Back pain and scoliosis

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What causes back pain? Well, having a back and two legs to begin with! That’s right! As humans, we have one particular body part that is always going to be more exposed than the others to the risk of discomfort and overloading. And that body part is the spine.

You have probably sometimes wondered why certain people who do heavy jobs and spend their entire lives “mistreating their spine” don’t even know what it means to have back pain.

It is well established that “good” or “bad” loading of the spine is a result of its conformation in the sagittal (lateral) plane, in other words, on the distribution of its curves.
Unfortunately, the lateral profile of the spine, meaning the particular way in which the spine’s natural curves, called lordosis and kyphosis, are distributed, does not depend on the will of the individual, but on a genetic predisposition to one pattern or another.

Basically, whether or not we are predisposed to back problems is a matter of luck.

So, what should we do? Simply resign ourselves to the fact that, morphologically speaking, we are among the less fortunate? Simply accept that we are prone to back pain and put up with it, since there’s nothing that can be done?

No, absolutely not! Because back pain, affecting our work, mood and social activities, can really condition our lives!

Things to know

– You have to take care of your back because, for better or worse, it’s yours and it’s the only one you’re ever going to have.

– Taking care of your back means keeping it fit and knowing how to use it properly. So, make sure you do regular physical activity to keep your spinal muscles in shape, but also your leg and arm muscles. What kind of activity? There’s no “best” kind of physical activity; the important thing is to choose something you enjoy and do it at least twice a week, or better still three times. 

– Knowing how to use your back means making sure that you do not spend too long sitting down. You need to alternate sitting with spells of movement. Also learn to sit correctly, and if your work means you have to spend hours sitting at a desk, look at how to set everything (computer, seat, etc.) at the right height. Also, you need to think about how to correctly manage your body under stress, in other words when it is subjected to loads and also during physical effort.

– It is important to learn about the shape of your own spine and how forces are distributed over the body, and then to assess your particular limits and strengths. It can be helpful to do all this with the support of a specialist who can help to familiarise you with your own specific ergonomic and training needs.

What if I have scoliosis?

Even though there is still a lot to be discovered and learned in this field, we know that scoliosis, as it progresses, creates an abnormal alignment of the vertebrae, which is seen both in the frontal plane (as scoliotic curves) and in the sagittal plane (as changes in physiological lordosis and kyphosis).

Indeed, treatment of scoliosis aims to curb this progression and remodel the spine so that, by the time the individual finishes growing, it is as well aligned as possible.

According to scientific studies, if we can achieve good spinal balance in the sagittal plane (in particular, this means maintaining good lumbar lordosis), and if we can keep the scoliotic curves under 25-30°, the scoliosis outcome will not affect the proper functioning of the spine.

In such cases, the risk of back pain will be the same as that seen in people without scoliosis.

In the presence of more severe curves, it is necessary to be even more aware of the need to safeguard the spine. In the knowledge that it is a delicate and vulnerable part of the body, you must take good care of it and do physical activity to keep your back fit.

Can scoliosis be treated with exercises?

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The answer is yes, and they are indeed fundamental, but sometimes exercises alone are not enough. Whether or not an exercise-based treatment is sufficient depends, above all, on the severity of the curves and the evolutionary potential of the scoliosis itself, which is partly determined by growth.
Therefore, exercises sometimes need to be combined with another treatment, such as bracing. Rigid  brace wearers always need to do specific exercises in order to minimse the side effects of the brace and maximise its corrective impact.
Patients prescribed the Spinecor wrapping system, a dynamic brace, do not need to do any specific exercises since this device allows movement and therefore guarantees the natural trunk muscle strengthening  that favours correction of the spine. 

Scoliosis treatment can be likened to climbing a mountain; a true climber is well aware that the path ahead of him will present obstacles, but he  is confident he will be able to overcome them in order to reach the top.
That is his goal and he is determined to achieve it, whatever it takes and however long it takes him, because he already anticipates the enormous satisfaction he will feel on finally reaching the summit .

The various treatment options can be seen as different steps on a ladder, where the lowest is the one that has the least impact on the individual, but is also the least effective; instead, the highest step represents the very most that can be done in terms of treatment, and the treatment that will have the greatest impact on the youngster’s daily life. 

The ideal therapy is one that allows the best possible results with the least possible impact.

The first step on the treatment ladder is simple observation; at this level the patient needs to attend frequent medical check-ups in order to keep the scoliosis monitored, and the physician needs to be ready to intervene if the need arises.
The next step involves exercises alone, which are sufficient to control scoliosis of mild and mild-medium severity.
At the next level, patients are offered braces consisting of soft bands, and then, if the condition warrants it, braces made of more or less rigid materials.

Sometimes parents immediately want a therapy that, in their view, gives greater guarantees of success, regardless of the impact on their child.
This attitude is generated by the mistaken belief that opting for  the most aggressive therapy will allow the worst outcome to be avoided, and also by the idea that bracing is more convenient .
To return to the metaphor of the mountain, this amounts to starting the ascent running, in the hope of getting to the top more quickly, but it is an approach that may see the climber paying a very high price in terms of his health and even ending up having to end his career early.

Since scoliosis is an evolving disorder, the treatment, too, needs to be constantly evolving: the best strategy is to be ready  to introduce timely changes in response to emerging needs.

It is important to see the treatment from a global perspective: a patient who starts off simply doing exercises, and does them well for a certain number of months, before then being obliged to wear a brace  will at least have avoided some months of brace wearing, which is certainly a good thing.
Changing treatment does not mean that the previous one was unsuccessful, it simply means that it has become apparent that a  stronger method is needed order to win the struggle (like an arm wrestling contest!) with the scoliosis.