One doesn’t have to live with debilitating back pain that could be caused by an adult form of scoliosis
June is Scoliosis Awareness Month and if you’re an adult with severe back pain, you’ll want to learn more about how this condition may be the source of your suffering. Scoliosis has become a catchall term for spinal deformity in adults and children. For the 500,000 people in this country with some kind of adult spinal deformity, the pain can be debilitating. It’s not unusual for people with this condition to find it impossible to walk any distance or get restful sleep at night, causing a severe decline in quality of life. You can have a completely normal spine and suffer from muscle spasms, but relentless, intractable pain can signal a spinal issue. The good news is that advances in diagnosis and treatment can reverse these negative impacts and help you get back to living your life again
Could my backache be a sign of a spinal issue?
Back pain has many causes, but one possibility is an underlying spinal problem. In addition to back and leg pain, adult forms of scoliosis may cause a noticeable change in your appearance and posture. A common problem you may see in yourself and others around you is kyphosis, which causes people to hunch over due to the outward curvature of the spine. If you feel as though you can’t stand up straight or you’re bent forward or to one side more often, those can be signs of a spinal deformity. Another sign of kyphosis is leaning that occurs above the hip, where the individual has to compensate for it by bending their knees in order to stand up straight. Spinal deformity can also cause a loss of height, with patients reporting a loss of 3 or 4 inches in a span as short as 5 years. That can signal an underlying scoliosis in which the spine is bent to one side. This 'shrinkage' can be one of the earliest signs and it’s very important to get that checked out by a doctor.
Causes and treatment of adult forms of scoliosis
The most common cause of adult spinal deformity is degenerative scoliosis, mostly due to degenerative disc disease, in which the spine twists as we grow older due to arthritis and other age-related changes. Another form is iatrogenic scoliosis, or surgical scoliosis. In this case a spine surgery in the past has left the spine without its normal support structures after the surgery, leading to degeneration. There is also the adult progression of adolescent or congenital scoliosis, which results from abnormal spine development in the womb or in childhood. This doesn’t necessarily require treatment when we’re young, but as we get into our 30s, 40s, 50s and beyond, the spinal curve causes pain, or in some cases can get severe enough to restrict breathing or other bodily functions.
There are many successful surgical and nonsurgical treatments for adult spinal deformities. There is no one-size-fits-all solution because each patient has a unique type of deformity that requires a unique approach. But the bottom line is that you do not have to live with debilitating pain that interferes with your ability to live your life.
A personalized multidisciplinary approach to your spine
At Montefiore, scoliosis is diagnosed and treated by a multidisciplinary team of physiatrists, interventionists, surgeons, therapists, and others who see the patient together. Using state-of-the-art imaging technology, a comprehensive image of your spine will be created to guide the process.
Depending on the severity of the deformity, non-invasive treatments such as physical therapy, exercise, aqua therapy, acupuncture and chiropractic care provide all the relief necessary. There are also epidural steroid injections and radiofrequency ablation — a procedure that heats nerve tissue in the affected area — to block pain. About half of our patients at Montefiore get good results without surgery.
Optimizing for a better outcome after surgery
Patients who require surgery to correct a spinal deformity benefit from our process of patient optimization, which dramatically reduces complications. Montefiore’s multidisciplinary teams work with patients to make sure they’re in the best possible condition to undergo their procedure. For example, a patient with osteoporosis will be treated by an endocrinologist with medications to improve bone health. Certain lifestyle issues lead to complications, and we work with patients to resolve those as well. We refer patients with a body mass index of 40 or higher to bariatric care to lose weight prior to surgery. Because cigarette smoking inhibits bony spinal fusion and increases the risk of wound infection, nearly 100% of smokers have complications after these surgeries. We work with patients on smoking cessation, and test for any traces of nicotine in the body before going to surgery. These simple optimization steps have been demonstrated to significantly reduce complications and improve outcomes for our patients.
You do not have to live with crippling back pain, so don’t wait until it affects your ability to get the most out of every day. No matter what your age or what stage your scoliosis may be in, relief is available. You can get back to getting the most out of every day with the right treatment and care.
The Montefiore Spine Center offers patients an array of surgical and non-surgical treatment options.
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