What is scoliosis?

Scoliosis is defined as a curve in the spine which measures ten degrees or more. While some types of scoliosis can be tied to injuries or conditions like cerebral palsy, the cause of most cases is not fully understood. Scoliosis is usually diagnosed during adolescence and is typically relatively mild, but will usually be monitored via x-rays over time as the curve may grow more severe with growth. This curve in the spine can cause uneven posture with a slight lean while standing normally and the line of your hips or shoulders being crooked or uneven.

Which muscle groups does scoliosis affect?

The imbalance caused by a sideways curve of the spine can have a major impact on the muscles of the back. One common issue for people with scoliosis is a muscular imbalance, where the muscles on one side of the back are weaker than those on the other. A rightward curve, for instance, can result in the muscles on the right side to work harder, which makes them grow at a disproportionate rate and also increases the risk of strains or injuries, while the left side gets less use and becomes weaker. The diaphragm can also be compressed, which may make breathing more difficult.

A curved spine can also have a negative effect on the lower body. When your posture is crooked, you may also have an uneven gait which grows worse over time, causing pain that can radiate down one or both legs to your feet.

What causes chronic pelvic pain in patients with scoliosis?

A similar imbalance to the one affecting the muscles of the back can also have a profound impact on the muscles which are most commonly associated with pelvic pain. These include the hip flexors, levator ani, and abdominal muscles. While mild scoliosis is relatively unlikely to cause serious pelvic pain symptoms, a moderate to severe curvature of the spine can cause the pelvis to slant, putting unusual torsion and pressure on the muscles, tendons, and ligaments of the pelvic girdle. This can also cause hip pain, as the pelvic tilt will force one hip to bear a heftier load than the other.

What other pelvic conditions can scoliosis pelvic pain be associated with?

Postural syndrome is generally defined as any condition in which pain or reduced function develops in the muscles or joints due to long or frequent periods of bad posture. Scoliosis is often tied to these kinds of issues, as the imbalance caused by a curved spine can make it difficult to maintain healthy posture. In some cases, a pelvic tilt which has developed as a consequence of scoliosis can make you more likely to suffer from SI (sacroiliac) joint pain.

What are the treatment options for scoliosis pelvic pain?

Pelvic Rehabilitation Medicine takes an integrative approach to treating pelvic pain which emphasizes lifestyle interventions to correct imbalances caused by scoliosis. A physiatrist may recommend stretches or exercises which help to strengthen muscles of the back and pelvis and improve posture. Physical therapy may also be incorporated. To alleviate chronic pelvic pain, we use non-opioid pain treatments which may include over-the-counter medications or our ultrasound-guided outpatient protocol which includes a trigger point and nerve block injection to treat underlying muscle and nerve dysfunction. Severe cases of scoliosis which cause serious pain and loss of function may require surgical correction, but this is generally considered to be a last resort due to the risks associated with spinal surgery.