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Back Pain and Scoliosis

common-complaints

Back pain

Back pain plagues many people in the United States. It is one of the top main reasons to visit the doctor. Young children and adolescent females are often diagnosed with scoliosis and treatment can begin at an early age (Scoliosis). Into adulthood, degenerative disc disease as well as other arthritic conditions often present and can lead to a painful condition known as sciatica, otherwise referred to as any radiating nerve pain below the waist.

There are many conservative treatments that work to treat back pain and the associated nerve pain, otherwise referred to as radiculopathy. Core strengthening, diet, low impact exercise, evaluation of sacroiliac joint dysfunction, and leg length differences are among the few. Athletics are often associated with high demand performance. Strength training is key.

As a former track athlete who ran in college and retired national figure skater, Dr. Saukin appreciates the need for a well-rounded approach to back pain as well as other associated athletic injuries. She will review training regimens and will evaluate sports injuries for all age children and teenagers. It is also important to remember that athletes have unique nutritional, emotional, and physical needs.

Symptoms of back pain may include

  • Muscle ache
  • Shooting or stabbing pain
  • Pain that radiates down your leg
  • Limited flexibility or range of motion of the back
  • Inability to stand up straight

When to see a doctor

Most back pain gradually improves with home treatment and self-care.  One should notice some improvement within the first 72 hours of self-care. If not, see your doctor.

In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:

  • Causes new bowel or bladder problems
  • Is associated with pain or throbbing (pulsation) in the abdomen, or fever
  • Follows a fall, blow to your back or other injury

Contact a doctor if your back pain:

  • Is constant or intense, especially at night or when you lie down
  • Spreads down one or both legs, especially if the pain extends below the knee
  • Causes weakness, numbness or tingling in one or both legs
  • Is accompanied by unexplained weight loss
  • Occurs with swelling or redness on your back

Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse as these symptoms may indicate more serious conditions.

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Scoliosis

Scoliosis is a lateral (toward the side) curvature in the normally straight vertical line of the spine. When viewed from the side, the spine should show a mild roundness in the upper back and shows a degree of swayback (inward curvature) in the lower back. When a person with a normal spine is viewed from the front or back, the spine appears to be straight. When a person with scoliosis is viewed from the front or back, the spine appears to be curved.

What Causes Scoliosis?

There are many types and causes of scoliosis, including:

  • Congenital scoliosis (Caused by a bone abnormality present at birth).
  • Neuromuscular scoliosis (A result of abnormal muscles or nerves. This is frequently seen in people with or spina bifida, cerebral palsy, or in those with various conditions that are accompanied by, or result in, paralysis).
  • Degenerative scoliosis (This may result from traumatic injury or illness, bone collapse, previous major back surgery, or osteoporosis).
  • Idiopathic scoliosis (This is the most common type of scoliosis but has no specific identifiable cause). There are many theories, but none have been found to be conclusive. There is, however, strong evidence that idiopathic scoliosis is inherited.

Who Gets Scoliosis?

Approximately 3% of Americans at age 16 have scoliosis. Less than 0.1% have spinal curves measuring greater than 40 degrees, which is the point at which surgery becomes a consideration. Girls are more likely to be affected than boys. Idiopathic scoliosis is most commonly a condition of teens affecting those ages 10 through 16. Idiopathic scoliosis may progress during the “growth spurt” years, but usually will not progress during adulthood.

How Is Scoliosis Diagnosed?

Most scoliosis curves are initially detected on school screening exams, by a child’s family doctor or by a parent. Some clues that a child may have scoliosis include uneven shoulders, a prominent shoulder blade, uneven waist, or leaning to one side. The diagnosis of scoliosis and the determination of the type of scoliosis are then made by a careful bone exam and an X-ray to evaluate the degree of the curvature.

What is the treatment for scoliosis?

The majority of teens with significant scoliosis with no known cause are observed at regular intervals (usually every four months to six months), including a physical examination and X-ray.

Treatments include:

  • Bracing is the usual treatment choice for adolescents who have a spinal curve between 25 degrees to 40 degrees, particularly if their bones are still maturing and if they have at least 2 years of growth remaining.

The purpose of bracing is to halt progression of the curve. Generally the curve will assume its original magnitude when bracing is eliminated.

  • Those who have curves beyond 40 degrees to 50 degrees are often considered for scoliosis surgery. The goal is to make sure the curve does not get worse. Surgery does not perfectly straighten the spine. During the procedure, metallic implants are utilized to correct some of the curvature and hold it in the correct position until a bone graft, placed at the time of surgery, consolidates and creates a rigid fusion in the area of the curve. Scoliosis surgery usually involves joining the vertebrae, called spinal fusion.

In young children, another technique that does not involve fusion may be used because fusion stops growth of the fused part of the spine. In this case, a brace must always be worn after surgery. Teenagers with scoliosis should stay active and fit.