Scoliosis is a condition that causes the spine to curve forming a “C” or “S” shape. The curved spine can irritate and stretch nerves, strain joints comprised of two bones, affect the posture, and make muscles fatigued. It causes pressure on the disks between the spinal vertebrae making them inefficient shock absorbers and causes strain with pressure on facet joints of the spine. The cause is unknown and there is no cure. Managing symptoms associated with the condition is the main course of treatment.
The single worst symptom is pain. The condition impacts quality of life and is a long-term disability. The curve is not usually painful but when changes cause it to become painful, it is debilitating. For some patients, over-the-counter medication helps them cope with the pain and discomfort, while others require stronger pain relievers that are taken several times a day. Pain is individualized and each person perceives it differently. Pain medications are not a long-term solution because they have no impact on the source of the pain.
There are several factors that affect how well the nerves work to decrease pain. These factors are:
- Personal beliefs or perception
The most common pain is due to muscle strain as the individual tries to compensate for the curve while completing activities of daily living. (getting dressed, taking a bath, cleaning…)
The basic treatments for muscle strain include over-the-counter pain relievers, hot packs, cold compresses for inflammation, and rest. Often a brace is worn but can be uncomfortable and burdensome. Surgical intervention depends on the progression of the condition.
Finding appropriate treatment(s) begin with:
- Talking to your healthcare provider
- Participating in alternative therapies
- Wearing a brace for support, if able to tolerate
- Possible surgical intervention
Physical Therapy can help with pain management by incorporating exercises to improve back strength and flexibility. Stretching often is recommended. If an activity causes increased pain, stop doing it and rest. Other recommended therapies and programs include Pilates and Yoga to promote balance, develop deep and superficial muscles, and relax the mind.
Other treatments and therapies that can help alleviate pain and improve coping skills include:
- Massage Therapy
- Steroid or Anesthetic Injections
- Surgical spinal fusion
Counseling can include Cognitive Behavioral Therapy (CBT). Cognitive Behavioral Therapy allows a counselor and patient to identify ways to manage and cope with pain and limitations. It can help the individual to overcome beliefs or behaviors that aggravate or cause more spinal damage and leads to the identifying techniques, like meditation, that help with mental ability to deal with pain (coping skills).
Surgical intervention is generally recommended when the curve is greater than 40-degrees. It is done to ensure the curving stops. Without surgery, the spinal curve would continue to increase by 1-2 degrees annually. But surgery has risks, so alternative therapies are recommended first.