Scoliosis

Overview

Scoliosis is a curvature of the spine that occurs most often in adolescents, but adults develop the condition too. An estimated 60 percent of the older population have what is known as adult scoliosis. As people live longer and are more active, this number is expected to increase.

Adult scoliosis is most common in people between the ages of 50 and 80. It is characterized by a side-to-side curvature of the spine caused by degeneration of the spine's facet joints, which act as hinges to help the spine bend.

As people age, the cartilage that protects the joints may develop arthritic changes, causing the joints to become irritated and inflamed resulting in back and leg pain. Some adults had childhood scoliosis that worsened with age or was untreated in their youth.

Spinal curvature is measured in degrees. Unlike the slow progression of adolescent scoliosis, adult scoliosis can remain the same, can progress slowly and can progress at higher rates of more than 3 degrees a year. Often, the condition causes significant physical pain and can impact quality of life.

Our approach to scoliosis

UCSF is home to one of the largest centers in the country dedicated to evaluating and treating spinal disorders such as scoliosis. Patients have access to the most up-to-date diagnostic imaging techniques and to innovative treatments that are not widely available. Our team includes world-renowned specialists in neurosurgery, orthopedic surgery, neurology, pain management, physical therapy, psychiatry, radiology and rheumatology. These experts work together to personalize a plan for each patient.

Treatment for scoliosis usually begins with physical therapy to stabilize the spine and medications to manage pain. Patients who do not respond to these treatments may require spinal surgery. Our team’s expertise in state-of-the-art surgical repair and rehabilitation results in less time under anesthesia, faster recovery and, ultimately, improved quality of life.

Signs & symptoms

Common symptoms of seasonal affective disorder (SAD) include:

• Increased appetite
• Weight gain
• Inactivity and low energy levels
• Excessive sleep
• Negative feelings and depression
• Headaches
• Anxiety
• Self-imposed isolation

Diagnosis

Seasonal affective disorder (SAD) can be difficult to diagnose because it's hard to differentiate from other forms of depression. Your doctor will ask about your symptoms and how long you have been experiencing them — in particular, whether you've experienced symptoms of SAD for at least two consecutive years and whether it was during the same season each year.

In addition, your doctor will want to know if the periods of depression were followed by seasons when you did not feel depressed. Lastly, your doctor will want to make sure that there are not other explanations for the changes in your mood or behavior.

Treatments

If you are diagnosed with seasonal affective disorder (SAD), your doctor may choose one of several approaches to your treatment.

• Light Therapy. Short periods of exposure to light can help ease depression. Doses of sunlight are measured in "lux." For example, the sun emits about 90,000 lux and blue sky reflects about 45,000 lux. Treatments could range from two hours of light at 2500 lux every morning to 30 to 40 minutes of light at 10,000 lux every morning. However, light therapy in the evening may interrupt sleep patterns. There are few, if any, side effects to the eyes from using light therapy. Sometimes, an hour walk in the morning can help without any other treatment.
• Medication. Your doctor may prescribe an antidepressant in combination with light therapy or if light therapy isn't effective. Antidepressants often are used when the condition occurs in the summer.
• Psychotherapy. Psychotherapy may help you identify ways to avoid behaviors or environments that tend to trigger episodes of SAD, or to reduce stress in your life, which may worsen the symptoms.

In addition to the treatments described above, there are a number of things you can do to help your body cope with seasonal depression. For example, try increasing the amount of light in your home or workplace by opening window shades. Increase your physical activity as exercising regularly can help relieve stress. Also, you may want to consider visiting a warm, sunny place during the winter, such as vacationing in a tropical location.