Treatment for scoliosis in older adults – While it is a common misconception that Scoliosis is a condition that usually occurs in just young children or teenagers, the fact of the matter is that it can occur in adults as well. Usually, the diagnosis of Scoliosis in younger age groups is higher because these age groups (being high risk for developing Scoliosis) are screened for the condition more often. Once you began to study whether adults have Scoliosis, it is pretty surprising to find that several adults suffer from the condition as well. One study recently demonstrated that over 65% of adults above the age of 65 suffer from Scoliosis, even if there were no evident signs of the condition being present, or even if there was no pain. Taking from this surgery, it is safe to assume that even those in their middle ages or their 20s could be prone to Scoliosis, but aren’t screened for the condition effectively.
Scoliosis refers to the bending or a curvature in the spine that is beyond the normal degree. In adults and geriatric populations, Scoliosis occurs primarily due to the following reasons. The first possibility is that the Scoliosis is progressive, and has existed from a younger age but has just been diagnosed. Second, due to the deterioration of the spine (due to deficiency in calcium or due to conditions like osteoporosis), the discs can degenerate leading to Scoliosis in adults. The third possible reason as to why an adult may develop Scoliosis may be due to an impact injury or an accident, that has caused injury to the spine, the foot, or other areas that affect the posture of the spine. While they may have common pain symptoms, the treatment of these types of Scoliosis may be different based on the cause due to which it has occurred.
Adult Idiopathic Scoliosis
Idiopathic Scoliosis refers to Scoliosis for which the cause is unknown. Usually, adult idiopathic Scoliosis develops from untreated Scoliosis that has occurred in the teenage. While pre-pubescent individuals are at most risk for developing Scoliosis, the spinal curvature can degenerate due to progression. While those diagnosed with Scoliosis may have been required to wear a brace to correct their spinal posture and restore it to normalcy if they were diagnosed when they were younger, it is also quite possible that they did not take any corrective action, or were not diagnosed at all. Therefore, due to the progression of the spinal bend, Scoliosis extends to adulthood as well in these cases.
Two aspects must be kept in mind while thinking about adult idiopathic Scoliosis – either it can worsen due to the extent of the curvature (especially if the degree of the bend is high), or it may not progress or worsen at all. However, even if there is no progression in the extent of the curvature, spinal and nerve compression may still occur leading to symptoms and pain.
When it comes to braces for Scoliosis in adults, there are both soft braces and regular braces. Soft braces are meant to treat the symptoms and the pain that arises from the condition but do not help treat the condition itself. Usually, the most effective and ideal option to treat Scoliosis in adults is in the form of surgery. It must be kept in mind though that surgeries are invasive and radical in terms of intervention processes, and may also lead to more complications in adults than in younger people. Recovery time, mobilization, and other aspects also tend to be more challenging for adults than for their younger counterparts.
The most important requirement that arises from treating adults with Scoliosis is ensuring that they have a better quality of life. Various day to day activities and activities of daily living should be performed without pain or effort, and this is one of the main goals in treating adults with Scoliosis. When it comes to the CLEAR protocol or other exercise regimens intended to treat Scoliosis, it has been shown that there has been a high rate of success with regards to those suffering from adult idiopathic Scoliosis. Various improvements such as a lower rate of pain, flexibility, better energy, and other such positive effects are visible.
Degenerative Scoliosis develops later in life and not during the teenage or during younger years. Usually, degenerative Scoliosis occurs after the age of 40. As the name suggests, it is degenerative and occurs due to the deterioration of the spinal discs. Such deterioration may be due to a variety of reasons. Even though degenerative Scoliosis is more severe than idiopathic Scoliosis, it may not be possible to tell whether someone has degenerative Scoliosis just by looking at the individual. Usually, imaging scans such as an x-ray or an MRI is required. For instance, in an x-ray, the spinal discs tend to be curved steeply in those individuals with degenerative Scoliosis due to the wearing of the spinal disc fibers.
The appearance of the discs in degenerative Scoliosis also tends to be thinner than a normal healthy spinal disc, and the spinal holes tend to be narrower as well. Decreased hydration or content in water levels in the spine are also witnessed in the case of degrative Scoliosis. This type of Scoliosis can, unfortunately, lead to significant pain that not just occurs in the spine, but that extends to the feet due to the weakening of the spine and due to possible compression of the nerves.
For those suffering from degenerative Scoliosis, braces may be suggested as a possible option combined with exercises and stretching as an alternative to surgery. However, whether these braces are effective is questionable, leaving surgery as the only option to deal with the condition effectively. Unfortunately, given the age group of those most commonly suffering from degenerative Scoliosis, surgeries can often be risky given that many of these individuals also suffer from other comorbid conditions. It must be noted that physical exercises and stretches do not appear to offer significant benefits to those suffering from degenerative Scoliosis. As per the CLEAR protocols, while there is no set mechanism in dealing with degenerative Scoliosis, research is being undertaken to improve the lives of those suffering from this condition and to manage their pain.
Traumatic Scoliosis usually occurs as a result of an injury, impact, or trauma to the spine or areas that the spine is affected by. For instance, if you are in a high impact injury while playing a sport or are in a high impact car accident, the injury or the impact may result in Scoliosis. The exact reason as to why traumatic Scoliosis occurs is unknown. The body can even bend or develop a curve after an injury or a trauma to deal with the pain that the injury has caused. For instance, if you are having pain on your right-hand side, you may bend towards the left to relieve yourself of the pain. While for most people Scoliosis disappears after the pain also goes, for many people it can persist even after the pain disappears.
If you believe that you have developed traumatic Scoliosis, the best course of action would be to consult a physician and find out a holistic plan to treat the symptoms as well as the condition itself. To improve the chances of recovery and to ensure a shorter recovery period, the intervention must be sought as soon as possible after the injury.
While it is often assumed that surgery is a permanent fix for the condition of Scoliosis, in many cases, a single surgery is usually not successful in curing the condition completely. If the surgery is not successful, revisional surgeries may be suggested. This is both true for surgeries that are meant to cure the condition, relieve the pain, and improve the aesthetic appearance of the body that is affected due to Scoliosis.
As per the CLEAR case report of 2014, it was documented that there are improvements for those who go in for a surgical procedure that involves the fusion of the spine combined with CLEAR protocols. While it is true that physical therapies and CLEAR protocols may not improve the condition directly, various aspects involved with Scoliosis can be managed successfully with such protocols. Some of them include aspects such as reducing the wear and tear on the rods and screws used in the surgery, improving energy, improving the posture, increasing flexibility, and other added benefits. To understand how the CLEAR protocol can benefit those diagnosed with Scoliosis, you should contact your physician to chalk out a holistic treatment approach.
Treatment for Scoliosis in older adults
While many treatment options have already been discussed previously, here are some of the other options that a person suffering from Scoliosis can exercise to relieve pain and other symptoms that occur. Some of the most commonly prescribed medicines are these.
- Pain relievers: Pain medications such as Acetaminophen (commonly sold under the brand name of Tylenol) or Ibuprofen (sold under the brand name Celebrex, also used to treat bone and joint pains from arthritis) may be prescribed. Two aspects must be remembered while choosing to take pain medication – the first being that the pain medication only relieves the symptoms and does not effectively treat the condition itself. The second aspect that must be kept in mind that these medicines are easy to form a dependency upon, and therefore must be used as a last resort option if no other mechanism to manage pain exists.
- NSAIDs: Non-Steroidal Anti Inflammatory Drugs
- Injections: Injections such as epidurals to relieve pain, steroid-based injections, facet block injections can prevent the neurotransmitters of the body from communicating pain impulses to the nervous system. This must be done under the guidance and supervision of a qualified physician only.
With all of these types of pain management techniques, they are only useful to manage the pain and not to treat actual Scoliosis. Therefore, it is quite possible that once these medicines or injections are stopped, the pain might return if the condition itself is not treated either in the form of surgery or through other means such as exercise and physical training.
Other nonsurgical treatments
While medicative options and surgical options have been discussed, there are a couple of nonsurgical options that a person suffering from Scoliosis can look into.
- Weight Loss: It is a well-known fact that an excessive amount of weight puts a lot of pressure on your joints. It is not just your back, but even other joints of your body such as your knees or ankles also bear a lot of weight and degenerate over time due to conditions such as obesity. If you have been diagnosed with Scoliosis or believe that you are at risk for the condition and want to take steps to ensure that it does not get worse, one of the best things you could do is shed some pounds. Not only will it relieve the stress on your back, but it will improve your posture and flexibility as well.
- Braces: Soft braces or normal braces may be recommended for those with Scoliosis as well, as an alternative to surgical options. It is especially suggested to those with idiopathic Scoliosis to ensure that the progression of the curvature does not become worse. The main goal of the brace is to ensure that the spine remains fixed in the neutral or the ‘correct’ position while also allowing the individual to carry out their daily activities without any interference. For degenerative Scoliosis, the main motive for prescribing a brace is to reduce the pain that occurs as a result of the condition, and in idiopathic Scoliosis, the main reason that a brace is prescribed is to reduce the progression of the spinal bend.
- Manual Manipulation: Physical therapies by a chiropractor or an orthopedic may be considered to improve joint movement, flexibility, strength, and to improve posture. It may not be effective for everyone or all types of Scoliosis and may vary in results from one individual to another.
- Nutrition: What you put in your body is as important as what you do with it. Various supplements such as to improve your bone strength and density may be prescribed. Ingredients with anti-inflammatory properties may also be suggested to reduce the pain that occurs due to Scoliosis. Ensuring a vitamin-rich diet is important. It is also equally important to ensure that the body is adequately hydrated by drinking enough water.
- Ice or Heat: As with any other local injury, cold packs or hot packs can help those with Scoliosis as well to alleviate the symptoms and the pain that they face from the condition. While cold packs are usually given to reduce inflammation, heat packs are prescribed to increase blood flow and reduce stiffness.