Pain from Scoliosis
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.
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.
Obvious 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. Nevertheless, having a curve will influence treatments chosen.
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