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CHRONIC PAIN FROM A CURVED SPINE

Q: I'm 38 years old and have just been told I have scoliosis. I had a back injury at work more than two years ago and have been going to a spine specialist. That was his diagnosis. I have severe chronic back pain and left leg pain. I have flare-ups that put me in a wheelchair for days. I was given a camp brace and aquatherapy, but I feel no change.

What does the future hold for my family and me? I have a 13-year-old daughter with cerebral palsy, and she needs help with personal care and support standing at times. I can't help her anymore or myself at times.

-- K.N., Philadelphia
A: I'm sorry to hear about your pain and the problems it's causing you, especially in caring for your daughter. Chronic pain is hard to cope with, but being unable to help your loved ones can be even worse.

Scoliosis is an abnormal side-to-side curvature of the spine, as opposed to the normal straight-up-and-down spinal column. It is usually seen in the middle of the back and is associated with some rotation of the involved vertebrae.

Most scoliosis (75 to 80 percent) is idiopathic, which means that we don't know what causes it. Idiopathic scoliosis is very often picked up in screening exams of young adolescents at school. It is much more common in girls.

Five to 7 percent of scoliosis is congenital or inherited. This form of scoliosis involves actual malformation of vertebrae, which can be seen at birth.

Some scoliosis can be caused by neuromuscular and other diseases, including polio, cerebral palsy and osteoporosis. It is possible that trauma, such as your back injury, can also cause it, but I suspect it was there already.

The major symptom seen with scoliosis is back pain caused by compression of nerves in the spinal cord or as they come between the vertebrae. This nerve compression can also cause muscle weakness.

Many people with scoliosis don't require specific treatment other than good care of their back. But some people require standard pain medications, special braces, electrical stimulation or surgery to fuse the vertebrae together.

I suggest that you talk with your doctor about all your options and evaluate which one(s) you want to pursue. You may also want a second opinion, especially if you are considering surgery from an orthopedic surgeon or neurosurgeon.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is DRFamily@aol.com.

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.

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