitable plan can be chalked out. Ensure that you talk to your physician about a holistic approach towards treating scoliosis. 

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