Scoliosis and degenerative disc disease are two different diagnoses that can develop independently but also overlap.
Degenerative disc disease (DDD) is when the structures between your back bones (discs) wear out, lose their shape, or tear, producing changes in the spine. This sometimes causes symptoms like nerve pain and muscle tension. Not everyone with DDD has scoliosis.
Scoliosis is when the spine curves sideways, adopting a C or S shape, instead of staying straight. In adults, when scoliosis develops from natural aging changes, doctors call it adult degenerative scoliosis (ADS). You don’t develop ADS without some level of disc degeneration, so most people with this diagnosis also have DDD.
Both ADS and DDD often show up after age 50, but younger people may develop these conditions as well, especially if they’ve had injuries and other risk factors.
Both scoliosis and disc degeneration can develop in a specific region of the spine (e.g., the lower back) or throughout the neck and back.
Your vertebral discs are like jelly-filled cushions between the bones of your spine. Over time, they naturally lose texture and elasticity, making them thinner. Small tears may develop, and the discs can change shape, bulge, or, in severe cases, collapse, resulting in degenerative disc disease.
The main risk factors and causes of this disc degeneration include:
- Aging: Discs get thinner as part of the natural aging process.
- Genetics: Some people may have inherited weaker disc structures from their close relatives.
- Repetitive stress: Heavy lifting, extreme sports, high impact activities, or persistent twisting may speed up the wear and tear in your discs.
- Tobacco use: Smoking may cut off oxygen supply to the spine, and this could speed up disc damage.
- Injuries: An accident, fall, or other types of trauma to the spine may accelerate disc changes.
What is the degenerative process?
As you age, your discs lose water, may shrink or bulge, or even rupture. When this happens:
- the bones get closer together
- bone spurs may develop
- spinal alignment may shift
- nerves coming out of both sides of the bone may get pinched
Many people develop scoliosis
- Adolescent idiopathic scoliosis (AIS): It’s not yet clear what causes scoliosis in teens, but experts suspect genetics and growth patterns may play a role.
- Congenital scoliosis: In some cases, the spine doesn’t develop as it should before birth, and a baby may be born with some level of scoliosis.
- Neuromuscular scoliosis: Conditions like cerebral palsy or muscular dystrophy may impact muscle control, which could lead to scoliosis.
In these cases, scoliosis develops long before age-related disc degeneration.
If you already have scoliosis as a young adult, you can still develop DDD later on from the causes listed before. The existing spinal curvature may make degeneration worse, and disc degeneration may, in turn, make the curve progress faster.
If you have DDD without scoliosis, you may still develop the latter. When discs wear down unevenly, one side of your spine may wear faster than the other. This may tip your spine sideways, creating the scoliosis curvature. Over time, the curve may worsen as more discs deteriorate, leading to ADS in people over 50.
Risk factors
Additional factors that may contribute to either or overlapping diagnoses may include:
- osteoporosis
- overweight or obesity
- repetitive trauma or injuries
- persistent spinal microstresses (repetitive strain injury)
- postural habits
- sedentary life
- metabolic and systemic conditions, like diabetes or chronic inflammation
Some people may not experience any evident symptoms of scoliosis, disc degeneration, or ADS.
When symptoms are present, these may include:
- persistent back pain
- shooting pain or numbness down your limbs (when a nerve is pinched)
- trouble standing straight
- back stiffness
- balance challenges
- coordination problems
- limb weakness
- muscular pain and tension
ADS is usually progressive, restrictive, and painful.
Diagnosis usually consists of a physical exam and imaging tests.
The exam may include assessing:
- the spine’s range of motion (how much and how easily you can move)
- exploration of painful spots
- nerve reflex tests
- muscle strength
- posture and gait
A doctor may also use a scoliometer, a noninvasive device that they place over your back to assess the severity of the spinal curvature. Doctors measure this scoliosis curvature in degrees, which they call the Cobb angle.
Imaging tests may include:
- x-rays
- MRI
- CT scan
Find a medical specialist in your area today
Your healthcare team may comprise several people who can provide support. Sometimes, a medical specialist will be required to diagnose, manage, or treat a healthcare condition.
You can find the following medical specialists who can both diagnose and manage scoliosis and DDD in your area today:
Depending on the severity and symptoms of your condition, a doctor may explore different approaches to scoliosis, ADS, or DDD. Typically, management will likely include:
- orthopedic physical therapy
- pain management with anti-inflammatory pain medications, like NSAIDs
- ergonomic support
Surgery is also available for severe or debilitating cases, especially when:
- scoliosis causes a curvature of more than 45 degrees
- nerve issues cause debilitating weakness or bladder or bowel incontinence
- severe pain and mobility challenges don’t improve with traditional treatment
You can also play an active part in managing scoliosis and disc degeneration. You can try:
- Staying active: Physical activity may be challenging if you have stiffness and pain, but it helps manage symptoms. Try low impact activities like walking, swimming, or gentle yoga.
- Watching your posture: Using supportive chairs and other posture-correcting aids may help slow down the progression of these conditions.
- Doing targeted exercises: A doctor or physical therapist may recommend specific stretches and exercises that may help relieve pain and discomfort from scoliosis and DDD.
- Caring for your bones: Asking a doctor about strategies to prevent osteoporosis may be a good idea to manage common risk factors for these conditions.
- Ceasing tobacco use: If you smoke, stopping this habit may help prevent further complications.
- Managing your weight: If you have overweight or obesity, the added pressure on your spine may speed up degeneration.
Adult degenerative scoliosis is when your spine curves to the side due to uneven spinal disc degeneration (wear and tear). Degenerative disc disease refers specifically to the progressive breakdown of your discs (the cushions between your back bones). It may or may not be accompanied by scoliosis. These conditions can occur together or on their own.
Yes. Although these are more common in people age 50 or older, anyone can develop scoliosis or disc degeneration. Injuries, obesity, sedentary lifestyles, and weakened bones are common factors.
Scoliosis and degenerative disc disease can develop independently or coexist. Not everyone with disc degeneration will have scoliosis, and many people with scoliosis don’t have disc degeneration.
When scoliosis develops in an older person due to disc degeneration, it is referred to as adult degenerative scoliosis.
Physical therapy, low impact physical activity, and ceasing to use tobacco can help manage both conditions. Surgery may be recommended for severe cases where persistent pain, weakness, and mobility challenges are present.