Scoliosis in the Elderly
Although we tend to think of scoliosis as something that occurs in adolescents, that is only because it is when we typically look for it and diagnose it. When we look for it in other age groups, we find that scoliosis in the elderly is quite common. One study found scoliosis to be present in 68% of healthy individuals over the age of 65 with no low back pain. If this study had included individuals with low back pain, the incidence of scoliosis might have been even higher. Cases of scoliosis in the elderly typically arise due to one of three reasons. First, there is adult idiopathic scoliosis, which is simply a case of adolescent idiopathic scoliosis that grew up. Second, there is degenerative or de novo scoliosis, which develops due to degeneration of the discs of the spine. The last form is traumatic scoliosis, which occurs as a result of an accident or injury. Although these three types of scoliosis have some similarities, they also have some important differences. Adult Idiopathic Scoliosis If you were diagnosed with scoliosis as a teenager, you might have worn a brace, or done nothing at all. Either way, the scoliosis continues to exist after skeletal maturity. If it is large enough, it will continue to worsen over time. Even if it does not worsen, the imbalance in the spine can slowly cause changes to the joints, discs, and muscles
over time, leading to pain and muscle tension. For adults with idiopathic scoliosis, bracing is not typically recommended. There have been a few studies suggesting that some types of soft braces might help reduce back pain, but these are not intended to correct the scoliosis. The only procedure that is recommended to correct adult scoliosis is surgery. However, surgery can be much more challenging for adults, especially older adults, than it is for adolescents. The complication rate of surgery to treat scoliosis in the elderly tends to be higher, the recovery time longer, and the chance of revision surgeries being necessary actually increases. The CLEAR protocols and scoliosis exercise programs have demonstrated remarkable success clinically in helping people with adult idiopathic scoliosis. Patients commonly report reductions in pain, improvements in energy levels, and better physical functioning, especially in regards to breathing, sleeping, and walking for long distances or sitting/standing for long periods of time without pain. The main goal of treating scoliosis in the elderly is to provide the best possible quality of life for as long as possible. Degenerative Scoliosis Cases of degenerative scoliosis did not exist in adolescence, but rather developed later on in life (typically after the age of 40 or 50) due to degeneration of the discs of the spine. They have a very distinct appearance on x-ray; the curves tend to be steep, and there is often sideways slipping of the bone in the middle (called a lateral listhesis), caused by weakening of the fibers in the discs. The discs themselves tend to be thin, and
MRI’s will often report weak signal intensity due to decreased water content. Canal stenosis (narrowing of the holes for the spinal nerves) is another common occurrence in degenerative scoliosis, which can lead to pain that radiates down into the hips and legs. The options for older people suffering from degenerative scoliosis are limited. Braces - even soft braces - tend to be less effective. For older individuals with degenerated discs, it can be difficult to go through and recover from surgery. General physical therapy and traditional chiropractic approaches do not appear to offer significant benefit. While research is ongoing, the CLEAR protocols show great promise in helping to reverse the degenerative changes, reduce pain, and restore function and quality of life in individuals with this condition. Traumatic Scoliosis Not a great deal has been written regarding traumatic scoliosis, besides the fact that it exists. It is known that it is possible for an existing case of scoliosis to worsen after an accident or car crash; it is also possible for a case of scoliosis to develop due to injury to the spine, ligaments, or muscles. Sometimes this can be an antalgic scoliosis, which is a case of scoliosis that develops in the body to reduce pain. Once the pain is gone, the scoliosis disappears on its own. However, if there is significant enough damage to the muscles, disc
s, and ligaments, the scoliosis can persist even after the pain subsides. Cases of traumatic scoliosis require a personalized rehabilita
tion program to address both the acute and chronic aspects of the injury. The sooner after the injury treatment can begin, the better the chances of long-term success. Post-Surgery After an individual undergoes surgery for their scoliosis, it is commonly assumed that the surgery will “fix” the problem for good. Sadly, for many individuals, this is not the case. When surgery is not successful in reducing pain or correcting cosmetic appearance, the only treatment option left for surgeons to recommend is additional surgeries. In 2014, CLEAR presented a case report at the World Federation of Chiropractic (WFC) Congress that documented improvements in a surgically-fused spine after CLEAR treatment. While little can be done to treat the fused areas of the spine directly, it is still possible to influence unfused areas and, in doing so, reduce the stress upon the metal rods and other components. If you or a loved one has had scoliosis surgery in the past, and are interested to know if CLEAR could help your pain or improve your mobility, please consider contacting one of our certified doctors.
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