Scoliosis is a condition characterized by a sideways curvature of the spine, which can resemble a “C” or “S” shape when viewed from behind. While it can be diagnosed at any age, scoliosis is most frequently identified in children and adolescents. A diagnosis is typically made when the spinal curve measures greater than 10 degrees on an X-ray. Many people wonder if scoliosis stops progressing once they are past puberty.
Scoliosis Progression During Growth
The period of rapid growth is when scoliosis curves are most likely to worsen. This is because the spine’s growth plates are highly active during these years. As bones lengthen, uneven forces on these growth plates can exacerbate an existing curve.
Hormonal changes also contribute to this heightened risk of progression. The adolescent growth spurt, typically between ages 8 and 14 for females and 10 and 16 for males, is when significant spinal growth occurs, leading to faster changes in the curve. Regular monitoring of spinal curvature is often recommended for children and teenagers during these periods of accelerated development.
Scoliosis Stability After Growth
For many individuals, scoliosis curves tend to stabilize once skeletal maturity is reached. Skeletal maturity is when bones stop growing and growth plates close or fuse into solid bone. This typically occurs in the late teens or early twenties, after puberty.
Once this stage is achieved, the rapid progression observed during growth spurts usually diminishes significantly. For instance, progression rates can slow from 10-20 degrees per year during childhood to about 0.5-1 degree per year after skeletal maturity. However, while stabilization is common, it is not a universal outcome, especially for larger curves.
Factors Affecting Adult Progression
Despite reaching skeletal maturity, some scoliosis curves can continue to progress in adulthood, or even develop anew. One of the primary factors influencing this continued progression is the initial magnitude of the curve; larger curves, particularly those exceeding 30 degrees at skeletal maturity, carry a higher risk of worsening over time.
Degenerative changes within the spine also play a significant role. Conditions such as intervertebral disc degeneration, facet joint arthritis, and osteoporosis can cause the spine to lose stability, leading to a gradual increase in curvature. This is particularly common in individuals over 40 or 50, where age-related wear and tear can result in “de novo” scoliosis, a curve that develops in adulthood without a prior adolescent history. Additionally, factors like a sedentary lifestyle, previous spinal injuries, and muscle imbalances can contribute to progression in adult scoliosis.
Monitoring and Management in Adulthood
Managing scoliosis in adulthood often involves a focus on monitoring and conservative strategies, particularly for curves that have stabilized or are progressing slowly. Regular check-ups, including physical examinations and imaging, help track any changes in the spinal curvature.
Pain management is a common aspect of adult scoliosis care, and non-surgical approaches are often the first line of treatment. These can include physical therapy to strengthen core muscles and improve flexibility, pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), and sometimes corticosteroid injections to reduce inflammation. Lifestyle adjustments, such as maintaining a healthy weight and practicing good posture, can also contribute to spinal health. While surgery is generally reserved for severe cases or those with significant pain and neurological symptoms that do not respond to conservative treatments, it can effectively correct curves and improve quality of life.