Types of Scoliosis

Scoliosis is grouped by its cause. In adults, two types account for most cases:

Adult Idiopathic Scoliosis

This is a curve that began in adolescence, often without being noticed, and continued into adulthood. Idiopathic simply means the cause is not known, though scoliosis can run in families. The curve may stay stable for years or slowly progress over time, and it can affect the mid back, the lower back or both.

Adult Degenerative Scoliosis

Also called de novo scoliosis, this type develops later in life and has no connection to adolescence. It typically begins after age 50 and happens when the discs and joints of the spine wear unevenly with age, which allows the spine to tilt and curve, usually in the lower back. Because it comes from the same wear that causes other spine problems, degenerative scoliosis often occurs alongside conditions like degenerative disc disease and spinal stenosis.

Less commonly, scoliosis can be congenital, meaning a curve that a person is born with, or neuromuscular, caused by a condition that affects the nerves and muscles supporting the spine.

What Causes Scoliosis?

The cause depends on the type. Most idiopathic scoliosis has no identifiable cause, although genetics appears to play a role, since it often runs in families. Adult degenerative scoliosis, by contrast, has a clear driver: the gradual, uneven breakdown of the discs and joints of the spine with age, which is sometimes accompanied by arthritis and thinning bone. A curve can also result from a condition present at birth or from a disorder that affects the nerves and muscles that support the spine.

Scoliosis Symptoms

Mild scoliosis often causes no symptoms and may only be noticed as a change in posture. When symptoms do occur in adults, they can include:

• Visible Curve: A visible curve of the spine, or uneven shoulders, hips or waist
• Leaning: Leaning to one side
• Back Pain and Stiffness: Back pain and stiffness, which is often what first prompts an adult to seek care
• Loss of Height: A gradual loss of height
• Leg Symptoms: Pain, numbness, tingling or weakness in the legs if the curve narrows the space around the nerves

The leg symptoms happen because an adult curve can crowd the nearby nerves or narrow the spinal canal, which links scoliosis to conditions such as spinal stenosis and sciatica. In severe cases, a large curve may also affect the rib cage and make breathing less comfortable.

Please Note: Scoliosis is usually not an emergency, but a curve that is visibly worsening, back pain that does not settle or new numbness or weakness in the legs should be evaluated by a spine specialist. Prompt evaluation helps protect the nerves and can help keep more treatment options open.

How Scoliosis Is Diagnosed

A spine specialist can usually diagnose scoliosis with a physical examination and imaging. Your physician will look at the alignment of your spine, shoulders and hips, often using a forward-bending test in which you bend at the waist so the curve is easier to see, and will check your strength, reflexes and sensation. An X-ray confirms the diagnosis and shows the size and location of the curve, measured as an angle known as the Cobb angle, which helps guide treatment and track whether the curve is changing over time.

Scoliosis Treatment

Treatment for adult scoliosis is guided by your symptoms as much as by the curve itself, and many people are managed without surgery. Treatment typically begins with physical therapy, pain management and other nonsurgical options. The goals are to relieve pain, maintain function and keep the curve from progressing.

Nonsurgical Treatment

Conservative care is the starting point for most adults:

• Physical Therapy: Exercises to strengthen the core and back muscles, improve flexibility and support better posture
• Medication: Anti-inflammatory or other medication to manage pain
• Low-Impact Exercise: Activities such as swimming or walking to stay active and support the spine
• Spinal Injections: In some cases, injections to relieve pain from nerve irritation or arthritis

Surgical Treatment

Surgery is reserved for a smaller number of adults whose curve is severe or clearly progressing, or whose pain or nerve symptoms do not improve with conservative care. A common procedure is a spinal fusion, which straightens and stabilizes the affected part of the spine using rods and screws, often along with relieving pressure on any compressed nerves. Your Resurgens spine specialist will explain whether surgery is appropriate and what recovery would involve.

Find a Scoliosis Specialist in Metro Atlanta

If you are looking for expert scoliosis care, the spine specialists at Resurgens Orthopaedics diagnose and treat scoliosis at locations across metro Atlanta. Book an appointment online today with Resurgens Orthopaedics or call us at (404) 847-9999.