Scoliosis is a condition characterized by a sideways curvature of the spine. While often associated with adolescence, scoliosis can develop or progress in adulthood. Understanding the potential consequences of unmanaged scoliosis in adults is important.
Progression of the Spinal Curve
An untreated scoliosis curve in adults can worsen over time. Degenerative changes within the spine, such as intervertebral disc degeneration and facet joint arthritis, contribute to this progression. These changes can lead to spinal instability and an increase in curve severity.
Osteoporosis, a condition causing reduced bone density, can accelerate this worsening by weakening the vertebrae and increasing the likelihood of vertebral body collapse and deformity. Mechanical forces acting on the curved spine also contribute, as asymmetric loading on spinal segments can lead to further degeneration and increased deformity. Curves measuring over 30 degrees at skeletal maturity are more likely to progress, particularly in those with underlying degenerative conditions or osteoporosis.
Physical Symptoms and Functional Limitations
Adults with untreated scoliosis commonly experience chronic back pain. This pain often results from pressure on spinal discs and joints, as well as muscle strain caused by altered posture. The spinal curve can irritate and stretch nerves, muscles, and tendons, leading to stiffness and fatigue.
Physical asymmetries, such as uneven shoulders, hips, or a noticeable rib hump when bending forward, may become more pronounced as the curve progresses. These physical changes and associated pain can significantly impact daily activities, making routine tasks like walking, standing, sitting, or even sleeping more challenging. Reduced flexibility and muscle fatigue can also decrease capacity for physical activity.
Impact on Internal Organ Systems
Severe, untreated scoliosis can lead to more serious complications, particularly affecting internal organ systems. A significant spinal curvature, especially in the thoracic (upper back) region, can reduce space within the chest cavity, restricting lung movement and making it difficult for the lungs to expand fully. This restriction can lead to reduced lung volume and capacity, resulting in shortness of breath, particularly during physical activity. The continuous strain on the respiratory system may eventually lead to reduced lung function and increased susceptibility to respiratory infections.
In very severe cases, the contortion of the rib cage can also put pressure on the heart, restricting its ability to pump blood effectively. While less common, this mechanical constraint can contribute to cardiovascular issues, including increased risk of heart failure and atrial fibrillation. Beyond the chest cavity, neurological complications can arise from nerve compression due to the abnormal spinal curvature. This compression can cause radiating pain, numbness, tingling sensations, and muscle weakness in the limbs, often affecting the legs and feet.
Psychological and Quality of Life Implications
Living with untreated scoliosis can impose a psychological burden, extending beyond physical discomfort. The visible spinal deformity and body asymmetry can lead to issues with body image, causing self-consciousness and reduced self-esteem. Individuals may feel dissatisfied with their appearance and become overly critical of themselves.
These emotional struggles, compounded by chronic pain and functional limitations, can contribute to anxiety and depression. The fear of societal judgment and a perceived difference in appearance can lead to social isolation and a reluctance to participate in activities, including sports or other physical pursuits. This combination of physical discomfort, functional limitations, and psychological distress can result in a decrease in an individual’s quality of life.