Degenerative Scoliosis

Each year, more cases of degenerative scoliosis are diagnosed as people live longer and more active lives. Approximately six million Americans are living with this condition right now. At the EvergreenHealth Neuroscience, Spine & Orthopedic Institute, we provide a comprehensive care plan for patients with degenerative scoliosis.

What is it?

Degenerative scoliosis is a side-to-side, often s-shaped, curvature of the spine caused by deterioration of the discs, facet joints, and other stabilizing structures of the spine.

What causes it?

Degenerative scoliosis can be due to a number of factors, including normal wear and tear of the body, aging, and injury to the spine.

Pre-existing conditions such as osteoarthritis and osteoporosis, which cause frail and brittle bones, may also lead to degenerative scoliosis.

Degenerative scoliosis typically affects people 65 years of age or older.

Adolescent scoliosis, which develops before puberty is reached, very rarely progresses during one’s middle years, but can progress in later years due to subsequent spinal degeneration.

What are the signs and symptoms?

Pain and stiffness are common in patients with degenerative scoliosis. Patients may experience pain in a variety of areas including:

Neck, middle or lower back
Shoulder or shoulder blade
Rib cage
Hips and buttock

Pain, stiffness, and instability can arise due to increased strain on the discs, facet joints, muscles and ligaments. Pain may be increased due to walking, standing, bending, and lifting. Scoliosis may lead to spinal nerve compression, which then causes radiating pain or numbness or weakness of the arms and legs. However, many people with scoliosis do not have pain.

How is it diagnosed?

Diagnosis of degenerative scoliosis related to scoliosis begins with a complete medical history and physical exam. Radiology tests such as an X-ray, CT scan or MRI can provide your doctor with images of your spine including your facet joints.

To better diagnose the source of your pain, your doctor may recommend diagnostic injections such as a medial branch block. During this procedure, an anesthetic is injected near the nerves that allow you to feel a specific facet joint. If a patient experiences significant pain relief right after the injection, then the facet joint is determined to be the source of the patient’s pain.

What are the treatment options?

Our team believes in using non-invasive treatment options when possible. Initial treatment plans may include:

Physical therapy. Our experienced physical therapists focus on correcting overall posture, muscle flexibility and strength and joint motion.
Massage therapy. Some patients find pain relief by relaxing surrounding areas impacted by scoliosis through massage therapy.
Acupuncture. Acupuncture has been found to help with pain in many patients.
Manual medicine. At times gentle manual therapy may be helpful.
Pain relievers. Ibuprofen or medications that treat inflammation from arthritis can reduce pain. Acetaminophen, such as Tylenol, may also be helpful.
Lifestyle changes. Lifestyle modifications such as eating a healthier diet, regular exercise and avoidance of smoking may also help reduce your pain.
Bracing. Some braces can limit the degree of back strain due to scoliosis by taking pressure off sensitive structures and relieving fatigued muscles.

If non-invasive treatments do not reduce your pain and your doctor suspects you have facet joint pain, a spinal injection may be considered. These options may include:

Corticosteroid injections. Injections into the facet joints can reduce inflammation and pain.

Radiofrequency neurotomy. During this procedure, the medial branches which allow one to feel their painful facet joints are melted via radiofrequency energy, which blocks the pain. This procedure provides long-term relief and, if the pain returns, can be repeated to often eliminate the pain again.

What is the long-term prognosis?

The long-term prognosis for patients with degenerative scoliosis depends on the severity of the condition and how the body responds to treatment. If you are diagnosed with degenerative scoliosis, consult with your doctor to gain a better understanding of your specific diagnosis and individual prognosis.