Pain from Scoliosis

By Gregory C. Keller, MD

Pain From Scoliosis

Scoliosis is a curvature of the spine in the frontal, AP, or coronal plane. This means that when you are looking at a person directly at their face, in front of their body and could see their spine, you would see a curvature or “S” shape. This is different from the normal curvature which is seen from the side view of the spine. The magnitude of the scoliosis is measured in degrees after an x-ray taken of the spine with the patient standing. To be considered true scoliosis, the magnitude of the curve has to equal or exceed 11 degrees. Generally, we do not believe any specific treatment is warranted until the curve is at least twice that magnitude. Frequently diagnosed in teenagers or young adolescents, idiopathic scoliosis is so named because we do not know its true cause.

Treatment can include observation as the child or young adult matures, then it is unlikely for the curve to progress, but if there is evidence of worsening during teenage years, then a brace can be prescribed to prevent worsening of the curve until the patient reaches skeletal maturity (typically 16 years old for a female and up to 18 years old for males). Only if the curve exceeds 45-50 degrees would we consider surgery.

The other time scoliosis becomes important is later in life when arthritis is the cause of the deformity or curvature.  This can lead to mechanical or low back pain as well as spinal stenosis and sciatica. Treatment for this includes bracing for comfort, steroid injections, or even surgery.

Pain from Scoliosis – Diagnosis

It is often times apparent when looking at the back of a patient if they have scoliosis as there will be a hump or rounded area on one side or the other reflecting the prominent ribcage. This is especially true if the curve is in the chest or thoracic spine.  A lumbar curvature is much harder to detect without a radiograph or x-rays.

Obviously, most people with low back pain do not have a scoliosis or, if they do, it is not the source of their pain since only a fairly severe curve will cause pain. However, pain from scoliosis is one of the most common symptoms. Nevertheless, having a curve will influence treatments chosen.

Physical Therapy for Scoliosis

Physical Therapy can certainly help with mild to moderate scoliosis. The strengthening of specific muscles can certainly help.  JOI Rehab has several physical therapists who work closely with our physicians. We can help design a program specific to your curve and weakness.

If you want to learn more about low back pain, please go to: https://www.joionline.net/trending/content/low-back-pain or for Scoliosis Symptoms.

• To schedule an appointment for physical or occupational therapy, call 904-858-7045 or call any of the 12 area JOI Rehab Centers. JOI Rehab also has a fast track program for the spine.                     

Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.