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The bones and connective tissue of the body age, suffer wear-and-tear, and begin to break down. When these changes occur, the spine takes on a lateral curve.

Conditions that are associated with adult scoliosis include spinal stenosis, degenerative disc disease, vertebral compression fractures, and osteoporosis.

The most obvious sign of scoliosis is an abnormal curve of the spine, which causes poor sense of balance, humpback, abnormal skin folds, shoulder asymmetry, irregular gait or limp, and leg length irregularity. The symptoms of adult scoliosis include:

. Spinal rigidity
. Pain in the back
. Stiff back
. Muscle weakness
. Unusual sensations in the body, such as leg pain, tingling, pins-needles sensations, and loss of feeling

The diagnosis of adult scoliosis involves a medical history and physical examination. The doctor may take x-rays of the entire spine and obtain a CT scan or MRI for additional evaluation. Adult degenerative scoliosis is assessed in terms of shape, degrees, and severity.

No one treatment is right for everyone, so therapy is tailored to suit the individual patient’s needs. Treatment options include:

Medications - Drug therapy is one treatment option for people with chronic pain associated with scoliosis.

Physical therapy - The physical therapist teaches you how to improve strength and mobility while reducing pain. Active exercises are done in a pool or equipment, passive exercises involve ultrasound and spinal manipulation, and biomechanical exercises improve posture.

Bracing - A brace is an external device developed to offer the spine support and to reduce movement, which facilitates healing. Common braces include the lumbar corset, the thoraco-lumbo-sacral-orthosis (TLSO), or the soft cervical collar.

Epidural steroid injection (ESI) - This injection is done under x-ray guidance (fluroscopy). The doctor inserts a needle into the area between the dura mater (outside the spinal cord) and the bony spinal canal. The long-acting corticosteroid is injected into the epidural space, with or without an anesthetic agent.

Radiofrequency ablation - The doctor inserts a small needle into the facet joint (between two adjacent vertebrae). Using fluoroscopy for precision placement, radiofrequency energy is transmitted through the needle and onto the nerves. This destroys the nerves that are responsible for the perception of back pain. In a recent clinical research study, the success rate of this procedure was 76%, with many patients reporting pain reduction 6 months after the procedure.

Facet joint injection (FJI) - FJIs are usually given in a series of three. The doctor inserts small needles into the facet joints, which are located between each vertebra. Using x-ray guidance to assure correct placement, the doctor will then inject a long-acting steroid with or without an anesthetic agent into the joint space and near the spinal nerves. Studies show that lumbar FCIs offer both short- and long-term pain relief.