Pain related to scoliosis

What is scoliosis?

It is a deformation of the spine in the shape of an 'S' or 'C' that causes a curvature and rotation of the vertebrae and ribs.

What are the causes of scoliosis?

The majority of scoliosis cases do not have a specific cause. Scoliosis can have different causes. Here are some possible causes:

• A neuromuscular disease (e.g., Duchenne muscular dystrophy)
• Any syndrome (e.g., Marfan syndrome)
• A neurological condition (e.g., cerebral palsy)

"Many people have small scoliosis in their spine, and that's completely normal. It's like having one foot bigger than the other, it's normal to be asymmetrical, and it's not problematic in itself."

What are the symptoms of scoliosis?

It is important to know that many people have small scoliosis without any pain. Having a small scoliosis does not automatically lead to pain. Some scoliosis cases will be more severe and cause more problems.

In general, when scoliosis is the cause of pain, back pain appears during childhood.

Here are some signs and symptoms that may be present:

• Visible deformation of the spine when viewed from the back
• Back pain (often in the lower back or thoracic region)
• One shoulder being noticeably higher than the other
• One hip being noticeably higher than the other

What are the serious symptoms of scoliosis to watch out for?

The presence of certain signs and symptoms should prompt you to seek immediate medical attention at the emergency room or from a doctor. These include:

• Severe weakness or paralysis of one or both legs
• Significant or even complete loss of sensation in one or both legs
• Recent loss of balance when walking
• Significant and new incoordination
• New difficulties with bladder or bowel control
• Loss of sensation in the genital area or when wiping after a bowel movement

Serious symptoms are only present in less than 1% of cases of lower back pain. Most of the time, although the pain can be very unpleasant, the condition improves.

How is scoliosis diagnosed?

Diagnosis is made based on a review of your symptoms and a clinical examination.

In some cases, radiological examinations (X-rays, MRI, EMG) are necessary to determine the severity of the scoliosis, especially in young children.

It's important to know that what we see on an X-ray or other types of imaging isn't always relevant. A small scoliosis in the back will have very little impact on our well-being.

When should you see a physiotherapist for scoliosis?

You should consult a physiotherapist if you have back pain or if your doctor has already ruled out any other cause that could explain your pain.

In a child, the earlier scoliosis is diagnosed, the better it will be to limit its impact.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

What are the physiotherapy treatments for scoliosis?

Your physiotherapist will perform an assessment to determine the cause of the pain and the severity of the scoliosis. To do this, they will assess the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

Based on the assessment results, your physiotherapist will:

• Mobilize your spine to reduce pain and improve your movement
• Give you specific exercises to re-educate the control of your back movements
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

It is important to know that in cases of severe scoliosis, especially in children, you should consult a physiotherapist who specializes in the treatment of severe scoliosis.

It is important to note that scoliosis cannot be cured as such, because that is how your spine is made. However, the symptoms associated with scoliosis can be completely eliminated with treatment, even if the scoliosis is still present.

What to do at home for scoliosis?

Temporarily stop doing the movements that cause too much pain, and then gradually start doing them again. Don't remain completely still for long periods, as you will become stiffer and experience more pain afterward.

If you don't see any improvement after 10 days, you should consult a physiotherapist.

Sources

• Janicki JA, Alman B. Scoliosis: Review of diagnosis and treatment. Paediatrics & child health. 2007 Nov 1;12(9):771-6.