Spinal deformity can be a very painful condition in the life of an adult. Nerve compression or the spine can both result in a great amount of pain due to Adult Scoliosis. With proper nonoperative treatment by a Pain Management Doctor in Las Vegas, patients can achieve a very tolerable level of baseline pain, avoid surgery, and get back to performing desired activities.
What is Adult Scoliosis?
Adult Scoliosis is a deformity of the spine. It can be carried from childhood scoliosis or be the result of degenerative disc disease and arthritic degeneration of the spine that resulted in a permanent deformity. It can cause a range of problems in adulthood, and many of the symptoms can be painful in the back and legs. Adult Scoliosis can affect the overall quality of life of a patient. It can be disabling with associated pain in the back and lower legs ranging from mild to severe from nerve compression.
Diagnosis of Adult Scoliosis
A series of diagnostic tests will be used by your Las Vegas pain clinic doctor to determine if there is an imbalance or spinal deformity. Some can be very obvious and seen with the naked eye, but others may rely on long views of the spine being positioned for the relationship of the pelvis, lower extremities, and spine to be investigated.
Adult Scoliosis is multi-factored. Many pre-operative tests may be performed to determine the nature of therapy or surgical intervention, such as a DEXA Scan, CT myelography (study of nerve positioning), or MRI. For example, if an individual has very poor bone quality on the DEXA Scan the spine may not be able to hold on to hardware so surgery would be a bad idea. The MRI can show if nerves are being pinched due to the arthritis, which is known as spinal stenosis.
X-rays are used to follow the progression of a spinal curve and as a follow-up after a surgical procedure. The X-ray is the most important diagnostic test for Adult Scoliosis, as it gives the most accurate information on subluxations (slips) and spinal rotation. Many patients do not have the crucial X-ray before surgery and this may warrant further revisional surgeries.
Treatment Options for Adult Scoliosis
- Non-surgical treatment
Non-surgical treatment has a twofold goal of reducing symptoms of pain, and to increase the functional abilities of the patient with strengthening, improving flexibility, and a wider range of motion. These are factors that impact the spine through its support and flexibility, to help ward off the progression of this degenerative condition.
Deteriorating facet joints and increased, or sustained, inflammation of the spine can be very painful. Usually the first treatment sought is through NSAIDS and pain relievers that are effective on arthritis conditions and these conditions typically share many common symptoms with Adult Scoliosis.
For acute exacerbations of adult scoliois, short term narcotics may be very beneficial. Over the long term, the risks of narcotics start to outweigh the benefits. So this needs to be weighed and discussed with your pain doctor in Las Vegas. During the painful times, muscle relaxers may also be used.
For the leg pains due to spinal stenosis, neurogenic stabilizing medications such as Lyrica can be beneficial.
To decrease inflammation and relieve pain, your Nevada pain management doctor may recommend epidural or facet injections for treatment. Medication or a numbing agent is directly injected into the affected region of the spine.
The epidural injections are the gold standard for spinal stenosis, and may provide relief for months at a time. A series of injections may be necessary, which can be repeated every few months.
Facet blocks may be helpful for the arthritis pain, or medial branch blocks to diagnose which joints are causing the most pain. In and of themselves, these injections can provide a few months of Pain Relief.
Once these injections wear off, a radiofrequency ablation may provide 12 to 18 months of extended pain relief. The issue with adult scoliosis is that a lot of joints are typically affected, so the RFA may be necessary in quite a few joints. The good news is that RFA is such a revolutionary procedure, it can help patients avoid the need for surgery as operations for adult scoliosis have potential complications.
Candidates for surgery are the patients who are experiencing limited range of motion when walking that may be accompanied by severe pain (lumbar stenosis and neurogenic claudication). Lumbar stenosis patients usually have spinal decompression surgery along with the extensive fusion. If a spinal curve is present which may cause further complications involving stability or acceleration in the progression of the curve, then a spinal fusion procedure will be considered.
These procedures have significant complication risks and are used as a last resort, quality of life procedure.
Adult Scoliosis can cause considerable pain and limited function for patients. Thankfully, Pain Management Doctors in Henderson and Las Vegas have considerable nonoperative options that are well over 90% successful at helping patients avoid the need for surgery.
For the best pain management Las Vegas has to offer, call the Nevada Pain Network today at (702) 323-0553.