Scoliosis Pain

Diagnosis

Pain management has undergone huge research in the past decade—especially for those with scoliosis. We have participated in research studies and worked to understand its genesis and how it can change one’s life. Some pain is instantaneous, and in other situations, it slowly appears, and before you know it, you have so much pain you can hardly get through the day. It is interesting to note that some people experience little or no pain with adult scoliosis, yet others have so much pain that it is hard for them to sleep and attend to daily activities. We know the pain and we can help.

A licensed massage therapist can provide a targeted or full-body massage that should help relax your muscles. Regular massages can be a useful component of a scoliosis treatment program. Depending on the type of pain, there are treatments called complementary therapies that might help, in addition to pain medication. These include things like hydrotherapy and massage and are usually done alongside medical treatments. An exercise that strengthens the core muscles, such as yoga, Pilates, stretching, and swimming, can also help with back pain.

For those dealing with idiopathic or degenerative scoliosis, nonsurgical treatments can be very effective. These include periodic observation and:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as aspirin, ibuprofen, and naproxen can reduce swelling and relieve pain.
• Exercises: Strengthening the core abdomen and back muscles through specific exercises can offer significant relief.
• Epidurals or nerve block injections: These can provide temporary relief from leg pain and other symptoms.
• Temporary braces: While not a permanent solution, they can offer short-term pain relief.

Incorporating these treatments into a comprehensive care plan can help manage symptoms and improve overall quality of life. By combining massage therapy with other strategies, individuals with scoliosis may find greater relief and enhanced well-being.

Scoliosis in Adults

Although scoliosis is not common in adolescents, adults also suffer from it. While there are instances where adults develop scoliosis, most of the cases are not diagnosed and age with the condition remaining untreated into adulthood. Most scoliosis in adults has traumatic, degenerative, or pathological causes. Irrespective of the cause, once there is scoliosis, adults can deal with pain from scoliosis better than adolescents.

Since adults have stopped growing, the curve in the spine compresses the spine and the surrounding tissues and nerves. This causes lots of pain and discomfort. Adult patients usually experience pain in other areas apart from the back, like the knees, feet, neck, legs, and hips. The condition can also cause headaches. These are a result of spinal misalignment in the lower body.

In adults, scoliosis symptoms can lead to a gradual loss of function. They include:

• Low back pain and stiffness
• Numbness, cramping, and shooting pain in the legs from pinched nerves
• Fatigue from the strain on the lower back and leg muscles
• One shoulder or hip may be higher than the other
• One arm may hang lower than the other
• A rib hump can occur in the lower back

Scoliosis in Children

Scoliosis in children most often affects girls during growth spurts in their early teens. This is typically known as idiopathic scoliosis, which can affect either the upper (thoracic) or lower (lumbar) spine. During these growth spurts, the spine can develop a curve that might go unnoticed until it becomes more pronounced.

Degenerative Scoliosis

Degenerative scoliosis usually begins after age 40, when age and a deteriorating spine combine and scoliosis develops. Other factors include facet joint arthritis and the collapse of disc spaces. This type of scoliosis is often related to osteoporosis, especially in women, as the changes combine and the spine slowly sags into a curve.

By understanding the differences in how scoliosis affects children and adults, it becomes clear that early detection and treatment are crucial for managing this condition effectively at any age.

Common Symptoms of Scoliosis in Adults

Adults with scoliosis may experience a range of symptoms, including:

• Low back pain and stiffness: Persistent discomfort in the lower back.
• Numbness, cramping, and shooting pain in the legs: These symptoms result from pinched nerves.
• Fatigue: The strain on the lower back and leg muscles can lead to overall tiredness.
• Physical asymmetries:
• One shoulder or hip may be higher than the other.
• One arm may hang lower than the other.
• A rib hump may develop in the lower back.

These symptoms highlight how scoliosis can affect various parts of the body, often extending beyond the spine itself. Understanding these symptoms can help in recognizing and managing the condition more effectively.

Types of Pain Caused by Scoliosis

Pain is one of the major symptoms of scoliosis and it can come from different areas of the body. It is important to know how the symptoms of scoliosis occur in the body to understand the appropriate treatment to provide. Here are the types of pain that scoliosis causes:

Head and neck pain

People with scoliosis usually experience chronic headaches, which are usually a result of tension in the neck muscles. Muscle tension and spinal misalignment occur in the neck as a result of a forward head posture. This tension can cause pain in the base of the skull, thereby leading to all forms of headaches like migraines, tension-type headaches, and cluster headaches.
While scoliosis most commonly develops along the thoracic spine (middle-upper back), it can also develop along the cervical and lumbar spine. Particularly common with abnormal curvatures of the cervical spine, muscle tension can become a significant factor as the neck muscles try to overcompensate to support the stressed spine and the weight of the head.
As mentioned earlier, the spine’s healthy curves help evenly distribute shock and weight. If there is a loss of the neck’s healthy curvature and it slants forward as a result, it’s no longer able to properly support the weight of the head. This shift in posture increases the workload for the muscles closely attached to the cervical spine.
Over time, this can lead to muscle imbalance, which can make the neck muscles feel overly tight and sore, causing tension headaches to develop. Especially if left untreated, as the condition progresses, scoliosis-related tension headaches can escalate to debilitating levels.

Understanding Migraines vs. Regular Headaches

Although anyone who has had a true migraine knows how different they are from an average headache, many people don’t fully understand the difference.

• Typical Headaches: Defined as pains in the head that can cause feelings of pressure and discomfort. They can occur on one or both sides of the head and affect the temples, forehead, and the back of the neck. These headaches can last as little as 30 minutes, persist for days, or come and go. Common triggers include tension, stress, muscle strain, and anxiety.
• Migraines: Characterized as severe headaches that are intense, generally last for long periods, and are accompanied by migraine-specific symptoms like nausea, vomiting, temporary vision loss, numbness and tingling in the face and/or arms, and sensitivity to light and movement. Migraines most commonly affect one side of the head but can also be felt on both sides. They can be so debilitating that a person has difficulty moving and fulfilling daily responsibilities. Some migraine-sufferers also experience signs like an aura (swirling bright-colored lights) days or moments before the migraine strikes. Others report having a hole in their visual field, numbness in the hands and/or face, disrupted speech, and feelings of being overly emotional or confused.

The Connection to Scoliosis

Whether due to muscle tension or low CSF pressure in the brain, scoliosis has the potential to cause both regular headaches and migraines to occur, and either can escalate to debilitating levels. Understanding the difference between common headaches and migraines, and recognizing the role scoliosis can play, is crucial for managing symptoms and seeking appropriate treatment.

Shoulder pain

The muscles and ligaments in the shoulders can also become affected by scoliosis. Shoulder pain is usually felt in the side of the body where the spine curves away. The pain is felt because the body tries to pull the spine back into place.

Thoracic (upper back) pain

Most adults with scoliosis end up having a hunched posture (i.e. Kyphosis); this is the major cause of the pain. Osteoporosis can also become associated with scoliosis. If it is severe, it can cause fractures and dislocations in the spine.

Many scoliosis patients develop kyphosis, a hunched-over posture that causes most of their pain. The role of osteoporosis in scoliosis cannot be overlooked, as it weakens bones, potentially leading to spinal fractures, dislocations, and deformities.

Lumbar (lower back) pain

Lumbar pain is one of the main complaints that adolescents and adults with scoliosis complain of (even those with milder scoliosis have this pain). Older adults usually experience more significant degenerative disc disease; a condition that damages the ligaments holding the spine in place. This leads to more severe pain in the lower back.

Adolescent and adult scoliosis patients often cite lower back pain as a significant issue, regardless of the scoliosis’s severity. This pain is exacerbated in older patients by degenerative disc disease, which compromises the spinal ligaments and intensifies discomfort.

Dr. Hostin explains that patients may sometimes experience both upper and lower back pain, while others may only have symptoms in one area. He notes, “Upper and lower back pain can be separate or related in patients with scoliosis. Most scoliosis patients are different. The differences depend on the exact type of scoliosis that is present and should be evaluated with full-length scoliosis or spinal radiographs.”

Hip pain

In some cases, patients with scoliosis notice that one of their hips appears higher than the other. This is usually more prominent than the actual spinal curvature. This can cause hip pain and discomfort after standing or walking for a long period of time.

Sciatic nerve pain

Sciatic nerve pain is caused by a combination of the misalignment of the spine and arthritis. This can lead to leg pain. These conditions can lead to a narrowing of the joints of the spine that nerves pass through.

Post-surgical pain

Patients who undergo surgery have a high chance of experiencing post-surgical pain. During recovery, the patient may experience short-term discomfort. If there are complications, the patient may experience severe and long-term discomfort.

In rare situations, surgeons may perform an osteotomy to either reduce or increase the length of the patient’s leg. Recovery from osteotomy can take several months.
For scoliosis, an osteotomy serves a different purpose. It realigns spinal segments to correct the curvature of the spine. This precise adjustment helps to improve posture and alleviate associated pain.
By strategically cutting and repositioning bones, the procedure offers a tailored solution to various orthopedic issues. Whether for leg length discrepancy or spinal realignment, osteotomy can be a critical intervention in restoring function and quality of life.

Scoliosis Pain Management Treatment

Depending on the type of pain, there are treatments called complementary therapies that might help, in addition to pain medication. These include things like hydrotherapy and massage and are usually done alongside medical treatments. An exercise that strengthens the core muscles (the back and stomach muscles that support the spine) such as yoga, Pilates, stretching, and swimming can also help with back pain.

Because everyone is different, some therapies may be more effective than others. Understanding your unique situation is key. Collaborate with your physician to tailor a treatment plan that suits your specific needs and health circumstances. For those dealing with idiopathic or degenerative scoliosis, nonsurgical treatments can be very effective. These include periodic observation and:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as aspirin, ibuprofen, and naproxen can reduce swelling and relieve pain.
• Exercises: Strengthening the core abdomen and back muscles through specific exercises can offer significant relief.
• Epidurals or nerve block injections: These can provide temporary relief from leg pain and other symptoms.
• Temporary braces: While not a permanent solution, they can offer short-term pain relief.

Incorporating these treatments into a comprehensive care plan can help manage symptoms and improve overall quality of life. With resourcefulness and your physician’s support, you can take charge in managing your scoliosis back pain. Remember, the most effective therapy is often one that is customized to your individual needs.

Medical Treatments for Scoliosis Pain

The treatment administered for scoliosis pain depends on the type of scoliosis the patient has. The treatment options include the following:

Epidural Steroid Injections Spinal Injections

Epidural or nerve block injections can provide temporary relief of leg pain and other symptoms associated with scoliosis. These treatments are particularly useful for alleviating nerve pain that radiates down the legs, a common issue for those suffering from scoliosis.

ESI injections are powerful steroids that are injected into the joint space to help ease pain and inflammation. Injections are used to settle the nerve pain down. Most do not have any proven long-term effect but injections can reduce acute pain or be used as part of a formal pain management program.

As a first and conservative treatment option, we’ve found that a lot of our patients find significant pain relief with a single injection, while others take a few injections to find some relief. Injections are helpful for most patients, and others do not find relief with an injection series.

By targeting the affected nerves, these injections can provide a much-needed respite from the discomfort and pain that scoliosis often brings. While not a permanent solution, they offer a valuable option for managing symptoms and improving quality of life.

Medication

Finally, today, many different types of medication can help to relieve pain. Even with a wide range of pain medications, it is not easy to control chronic pain and we will use a combination of treatments along with medication to ease and eliminate pain.

How Can the Choice of Mattress Impact Scoliosis Back Pain?

When managing scoliosis back pain, selecting the right mattress can significantly affect comfort and spinal health. Here’s how your mattress choice can make a difference:

Support and Alignment

• Medium-Firm to Firm Options: Opting for a medium-firm to firm mattress can provide the necessary support to maintain proper spinal alignment. This support helps in reducing morning stiffness and discomfort.
• Spinal Support: A mattress that offers adequate support helps to keep the spine aligned, preventing further curvature or strain on the muscles and tissues around the spine.

Pressure Relief

• Even Weight Distribution: A well-chosen mattress ensures even weight distribution, reducing pressure points that can lead to aches and pains during the night.
• Adaptive Materials: Consider materials like memory foam or latex, which contour to the body, offering personalized support and pressure relief.

Comfort and Sleep Quality

• Balance of Comfort and Support: While support is crucial, the mattress should also be comfortable to enhance overall sleep quality. A supportive yet comfortable mattress can lead to more restful sleep, crucial for pain management.
• Breathability: Choose materials that allow airflow, keeping you cool and comfortable throughout the night.

Selecting the appropriate mattress is a key element in managing scoliosis-related pain, as it directly affects your spinal support and overall sleep quality. Taking the time to find the right fit for your sleeping habits and personal comfort can make a significant difference in managing symptoms and improving your quality of life.

How Cold Weather Influences Scoliosis Pain and Ways to Alleviate It

Cold weather has a knack for making muscles and joints feel more rigid, which can intensify the discomfort associated with scoliosis. The body’s natural response to cold causes muscles to contract, creating stiffness and, in some cases, heightening pain levels.

Strategies to Mitigate Cold Weather Impact

• Stay Cozy Indoors: Keeping your body warm can help counteract the effects of cold weather. Consider layering your clothing and utilizing blankets to maintain a comfortable body temperature at home.
• Dress Appropriately Outside: When venturing outdoors, ensure you’re bundled up with warm clothing, including thermals, scarves, and gloves, to keep your core temperature stable.
• Heat Therapy: Applying heat can be soothing for scoliosis-related pain. Opting for a hot bath can relax the muscles, while a heating pad or an electric blanket provides targeted warmth to the spinal area.
• Regular Movement: Engaging in light stretching or low-impact exercises indoors can improve circulation, promoting muscle flexibility and reducing stiffness.

By incorporating these strategies into your routine, you can better manage scoliosis discomfort during the chilly months and enjoy greater comfort.

Precautions During Recovery from Scoliosis Surgery

Recovery time can vary, but it is crucial to follow your surgeon’s recommendations closely. Your specific condition and the type of surgery performed will dictate the timeline for your recovery.

Limit Physical Strain

Avoid lifting heavy objects and minimize activities that require bending. For the initial 6–12 weeks, it’s important to keep physical strain to a minimum to prevent complications.

Manage Activity Levels

• Rest Appropriately: Ensure adequate rest to promote healing.
• Gradual Increase: Gradually increase activity levels under medical guidance to build strength and flexibility.

Attend Follow-Up Appointments

Regular check-ups with your surgeon are essential to monitor progress and address any concerns promptly.

Use Support Devices

Braces and supportive equipment recommended by your healthcare provider should be used as directed to aid in proper alignment and support during recovery.

Posture and Ergonomics

Maintain good posture and use ergonomically designed furniture to support your spine while sitting and sleeping.  By following these precautions, you can help ensure a smoother and more effective recovery from scoliosis surgery and relief from pain.

Conclusion

Patients should choose to seek treatment for scoliosis pain at specialized centers that offer expertise in the diagnosis and treatment of this condition. Such centers like the Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas offer a multidisciplinary approach to treatment, which involve a team of specialists, including orthopedic surgeons, physical therapists, and pain management specialists. Additionally, the Southwest Scoliosis and Spine Institute offers access to advanced diagnostic tools and treatment options, such as minimally invasive surgery and spinal fusion. Patients may also benefit from a personalized treatment plan that takes into account their unique needs and medical history. Ultimately, the decision to seek treatment at a particular medical institution will depend on various factors, but for those wanting to get the very best, we should be considered your first choice.

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HealthLine – Scoliosis Pain

WebMD – Scoliosis Pain