Scoliosis gets the most attention, and should, in youth, particularly during growth spurts. The reason for this is because this is when scoliosis curves can progress the quickest and small curves can rapidly become larger curves that potentially can lead to surgery.
However, only 3% of adolescents under 18 years of age have scoliosis. In comparison 9% of adults over 40 years old have scoliosis, 30% of adults over 60 years old and 50% of adults over 90 years old. There are two reasons for this:
- Some of the adults with scoliosis are adults who had scoliosis when they were younger.
- Many of them have different forms of scoliosis all together, known as de novo scoliosis or adult degenerative scoliosis. De novo comes Latin origin and means over again or anew.
Before skeletal maturity, the progression of scoliosis is caused by uneven pressure on growth plates in spine vertebrae. This known as the Hueter-Volkmann Law, which states, “Growth is retarded by increased mechanical compression, and accelerated by reduced loading in comparison with normal values.” Growth plates are stunted under mechanical pressure and
scoliosis begins to accelerate by unbalanced pressure on the vertebral bones that can cause the bones to grown unevenly.
Scoliosis progresses in adults for a different reason, degenerative reasons. Uneven pressure on bones will cause bones to breakdown and degenerate after skeletal maturity. This follows Wolf’s Law, which proposes the skeletal hard and soft tissues will remodel under stress. Increased pressure on unbalanced bones will cause the vertebra to breakdown and degenerate. This can be Adolescent Idiopathic Scoliosis in adults that became degenerative or a new scoliosis that begins in adulthood (De Novo Scoliosis).
Scoliosis Progresses in Adults
Larger curves have been shown to progress 1-3° per year. As curves in the lumbar spine progress they can become unstable. This degenerative process, combined with increased scoliosis curves, can lead to increased spinal instability, which is frequently accompanied by an increase in pain and discomfort.
Scoliosis Treatment for Adults
Scoliosis treatment for an adult is a case-by-case basis. Smaller scoliosis curves in adults are typically treated with scoliosis specific rehab and exercises. As curves progress, intensive scoliosis rehabilitation several times a week, or several times a day if patients are traveling from long distances to a clinic are appropriate. Larger degenerative scoliosis curves are frequently treated with bracing to stabilize the curve and often time gets the best results with intensive scoliosis rehabilitation programs.
Research Shows Bracing Is Effective In Slowing Scoliosis Progression in Adults
A retrospective study was done to determine the effectiveness of bracing in slowing the progression of scoliosis in adults. Both the progressions of idiopathic scoliosis in adults and degenerative scoliosis were observed. In both types of scoliosis, the rate of curve progression decreased from 1.28° to .21° after bracing. This study shows the bracing can be effective in slowing the progression of scoliosis in adults.
About the author:
Dr. Justin Anderson is a Boise Chiropractor, with advanced certification in Chiropractic BioPhysics, located at Optimal Spine & Posture. Dr. Anderson specializes in non-surgical spine correction and rehabilitation with a specialization in spine deformities and scoliosis bracing. To learn more about non-surgical chiropractic treatment options visit: https://optimalchiropracticboise.com/