Signs of adult scoliosis
- Back pain that worsens through the day
- Uneven shoulders or hips, a rib or waist asymmetry, or clothes fitting differently
- Leaning forward or to one side, loss of height
- Leg pain, numbness or fatigue with walking from associated stenosis
Evaluation
Full-length standing X-rays measure the curve and, just as importantly, overall sagittal (front-to-back) balance, which correlates strongly with pain and disability. MRI evaluates nerve compression. Bone density testing may be recommended before surgery.
Treatment
Most adults with scoliosis are treated without surgery: core and postural strengthening, low-impact exercise, medication, and injections for nerve or facet pain. Bracing is rarely helpful in adults.
Surgery may be considered for progressive curves, significant imbalance, or disabling leg pain from stenosis. Options range from limited decompression or short-segment minimally invasive fusion targeting the main pain generator, to longer fusions to correct deformity. Dr. Ferachi will discuss the trade-offs of each approach honestly, including recovery time and risks.
Common questions
Can scoliosis develop in adulthood?
Yes. Degenerative scoliosis develops as discs and facet joints wear unevenly, typically after age 50.
Does adult scoliosis always need surgery?
No. Most adults are managed nonsurgically. Surgery is reserved for progressive deformity, significant imbalance or nerve symptoms that limit quality of life.