Degenerative Scoliosis Posted in: Understanding Scoliosis

Scoliosis is most commonly seen as a disease found in children and adolescents, but degenerative scoliosis is prevalent in older adults as well. Unlike adolescent scoliosis, there is a known cause for degenerative scoliosis in adults. It occurs when the spinal discs begin to deteriorate and the spine falls into an unnatural curve without the support of those discs. Also called de novo scoliosis, which is Latin for ‘from the new,’ degenerative scoliosis is not generally found in anyone under 40 years old.

Causes of Degenerative Scoliosis

Spinal discs do not necessarily degenerate as people age. However it is common to see discs deplete in people over 40. Most often, lifestyle choices cause friction in the spine that, over time, wears down the discs. Seemingly small compromises or maladaptations can build up to an eventual end result of degenerative scoliosis. For example, poor posture while sitting at a desk day after day, lifting heavy objects incorrectly, or not exercising on a regular basis can all add up to eventual spinal disc degeneration.

Spinal osteoarthritis, which occurs when the joints of the spine break down, and osteoporosis, which is reduced bone mass, often appear together with degenerative scoliosis. Certain people can also be genetically predisposed. Some people have spinal discs that are naturally better at holding water than others, and are thus less likely to wear down and cause problems. It’s often thought that the causes of degenerative scoliosis as we know them boil down to a 2:1 ratio, 2 parts environment and 1 part genetics.

A sedentary life does not a healthy spine make. The root cause of the majority of degenerative scoliosis cases is a lack of motion. Spinal discs are able to replenish their liquid level naturally, but they do this through movement. Healthy spine movement sends moisture and nutrients to these discs via increased blood flow. Without movement and the moisture that it brings, the discs will continue to deplete.

On an x-ray, degenerative scoliosis typically has a steep curve in the lower back (lumbar region), and the middle bone in the curve often slips off to the side (lateral listhesis) due to weak fibers in the depleted discs. The holes for the spinal nerves often shrink as well, causing a shooting pain in the hips and legs. Lower back pain and changes in posture are telltale signs that it’s time for a visit to your chiropractor.

Treatment Options

There are only a few traditional treatment options for degenerative scoliosis. Braces are a common treatment for scoliosis in teens. They’re not as effective on a fully developed spine, although some types of soft braces might help with pain in adults. Most treatments center around medication to manage the pain or surgery. Doctors will often recommend surgery to correct the degenerative curve. However, adult spinal surgeries carry a higher risk of complications and more lasting side effects than their adolescent counterparts.

If the spinal discs are deteriorating and causing the problem, the logical way to reverse this would be to restore the health of the discs. Alternative scoliosis-specific exercises and therapies aim to do just that. Asymmetrical mobility exercises and therapies work to strengthen the muscles that have grown lax on the inside of the curve and tighten those on the outside of the curve. They’ve been shown to open up the closed wedge in the middle of the back to increase motion and re-establish good front to back curves. By focusing on balancing and strengthening those muscle groups that have weakened from inactivity on the inside of the curve, the muscles are able to hold the spinal column in its natural position once more.

This is not so different from the alternative treatments of idiopathic scoliosis. Regardless of the cause of the scoliosis, the body falls into the same patterns. When CLEAR doctors treat degenerative scoliosis, they pay close attention to the bone slipping sideways (lateral listhesis) in the middle of the curve. By focusing on this area, they can relieve and prevent the shooting pain in the hips and legs.

Rehabilitation for degenerative scoliosis can take a long time, often a year or longer. But if you’re willing to put in the time and the effort, it can be done. Some alternative treatments can make you feel better right away, but it’s important to keep going with the treatments. You want to stabilize the good curves, so they don’t revert back to their degenerative states.

Prevention

Walking, proper ergonomics, and spinal exercises can work to prevent degenerative scoliosis from occurring in the first place. It might take a while to get used to, but good posture is also important for spinal health. Sit up straight with your head centered over your shoulders and try to avoid hunching those shoulders. Kind of like brushing your teeth, practicing good posture and doing regular spinal exercises  is important for your spine’s health and can prevent all sorts of back problems.

Degenerative scoliosis can be painful and cumbersome, but it doesn’t need to be a permanent part of your life. Without the complications of a risky surgery, alternative treatments have achieved real results. Be sure to talk to your doctor about all of your options before you make your treatment decision.

Have you tried an alternative treatment for degenerative scoliosis? How did you like it? We’d love to hear about your experience in the comments below.

15 comments on “Degenerative Scoliosis”

  1. 1
    Rose on July 19, 2016

    I was told that I have degenerative scoliosis that had been getting worse and more painful every day. Without insurance and a provider, the free clinic is about it. But I have been trying for the last 5+ yrs after an injury to my back, the first yr I couldn’t do much of anything but shine because the pain from the 2 ruptured discs were excruciating. I started taking about 20+ ibprophen a day. With little pain relief. Before the accident I had amazing posture. Hurting seemed to be relieved a little by me bending over and to the left…need I say more? Well I started noticing I couldn’t right myself anymore after about a yr. Without GREAT pain. Both in my back, hips and stomach. I found it almost impossible to breath and I began getting acid reflux and heartburn so bad I couldn’t breath at all! I was in dire straights. I was told by a friend and by my delving into scoliosis myself..that if I could just get the muscles in front to relax more maybe I could straighten out a little and hold myself up a little better. So I decided to try inversion. I have been utilizing the inversion table about 2 times a day for about 10 mins. A day. It seems to of helped with my heartburn and breathing a little. I can’t be sure how ling I will have to do this but it took 5 yrs of painful posture to get this way…so we’ ll have to wait and see. Thanks for being there clear.

    1. 2
      Dr. Josh Woggon on July 20, 2016

      Thank you very much for taking the time to share your story and experiences! There are many people who have said that inversion therapy has helped them with scoliosis. Interestingly enough, however, there have never been any scientific studies conducted on the effect of inversion tables upon scoliosis. Perhaps this would be a good topic for future research…

    2. 3
      Katherine on July 30, 2017

      You might want to check out exercises that stretch the psoas, a set of muscles deep in the body that help you stand upright. When you contiually bend your body because it hurts you shorten the psoas. You must use exercise specifically created to stretch to psoas because stretches and the like wont target those muscles. People who sit a great deal would also benefit from such exercises.

  2. 4
    Connie Zagel on January 25, 2017

    It seems very odd that no scientific studies have been done to determine effect of inversion tables on scoliosis. Who could get this study done and in the journals? Sounds like a great idea to help people with scoliosis.

    1. 5
      Dr. Josh Woggon on January 25, 2017

      You raise a very good point! Unfortunately, there isn’t much funding for research into non-bracing, non-surgical methods of scoliosis treatment in the US. The only people who would be likely to fund such a study would be the manufacturers of inversion tables!
      Logan Chiropractic College did some preliminary research into scoliosis and hanging traction… the results honestly weren’t that impressive. Dr. Paul Harrington also did some research on bed rest as a treatment for scoliosis. Removing (or reversing) gravity might have some benefit for the muscles, but it isn’t going to correct or reduce the curvature of the spine. Plus, when it comes to the spinal discs, intermittent traction is proving to be more effective than constant, sustained traction.
      It’s also worth noting that most scoliosis specialists do not utilize or recommend inversion therapy for their scoliosis patients, although if the patient feels that it helps and wants to continue using it, there’s nothing wrong with using inversion therapy in moderation in most cases.

  3. 6
    Anne Harris on April 18, 2017

    In 1962 I had an extensive spinal fusion for scoliosis and until I was in my early 60’s it was never a problem in my life.. I had to retire at 62 due to the fact I could not work on my feet for 12 hour shifts. I was a nurse for over 30 years. Also an accomplished equestrian for 40 years. Then it seemed as over night, I had many problems with my back. Nothing seems to be offered to me except extensive and risky bi-approach surgery. Two doctors even refused to Rx me a brace. I went and got my own. What are some options that could be used to help this progressively worse problem.. And can it shorten my life span? Thank you

    1. 7
      Dr. Josh Woggon on April 25, 2017

      Have you tried reaching out to a CLEAR Certified Chiropractor? You can find a list here: https://www.clear-institute.org/find-a-doctor/
      Our doctors are trained in specialized therapies that can sometimes provide relief where other approaches fail – even in people who have had the surgery in adolescence. While the topic of whether or not scoliosis causes a reduction in life expectancy is controversial, it cannot be denied that scoliosis can cause a reduction in the quality of life. I hope that you can meet with a CLEAR doctor to find out if they will be able to help you!

  4. 8
    Sha P on May 18, 2017

    I’m 41 yrs old and was just diagnosed with Scoliosis last week. It’s something the Dr. said I was born with but no one has ever mentioned before. I finally broke down and went to the Dr. after suffering for nearly two years with this pain. Up until the last year, the pain would come and go. Now it’s constant any time I stand or walk. My quality of life has diminished significantly. They plan to start me on injections next week to see If that will help. I needed an MRI but due to money I was unable to get it. So all I’ve had so far is an X-ray. Is it safe to have injections without an MRI? I’m sure the Dr. wouldn’t do it if not but I’m just nervous. I too have an inversion table but it seems lately that I hurt more AFTER using it than I do before. Has anyone else experienced this?

    1. 9
      Dr. Josh Woggon on May 18, 2017

      Hello, and thank you for taking the time to share!
      May I ask what type of injections you are referring to? Do you know if they are steroid injections, perhaps, or prolotherapy/regenerative medicine? Where are they planning on delivering the injections? I’m friends with a fantastic doctor in Richfield, MN, Dr. Ron Hanson MD, who might be able to help answer some of your questions. You can reach out to him here: http://orthocureclinic.com/
      Regarding inversion tables, my father doesn’t usually recommend them to the patients in his clinic. You’re certainly not the only person to notice a worsening of symptoms after using one; it’s actually quite common. Inversion can worsen back pain, and also can cause problems with blood pressure (NEVER use an inversion table if you have hypertension or are taking a blood thinner, or if you have glaucoma or a history of hernias). Part of the problem as well is that it can take 15-20 minutes of inversion for the muscles to relax enough for the traction to start affecting the spinal discs, and most people cannot tolerate hanging upside-down for this long, as over-doing it can cause many other problems. Far better than inversion therapy, in my opinion, is swimming and water activities, which provide a weightless environment for the spine and help to improve the health of the spinal discs, without the risk of serious side effects.

  5. 10
    Sandy Murray on July 21, 2017

    I used an inversion table for my back problems. After 4 times, I woke up one morning with Bells Palsy on the left side of my face. It finally went away. But I met a man that was learning to walk and talk again after a stroke. He said using an inversion table caused a blood clot to loosen and gave him a stroke. Then it hit me that after using the inversion table I had Bells Palsy. Needless to say, my inversion table went into the dumps! Now I’m doing therapy with dry needles and electerol stimulation. Doing much better!

  6. 11
    Jade on August 3, 2017

    I think something is off base here. I was a baby jock at 8, and that activity level didn’t end until age 54 when multiple sclerosis slowed me down but by no means stopped me. Today, at 61, even in braces and on crutches, I still walk at least a mile a day. So it’s not inactivity with me. What is it?

    1. 12
      Dr. Josh Woggon on August 4, 2017

      When one or more joints in the spine become “stuck” or restricted, other segments will often become hypermobile to compensate for the lack of motion in the restricted segments. Global ranges of motion can be preserved even if individual segments of the spine aren’t getting any motion. When two bones of the spine aren’t moving as they should, the disc between them starts to degenerate at an accelerated rate. Exercise, yoga, and other physical activities won’t be as effective as they normally would in bringing water and nutrients to that disc, either, since those vertebrae aren’t functioning properly. This is why good chiropractic care is so essential to maintaining a healthy spine; exercise alone won’t fix spinal misalignments and subluxations!

  7. 13
    Dawn on November 29, 2017

    I’d like to know if there is pain relief apart from manipulation, surgery, or cortisone injections.

    I developed scoliosis in the past 3 years (I’m 64.) They diagnosed mine as Neuromuscular Scoliosis. I’ve had MS for 20 years. From what the doc says, my muscles on my left side now are so weak and atrophied that my torso is leaning to my right side and it is getting increasingly more painful. I have a Peak Scoliosis Brace and that used to make me stand up straight. I still wear it, but it doesn’t stop the leaning anymore. I still lean to the right, even with the brace on.

    Now I’ve developed an additional issue with a slight lean forward. I have a Baclofen pump, which has hardware in my spine and a catheter that delivers the baclofen My scoliosis curve starts at T10 down to L3. It was 45% when first diagnosed and that’s been a couple years ago. I go to PT to try to loosen up the spasm that occurs but it’s just a temporary fix.

    If I’m sitting or lying down the pain eases, but when my feet hit the floor, the pain kicks in and I have no ability to straighten up, I curve to the right to the point I can’t look up into someone’s face. Once my brace is on and my meds kick in (I have anti spasm meds and the baclofen is an anti spasticity, so you’d think it would help more.) but I don’t
    think this is in any way spasticity related because my lefts are loose and no clonus
    or hyperreflexia.).

    I guess I’m asking if there are any other pain relief therapies that others have found
    that bring relief. I can’t do chiropractic therapy due to the possibility of catheter displacement (I’ve had this happen twice and it just means you have to have more surgery to put everything back together , I have to have a massage therapist who is familiar with an intrathecal pump with a catheter into the spine (the Baclofen, and the pump are wonderful sources of relief for the spasticity.)

    I’m wondering about acupuncture. I have a severe allergy to cortisone, so the cortisone injections are out. Would there be some other type of injection that will give me relief or another type of brace that will keep me standing. If the curve gets much worse, I’m afraid I’ll have to go the wheelchair route because my bad leg is weak, and I won’t have the balance to stay upright if my curve gets much worse.

    Thanks for reading this. I haven’t found too other MSers that share the diagnosis of MS and Neuromuscular Scoliosis. (I did read a study that discusses the possibility of the baclofen pump and catheter into the thecal sac might be the cause of adult onset scoliosis.) But the pump has been so valuable for the last 7 years, that I’d have it implanted again even if it did lead to the scoliosis. I could not walk due to spasticity when I received the pump, and it’s been 7 years of mobility, and that has been so appreciated by me and my doctors.

    I really appreciated finding a forum wit advice for scoliosis patients.

    1. 14
      Dr. Josh Woggon on November 30, 2017

      Thank you for taking the time to share your story. The resilience and courage you have shown in your healthcare journey is truly inspiring.
      I do think acupuncture is a viable option for people with scoliosis. There are a few studies (https://www.ncbi.nlm.nih.gov/pubmed/19678786, and https://scoliosisjournal.biomedcentral.com/articles/10.1186/1748-7161-3-4 are examples) that have shown benefits not only in decreasing pain, but also in controlling progression and reducing the deformity. My good friend, Dr. Andrew Strauss, has a Doctorate in Traditional Chinese Medicine, and has used laser acupuncture to help many people with scoliosis (read more here: https://www.hudsonvalleyscoliosis.com/acupuncture_scoliosis/). I’d suggest reaching out to him, to help you find an acupuncturist with some scoliosis training in your area.
      Another option might be prolotherapy, or stem cell injections. Lately I have been studying PRP & stem cell injections, and while studies are ongoing, early results are very promising. These forms of regenerative medicine are designed to work with the body’s natural healing response, and can be delivered without steroids. Many patients experience pain relief, and histological studies of the disc show evidence of increased water content and regeneration after the injection.
      The best brace I have studied so far is the ScoliBrace, by Dr. Jeb McAviney. Rather than simply restoring symmetry, it strives to activate the weaker muscles by inducing an over-correction, forcing the muscles on the opposite side of the curve to work harder.
      You might be able to find some relief with upper cervical chiropractic, which would not risk the displacement of the pump. The CLEAR protocol includes 3-dimensional upper cervical care, using an adjusting instrument (so it does not involve twisting or turning the patient’s head).
      I hope this information is helpful. I would encourage others to please feel free to share their thoughts and experiences as well. We are honored to create a safe place for anyone with scoliosis to share whatever they would like! All comments & posts are read and pre-approved before they are made public, so you can be confident that hurtful words or mean-spirited comments will never find their way on to this forum.

  8. 15
    Dawn on November 30, 2017

    Thanks so much for your input. I will certainly pursue more information on the
    therapies you listed.

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