“Do you know that you have scoliosis?”, Aunt Margie’s internist asked her during a routine checkup while he was running his cold stethoscope down her back? Aunt Margie was speechless and remained silent. No, Aunt Margie is not younger than I, nor is she an aunt who was born as a child of older parents. She is not a preteen who is being routinely checked for adolescent idiopathic scoliosis, but she is an adult whose spine is not aligned correctly. No, she is not in her thirties, nor is she in her forties approaching middle age, but a senior citizen in her seventies who is being told by her doctor that she has a spinal abnormality.

Children and preteens today are usually routinely checked in schools or for sure at their annual doctor’s visit for symptoms of adolescent idiopathic scoliosis. Depending on the severity of the curve which is checked with accurate measuring tools such as x rays and the Cobb angle, the scoliosis specialist will determine if the patient needs a special scoliosis brace or some routine physical therapy. There are definite criteria for the percentage of curvature that determines if the scoliosis is identified as minimal, moderate, or severe. (If the Cobb Angle test results in a curvature of ten degrees or more it is called scoliosis.)

In general, scoliosis is thought of as a condition that affects adolescents. The rate of scoliosis in this age group is from two to four percent and surprisingly the estimate for adults is between twelve and twenty percent. In a study of healthy adults over sixty years of age, scoliosis was found to be sixty-eight percent. Problems such as leg numbness, neck pain and sciatica can be attributed to undiagnosed adult scoliosis.

There are different types of adult scoliosis, including, adult degenerative (de novo), adult idiopathic or arthritic, and neuromuscular scoliosis. Sometimes there is a remnant of childhood scoliosis which is named adult idiopathic scoliosis. Then there is scoliosis that is connected to surgery or sickness or even trauma. (Back problems that are due to trauma are successfully treated with psychological methods such as the Sarno approach.)

Arthritic Scoliosis

Aging and bone deterioration are responsible for degenerative/arthritic scoliosis. This condition is linked to osteoarthritis and declining bone density when the bones become brittle and break easily. Arthritis causes inflammation of the spinal joints which results in spinal tension deterioration. Any joint in the body can be affected by arthritis and this includes the spinal joints which are hinged-like parts of smaller joints that are located between the vertebrae of the spine. When joints are normal and healthy, they will support the spine letting it move in all different directions such as bending, twisting and stretching to name a few. When there is erosion and inflammation of these joints it is referred to by the medical term, Facet Joint Disease. As a person ages the spinal discs that lie between each of the vertebrae get thinner causing the person to be in pain since there is little cushioning of the weight which ends up bearing down on the facet joints. “The facet joints are the connections between the bones of the spine. The nerve roots pass through these joints to go from the spinal cord to the arms, legs, and other parts of the body. These joints also allow the spine to bend and twist, and they keep the back from slipping too far forward or twisting without limits”.

When we see an otherwise healthy looking senior with postural issues this is a sign of degenerative scoliosis. Some symptoms that you would notice is the person’s shoulders and hips are uneven, not being able to straighten up entirely and a person’s height looking reduced. At first the person may not feel physical pain since the pain of degenerative scoliosis develops slowly. It first begins with a light or dull ache in the lower back and increases in intensity when the person increases their physical movements. Sometimes the pain is worse upon waking and improves over the day if the person reduces their activities but standing for especially long periods can increase the pain since the person’s weight is put on the facet joints. Sometimes if the person leans forward the pain will subside, but this relief is only for people with mild scoliosis.

When the spinal canal in the lumbar area (the five main bones of the lower back that are fused together) narrows it will squeeze the nerves located there and this causes leg cramps and pain even during short walks.

When a senior is walking with a severe curve up to ninety degrees, he or she can resemble the Hunchback of Notre Dame. Called kyphosis, this condition is very serious since it causes balance issues and the pushing of the ribs against essential body organs. For instance, if the kyphosis causes the ribs to press against the chest the person’s breathing will be affected in a critical way.

It may surprise you to read that even our brain will be affected by scoliosis especially if the neck is involved. Tension headaches and even migraines can develop since the recirculation of cerebrospinal fluid which flows around the brain simultaneously feeds vital nutrients and cushions the brain.

Neuromuscular Scoliosis

As we have learned, not only are the bones and joints affected by scoliosis but the nerves of the person as well. The term pins & needles is loosely used to explain the icy-hot or tingling feeling in our arms and legs. As the pain radiates from one part of the leg or arm to the other the sensation increases. With the younger set this is just due to a lack of circulation after keeping the arm or leg in one position too long. However, with older individuals who have neuromuscular scoliosis the feeling will not necessarily come back that easily. (This is called radiculopathy.) The muscles pull against the spine causing this tingling and numbness which comes and goes day to day and hour to hour. The mere shaking of the hand or foot will not remove these symptoms since they are related to adult scoliosis and need to be treated either with medications, physical therapy and sometimes surgery. Unfortunately, surgery is not an assurance of a cure since neurological back surgery is quite complex and most experts are not even sure if you should consult an orthopedic or a neurological surgeon.

The pain of neuromuscular scoliosis is sometimes associated with a malady called spinal stenosis. Many medical experts believe that most older people have some form of this condition that manifests itself in different ways. If a senior has mild neuropathy (numbness, tingling and weakness in the legs) they can deal with it, however, if the spinal stenosis affects the person’s ability to walk then they will be advised to have medical intervention. This article will not deal with scope of this response; there are various opinions on how to deal with spinal stenosis.

What To Do if You Have the Symptoms Described Above

Each of us knows our own pain level and each person has a different pain tolerance. Some people prefer to not have Novocain for a cavity filling. They say that for the five minutes it takes it is just not worth it to have their mouth numb and to risk biting their lip or worse, their tongue. ( I actually know someone personally who bit off a small piece of their tongue after a dental procedure, and thank goodness it grew back.) Others, want to go to sleep for a mere teeth cleaning. However, if you or someone you care about has scoliosis symptoms that manifest themselves in poor posture that can affect their health or severe pain and trouble walking and standing, they should surely be checked out.

If you are experiencing some of the symptoms we described or other indications such as digestive issues and difficulty dealing with the symptoms emotionally then a trip to the doctor and x-rays are crucial next steps in determining if you have scoliosis. Other screening methods are not as effective as x-rays since this will be the first step in determining what exactly is wrong with you. Unlike an adolescent, an adult is not typically fitted with a brace because you cannot change the structure of the adult skeleton as you can with younger patients. By the way, therefore it is so crucial to get a child or adolescent checked out immediately if scoliosis is suspected.

The purpose of treating adult scoliosis is entirely unrelated to treating adolescent scoliosis. While the main goal with children and adolescents is to prevent the advance of the condition, with adults the goal is to reduce pain and restore physical functions such as leaning forward and reestablishing balance.

Final Words

Some seniors are fatalistic about their aging. To those unfortunate sufferers, becoming bent and broken are just par for the course of getting old. This is a pity because in this day and age there is lots to be done for people who experience different types of back problems. Yes, it’s true that not every back symptom can be cured but many can be controlled by competent medical authorities. The first dimension is to find a qualified doctor who will make a diagnosis for you. If you are already at an advanced stage of scoliosis where your walking and posture are majorly affected, it is still not too late to get help to avoid having your breathing and digestion affected by your posture.

If you are diagnosed with adult scoliosis your treatment will depend on how far it has progressed. You will be x-rayed and sometimes given the Cobb angle testing depending on how the scoliosis has manifested itself. Don’t give up or give in to this serious condition because there are quite a few options out there to help you.

There are experts who recognize that professions such as gymnastics and dancing can exacerbate idiopathic scoliosis. These wonderful athletic abilities are passions of young girls who upon reaching ages close to puberty are diagnosed with scoliosis. Should this medical condition stop these young girls from pursuing their dreams?

Imagine when a young girl is at a routine checkup with her doctor, and she finds out that she has scoliosis. By asking the simple question, “roll down and touch your toes’ ‘, a girl’s life can be altered forever. Don’t panic! This diagnosis does not have to be the shattering of a dream of a young girl with her heart set on being a dancer.

Would a professional baseball star stop playing because his orthopedist tells him that if he keeps playing his injuries will worsen? Does a boxer leave the ring when he gets hurt? Although dancing might indeed take its toll on a young girl’s body, no one can ask her to give up her desire.

Normally, the spine, the ribs and the pelvis will look mostly level and balanced with one another, however, if a dancer has scoliosis, he or she may have one shoulder higher than the other or look tilted to one side. Each case of scoliosis is unique and each one presents its own challenge. Let’s look at two passionate dancers and how they dealt with their scoliosis diagnosis at such critical times in their budding dancing careers.

“Bent But Not Broken”

The phrase above is the clarion call of a wonderful and talented dancer who was diagnosed with idiopathic scoliosis at age thirteen just as she started her high school journey. Paige Fraser learned that she suffered from scoliosis at a routine checkup when the doctor asked her to bend down so he could examine her back. He immediately sent her for an X-ray which confirmed his unfortunate diagnosis. He showed Paige the x-ray and explained to her that her spine was curved like an S. She left the doctor’s office scared, frustrated and angry since she had no prior warning, no symptoms, and no discomfort.

Paige’s mom saw her talent and when she was ten years old her mom enrolled her in a ballet school. At that time, this Bronx, New York native simply enjoyed dancing but as she excelled at her practice and lessons she realized this is something that she would like to dedicate her future to. Her mom enrolled her in the Performing Arts High School in New York City and Paige began to take her dancing seriously.

In ninth grade Paige was diagnosed with scoliosis and was forced to learn exactly how her body functioned under pressure, specifically her spine. The first specialist she went to, informed her that she needed spinal surgery. He also let her know in no uncertain terms that she would have metal rods inserted into her back and she would no longer be able to bend normally. This did not jive with her dancing talent because dancers have specific movements, and the rods would limit those actions. However, Paige’s parents would not accept this diagnosis sitting down and they asked around for other options. They were recommended to a chiropractor who fitted Paige with two braces, one for day and one for sleeping.

Paige has been dancing since she began to walk. One of her teachers noticed her talent and cast her as Clara in The Nutcracker when she was ten years old. In fact, her teacher in the school dance department suffered with severe scoliosis herself and since she herself had a severe curvature she was very helpful to Paige as she was getting used to her scoliosis diagnosis.

Scoliosis did limit the amount of turns that Paige could do at one time. It was not scientifically possible for her to do more than two or the most three turns. Paige had to work much harder than a normal dancer to achieve positions that her peers took for granted.

There was no stopping Paige no matter how difficult it was for her to dance while bracing and therapy. After completing high school, Paige was accepted at the Ailey School of Dance in addition to her attendance at Fordham University. After being accepted at the Ailey dance tour company she toured worldwide while dancing up a storm professionally.

Paige attained great success in professional dancing in spite of being treated for scoliosis. She was accepted full time at the Visceral Dance Center of Chicago, won the Princess Grace Dance Award in 2017 and ultimately won a role in the touring company of the Broadway hit, The Lion King after failing more than five auditions in previous years.

During a Zoom interview, Paige admits that her scoliosis is a challenge in her dancing career. The moves that a dancer with scoliosis must perform are often anti-scoliosis moves. For example, dancers must, “square off the hips” and ribcage and this is difficult for someone with her condition.

As a youngster Paige was trained in ballet dancing. As she got older her career branched out to Broadway and even Jazz. With Jazz, the dancer must roll up and roll down very quickly. She was quite concerned that she did not have the same mobility as the other dancers. There are some scoliosis sufferers who have one leg shorter than the other and it is difficult to get the feet to align properly. Because of her scoliosis, Paige is very sensitive to other dancers with various disabilities, whether physical or mentally challenged and she started a dance school in 2017 which is a virtual school that is free.

Leah Roddenberry

When Leah was in eighth grade her mom noticed that her right shoulder blade was strangely sticking out. This was right before Leah was scheduled to go to dance class and she was dressed in her leotard which showed every curve clearly and precisely. It was peculiar since Leah had already been evaluated for scoliosis in sixth grade and no problem was detected. She was told after an x-ray that she had a slight 20-degree curvature. Her doctor, Dr. Neustadt, a scoliosis specialist at All Children’s Hospital in St. Pete, recommended that she be fitted with a hard brace to wear to sleep. Even though the brace was uncomfortable Leah was determined and wore it every night. However, this therapy did not solve her scoliosis and not only was it getting worse, but she began having pain in her back. A noticeable hump was appearing on the right side of her back and since this therapy was not helping her doctor prescribed spinal fusion surgery.

When Leah asked her doctor if she would be able to dance after surgery, he could not give an affirmative answer. Imagine Leah’s concerns which she articulated to her doctor. Leah has been dancing since she was three years old, and her passion has only increased. The doctor theorized that Leah would need rods in her back and that would mean losing the flexibility of bending at will. Leah was so shattered and at that moment she truly believed that her dancing career was over.

G-d fortunately had different plans. After the surgery Dr Neustadt came to tell Leah the good news. Since her spine was very flexible, he did not have to fuse the entire spine. It took many months of practice, blood, sweat and tears and Leah went on to become Miss Florida in 2021 and competed in the Miss America Pageant. She performed a most difficult jazz dance in the competition with this song playing as she danced, “Don’t Stop Me Now”

How Do Dancers Such as Paige Overcome Such Great Obstacles?

As one of our dancers said, there are always obstacles in life to overcome. Sometimes they are obstacles that are outwardly noticeable and sometimes they are obstacles of the heart and soul. We don’t choose our obstacles, but we choose how to handle them. As a famous person noted, ‘Be a victim or be a victor”. That choice is in the realm of your reality.

All the dancers shared that strength of their family and acknowledging their scoliosis publicly were important catalysts in their successes. Leah remarked, “I started embracing my scar and surgery not as a weakness, but as my strength. I was motivated to push past my roadblock and pursue my passion for dance.”

Paige believed from the time of her diagnosis that it was crucial for her to tell people about her struggle,” I couldn’t be quiet if I wanted to be a dancer.” She also had to put aside any negative thoughts and only think about success. Through physical therapy Paige was able to stabilize her spine and has only occasional stiffness. Every dancer has pain so why should Paige and other dancers with scoliosis stop? These feminine heroes are role models for their younger contemporaries who are sometimes discouraged from following a dream if it becomes difficult. You may be a writer with writer’s block, a nurse with difficult patients, a worker with a tough boss, each challenge is unique.

Whoever you are and whatever roadblocks you are facing you can be successful if you have family who believe in you, you believe in yourself and your right to see your passion through. Also remember that it is so important to talk your problems over with someone who can commensurate with you. Paige was fortunate that when she was faced with adversity, she had a dance teacher who was also experiencing scoliosis. It might not be so easy to find the right person to confide in but keep trying and you will win.