Understanding Adult Scoliosis
Unlike the more commonly known adolescent idiopathic scoliosis, adult scoliosis can arise from or be worsened by age-related degeneration of the spinal discs and joints. This is often referred to as degenerative scoliosis. While some adults may have had undetected scoliosis since childhood (adult idiopathic scoliosis), the symptoms often become more pronounced after age 50 due to spinal wear and tear. The progression of the spinal curvature, combined with degenerative changes, can lead to nerve irritation, muscular fatigue, and noticeable physical changes that affect daily life.
The Most Common Symptoms of Adult Scoliosis Over 50
The most prevalent and often first symptom people over 50 experience is back pain, especially in the mid to lower back. This pain is not directly related to the size of the curve but is typically caused by degenerative changes and muscle imbalance. Other common symptoms include:
- Chronic Back Pain: A persistent, nagging pain, particularly in the lower back, that can worsen with activity and be relieved by sitting. This pain often results from degenerative changes in the lumbar discs and facet joints.
- Spinal Stiffness: A loss of flexibility and stiffness in the back, making it difficult to bend or twist. This is a direct result of joint degeneration and the compensating musculature.
- Radiating Leg Pain: Known as sciatica, this pain can shoot down one or both legs due to spinal stenosis, a narrowing of the spinal canal that pinches nerve roots.
- Numbness or Weakness in Legs and Feet: Nerve compression can also lead to numbness, tingling, or cramping in the legs and feet, and in more severe cases, can cause difficulty walking.
- Fatigue: Muscle fatigue is common as the muscles on the convex side of the curve work harder to maintain postural balance, leading to increased strain and exhaustion.
Visible Postural Changes and Deformity
In addition to internal pain, the spinal curvature can lead to visible physical signs that may become more obvious with age. These deformities result from the side-to-side curvature and the accompanying spinal rotation.
- Uneven Shoulders or Hips: One shoulder or hip may appear higher than the other, and one arm may hang longer than the other when standing straight.
- Leaning to One Side: The body may visibly lean to one side, an attempt to maintain balance despite the spinal curve.
- Trunk Asymmetry: The torso may appear unbalanced or shifted in relation to the pelvis, contributing to an off-center posture.
- Rib Hump: A rotational deformity can cause the ribs to protrude on one side, creating a noticeable hump, especially when bending forward.
- Loss of Height: Over time, the compression of the spinal column can lead to a gradual reduction in overall height.
Less Common but Notable Symptoms
While back pain and postural changes are the most common signs, larger, more severe curves can sometimes lead to additional, less common symptoms.
- Shortness of Breath or Quick Fatigue: In cases where a severe curve affects the thoracic (upper) spine, it can compress the lungs and affect breathing capacity.
- Bowel or Bladder Dysfunction: In very rare cases, severe nerve compression can lead to more serious neurological issues, including bowel or bladder control problems.
- Premature Satiety: Progressive thoracolumbar curves can put pressure on the abdomen, leading to a feeling of fullness even when the stomach is not full.
Comparison: Adult Degenerative vs. Adult Idiopathic Scoliosis
| Feature | Adult Degenerative Scoliosis | Adult Idiopathic Scoliosis |
|---|---|---|
| Onset | Develops after skeletal maturity, usually after age 50. | Present since adolescence but progresses into adulthood. |
| Cause | Age-related wear and tear, including disc degeneration and facet joint arthritis. | Unknown cause (idiopathic), but aggravated by aging. |
| Symptoms | Back pain is typically the chief complaint due to joint inflammation and nerve compression. | Often more focused on spinal deformity, but can also cause pain due to degeneration. |
| Location | Most commonly affects the lumbar (lower) spine, creating a C-shaped curve. | Can affect the thoracic or lumbar spine, often in an S-shaped curve pattern. |
| Progression | Can progress more rapidly (e.g., >3 degrees/year) once degenerative changes begin. | Tends to progress more slowly in adulthood than in the adolescent years. |
When to Seek Medical Attention
If you are over 50 and experience persistent back pain, stiffness, or any of the postural changes mentioned, it is important to consult a healthcare professional. A thorough diagnosis, which typically involves a physical exam and standing X-rays, can help determine the extent of the curve and the best course of action.
Conclusion
Scoliosis in adults over 50 is a condition driven primarily by degenerative changes in the spine, leading to chronic back pain, nerve-related symptoms like leg pain and numbness, and noticeable postural changes. While some cases are mild, monitoring for symptoms is crucial, as progression is possible and can significantly impact quality of life. Understanding what are the symptoms of scoliosis in adults over 50 empowers individuals to seek early intervention and explore appropriate management strategies, from physical therapy to pain management, to maintain an active and fulfilling life. For further information on scoliosis and its treatment, you can visit authoritative sources like the Hospital for Special Surgery.
