It might seem obvious that a curved spine would be painful, right? However doctors and other health professionals are taught that scoliosis (a spine that has a Cobb angle of more than 10 degrees on x-ray and is also rotating) is
usually not painful. Until recently there has not been much research into the link between scoliosis and pain.
Researchers from Canada have now discovered that in fact it is common for teenagers with scoliosis to suffer from mild, chronic pain and that the pain gets worse with curve size. This research exposes a common myth that scoliosis is not associated with pain. Their results are supported by further research from the United Kingdom which found that even children with small curves “had more days off school and were more likely to avoid activities that caused their pain”. Despite this research it’s still common for children with scoliosis complaining of pain to be told “it is just growing pains” and “not to worry about it”. This is a problem because if their pain is not taken seriously and is left untreated then the child continues to suffer. On the bright side, the Canadian research found that those children that were treated for their scoliosis had less pain.
In adults, it’s also a common misunderstanding that scoliosis is not a cause of their back pain. In fact there is a huge amount of evidence that there is a strong link between back pain and scoliosis,, and recent evidence even shows a link to neck pain. Unfortunately, adults are often told they have other conditions such as stenosis or a ‘bad disc’, meaning these patients often seek out treatments that are not designed to treat the underlying cause of the problems, allowing the scoliosis to progress for years until it is severe and treatment window opportunities have been lost. Adult scoliosis is also recognised as “a medical condition of significant impact, affecting the fastest growing section of our society to a previously unrecognized degree.”5
For adults with scoliosis, there is also good news. A 15-year study of a group of adult scoliosis patients found that left untreated their scoliosis progressed at approximately 2 degrees per year over 10 years. However, when they were treated with an adult scoliosis brace it essentially stopped them getting worse. There is also evidence that using a specific adult scoliosis brace can help with the pain caused by scoliosis.,
In summary scoliosis is a common cause of spinal pain in both adults and children. Scoliosis specific treatments including special exercise programs and bracing have been shown to help stop or slow the progression of scoliosis7 and in many cases, alleviate the pain caused by scoliosis8,9. The key to the best outcome is seeking the right treatment at the right time.
References
1 Théroux J, Le May S, Fortin C, Labelle H. Prevalence and management of back pain in adolescent idiopathic scoliosis patients: A retrospective study. Pain Research & Management : The Journal of the Canadian Pain Society. 2015;20(3):153-157.
2 Théroux J1, Le May S, Hebert JJ, Labelle H.Back Pain Prevalence is Associated with Curve-type and Severity in Adolescents with Idiopathic Scoliosis: A Cross-sectional Study.Spine (Phila Pa 1976). 2016 Nov 18. [Epub ahead of print]
3 John K. Birknes, M.D. James S. Harrop, M.D. Andrew P. White, M.D. Todd J. Albert, M.D. Christopher I. Shaffrey, M.D. ADULT DEGENERATIVE SCOLIOSIS: A REVIEW Neurosurgery (2008) 63 (suppl_3): A94-A103.
4 Glassman, Steven D. MD*; Berven, Sigurd MD†; Bridwell, Keith MD‡; Horton, William MD§; Dimar, John R. MD*, Correlation of Radiographic Parameters and Clinical Symptoms in Adult Scoliosis.Spine: 15 March 2005 – Volume 30 – Issue 6 – pp 682-688
5 Schwab, Frank MD*; Dubey, Ashok MD†; Pagala, Murali PhD‡; Gamez, Lorenzo MD†; Farcy, Jean P. MD* Adult Scoliosis: A Health Assessment Analysis by SF-36. Spine: 15 March 2003 – Volume 28 – Issue 6 – pp 602-606
- Scoliosis Spinal Disord. 2017 Jun 8;12:20. doi: 10.1186/s13013-017-0125-z. eCollection 2017.
Neck and back problems in adults with idiopathic scoliosis diagnosed in youth: an observational study of prevalence, change over a mean four year time period and comparison with a control group. Topalis C1,2, Grauers A1,3, Diarbakerli E1,4, Danielsson A5, Gerdhem P1,4.
- MD, PhD Clémence Palazzo, Jean-Paul Montigny, MD, Frédéric Barbot, MD, Bernard Bussel, MD, PhD, Isabelle Vaugier, MD, Didier Fort, MD, Isabelle Courtois, MD, Catherine Marty-Poumarat, MD, Effects of Bracing in Adult With Scoliosis: A Retrospective Study. DOI: 10.1016/j.apmr.2016.05.019
8 Weiss HR, Dallmayer R. Brace treatment of spinal claudication in an adult with lumbar scoliosisea case report. Stud Health Technol Inform 2006;123:586-9.
9 Weiss HR, Dallmayer R, Stephan C. First results of pain treatment in scoliosis patients using a sagittal realignment brace. Stud Health Technol Inform 2006;123:582-5.
