Just because you have adult scoliosis doesn't mean you are beyond help! And although the degree of pain may vary markedly with adult scoliosis it rarely requires surgery. Indeed, spinal mobilization and some specific straightening and strengthening exercises can have a remarkable effect. 

Spinal scoliosis is curvature of the spine, so when viewed from the rear it has an ‘S’ shaped or windswept curve from top to bottom. The crooked spine may vary greatly from being barely noticeable or shockingly marked, as with Quasimodo the Hunchback of Notre Dame. Quasimodo's hunch was caused by his rib cage, twisted around his spine and and thrust up at one side of the back like a fin. 

Just because you aren't young doesn't mean you aren't treatable. Scoliosis is one of the most satisfactory spinal conditions to treat at any age. Ideally, you should understand about the metabolic processes going on inside the discs before you start and you can see this in Sarah's 45 minutes scoliosis video. It will also show you how to use the BackBlock and other important exercises. Start by downloading Sarah's scoliosis video here.  

With some cases of adult scoliosis, it can be quite a surprise to hear you have a crooked spine, even though you may have known since adolescence that your hem hung crookedly or one shoulder was higher. As extreme as scolioses may be at one end of the spectrum, many others hide in the spinal machinery and only come to light with MRIs as a result of another, more recent back-hurting incident. 

On the other hand, patients with adult scoliosis may have known for years - and grappled all that time with thinking one day an operation will be inevitable (this is so common)!. The spectre of back fusion surgery can hang like the sword of Damocles over these poor people, when really it should never be necessary.

Primary and Secondary Curves of Spinal Scoliosis

In all cases of a scoliosis diagnosis, a distinction is made between the lumbar scoliosis and thoracic scoliosis, the latter usually being secondary to the primary lumbar curve. With lumbar scoliosis, the curve will either be concave left or right, with the thoracic curve the other way.

The apical segment of the curve is always the most compressed and corresponds to the maximum point of buckling of the spine. On spinal mobilization, this vertebra is always the most immobile - and always the sorest when palpated by investigating hands. 

The secondary curve of the thoracic scoliosis develops in compensation for the lumbar curve. This keeps the skeleton balanced over its narrow base in the pelvis. The compensatory curve twists the spine back over the line of gravity to maintain balance of the head at the top of the column. It also makes it easier to focus the eyes and judge distance.

Sometimes the primary lumbar scoliosis may be almost negligible and most of the rest of the spine taken up with the secondary curve. Studies have shown that many people have a slight concave curve to the right in the mid-thoracic area, probably because of the predominance of right-handedness and also because of position of the aorta in the chest cavity.

What's So Different About Adult Scoliosis?

Adult scoliosis usually comes to light with decreasing fitness levels and declining strength of the trunk and core muscles. The upper body gradually tips forward, in front of the centre of gravity. This makes the spine buckle down more, bringing the scoliotic 'S' bend to life. Suddenly, as if overnight, you become much more pitched forward and twisted, with a hump appearing through your clothing near your shoulder blades. Most alarming a all, you realise you need a walking stick!

Often the apex of the lateral scoliotic curve coincides almost to the same spinal level,with the maximum point of forward crumple in your high lumbar area. You become fixed in a twisted forward stoop which starts at waist level. Various forces of spinal compression induced by the 'double curvature' bring are multiple pains to the fore; around the waist and into the groin at the front and down through the buttocks and down the leg at the back.

Spinal Surgery for Adult Scoliosis

The gold standard scoliosis surgery is spinal fusion through Harrington rods. Any form of back fusion surgery is a big deal but this procedure is particularly invasive. It involves the drilling of holes through the transverse processes on both sides of the spine and inserting rods up through several spinal segments. As the rods are tightened into position the spine is straightened.

The image below is the surgically corrected view of the image higher up the page, showing Harrington rods extending up through a large part of the spine. In my view, the scoliosis was not severe enough, nor the degree of correction satisfactory enough, to warrant this intervention.

[Image]: Harrington Rods like this are the most typical form of idiopathic scoliosis surgery correction