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Doc: There are several ways to treat scoliosis

October 3, 2018

Dear Dr. Roach: I’m a 65-year-old male. I’ve had scoliosis since childhood. I experience stiffness, discomfort and some soreness. What is the best treatment for my scoliosis? Chiropractic was not helpful, and although I had only mixed results with physical therapy, I still do those exercises. What other treatments are available? I would like to avoid surgery; I’m not in extreme pain and don’t want the risks of it. Your thoughts?

P.S.

Dear P.S.: The cause of childhood scoliosis isn’t known. Many assume that it is due to poor posture, but that is clearly not the case. Scoliosis is more likely to progress and require corrective surgery in girls than boys.

Since you weren’t treated with surgery, you likely still have the scoliosis — it does not get better on its own, but usually does not progress during adulthood.

In general, there are three types of treatments for back pain, and scoliosis is no exception: medications, physical treatments and surgery. You haven’t mentioned medication, and while many don’t wish to take medications all the time for symptoms, they can reduce discomfort and improve quality of life. Plain Tylenol or low-dose anti-inflammatories carry a low risk and probably are worth a try. I recommend strongly against opiates for chronic back pain. If the pain is that bad, other treatments (including surgery) should be considered.

A review of nonsurgical treatments for symptomatic scoliosis in adults suggested that while physical therapy and chiropractic treatment do not provide long-term benefit, they may halt or slow worsening of symptoms. However, they may help some individuals.

Surgery is not commonly done on adults with childhood or adolescent scoliosis. If it is, it is generally reserved for people with severe curvature and symptoms.

Fortunately, complications from childhood scoliosis are rare in adults, and there is no reduction in life expectancy.

Dear Dr. Roach: My 74-year-old husband was recently diagnosed with Stage 3B kidney failure. The information we find on the internet recommends a strict diet, but his nephrologist said recent information indicates that diet doesn’t matter. Please help.

S.S.

Dear S.S.: Kidney function reliably decreases with age, and many older adults are confused after getting a new diagnosis of “kidney failure.” But the term applies to many people whose kidney function is as expected for their age. In other words, many healthy older adults whose kidney function is as expected for their age are now being classified as having kidney failure. I suspect that’s why your husband’s kidney doctor isn’t restricting his diet. I hope, though, that the doctors have looked carefully at his medication doses; they sometimes need to be adjusted.

There’s good evidence eating less meat and more plants can slow kidney failure progression.

Email questions to ToYourGoodHealth@med.cornell.edu.

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