Scoliosis—while most often thought of as a childhood condition—can in fact occur in adults (those who are “skeletally mature”) as well. And as adult idiopathic scolosis is unique due to its causes, so too are the types and goals of treatment.

A musculoskeletal condition, scoliosis or a scoliotic spine (when viewed from behind) may appear as a letter “C” or “S” rather than a straight line. And idiopathic scoliosis—a common type found it adults—comes from unknown origins, meaning the specific causes are a mystery but may be the result of childhood scoliosis that has worsened over time or from natural degenerative changes in the spine.

It’s believed that nearly 10 percent of adults have some degree of scoliosis. And while this curvature of the spine can present at any age, experts agree that the chances of developing it increase greatly as we get older. Still, only a small percentage of adults who have some degree of abnormal curving of the spine require active and aggressive treatment.

The most common symptom with adult idiopathic scoliosis is pain in the lower back as well as muscle fatigue, numbness down the legs, a hump on the back and uneven shoulder blades or hips. In determining a diagnosis of adult scoliosis, a medical history and physical exam are the first steps and may often find an underlying cause of the problem. Imaging is also important—specifically x-rays, CT scans and MRIs—which can also detect previously undiagnosed medical conditions that are causing the abnormal spine curve and back pain.

Thankfully, many adult patients who experience a mild form of idiopathic curving do not require treatment, although consistent monitoring is recommended and should include regular physical exams as well as imaging studies every five years. Treatment—both surgical and non-surgical—may become necessary when pain and serious loss of function are occurring. However, this depends on several factors, including how severe the symptoms are, how pronounced the scoliotic curve is, the location of said curve and the patient’s overall health.

Whereas as bracing, used to correct scoliosis in children, has shown to be ineffective in adults, pain relief may be obtained through the use of a brace, especially after surgery. Physical therapy, however, is an important part of adult scoliosis treatment, and is aimed at strengthening the body’s core and improving overall flexibility. Injections of pain medications—epidurals, nerve blocks etc.—may also be a part of treatment if pain is serious and persistent.

If non-surgical treatments don’t work adequately, surgery may be necessary. The purpose of the surgery will be to reduce the amount of the spinal curvature as much as possible while providing relief from pain. A doctor will recommend surgery based on the patient’s symptoms, the degree to which the spine has curved, the patient’s overall health condition and the rate at which the condition is progressing and worsening. Such surgery typically includes implanting screws and/or rods into the spine or performing some sort of spinal fusion. However, whereas surgery for adult scoliosis can restore a good degree of normal body function and alleviate pain, it does come with potential complications, and the time to recovery is often long.