Does Scoliosis Cause Shoulder Pain? Scoliosis Shoulder Pain

Uneven hips and shoulders are among the earliest telltale signs of scoliosis in its most-prevalent form: adolescent idiopathic scoliosis. Scoliosis, for adults, is a compressive condition, meaning compression of the spine and its surrounding muscles and nerves can cause varying levels of pain, shoulder pain included.

Scoliosis introduces a lot of uneven forces to the body, which is why the main symptom of adolescent idiopathic scoliosis (AIS) is postural deviation. Uneven shoulders are an early indicator of AIS, and scoliosis shoulder pain develops due to uneven wear and strained muscles.

Scoliosis can cause a variety of symptoms, so let's start our exploration of scoliosis shoulder pain by first defining the condition itself, including how the condition is classified.

Being Diagnosed with Scoliosis

Being diagnosed with scoliosis means an unnatural sideways spinal curve has developed, with rotation, making it a 3-dimensional condition, and a minimum Cobb angle measurement of 10 degrees.

Part of the diagnostic process involves comprehensive assessment of the condition to further classify conditions based on key patient/condition variables: patient age, condition severity, type, and curvature location.

Each case of scoliosis is unique, which is why the complex nature of the condition necessitates the customization of effective treatment plans, and the condition's classification points shape a person's experience of life with the condition, like whether or not it's likely to be painful, and patient age is a key factor.

Patient Age

Patient age is a key variable when it comes to whether or not the condition is likely to be painful, in addition to condition severity and the angle of trunk rotation (ATR).

Scoliosis becomes a compressive condition once skeletal maturity has been reached, at which time it tends to become painful due to the compressive force of the unnatural spinal curve, and its effects on the spine and its surrounding muscles and nerves.

In younger patients who are still growing, their spines are experiencing a constant lengthening motion, and this counteracts the compressive force of the unnatural spinal curvature, and it's compression of the spine, and its surroundings, that is the cause of the majority of condition-related pain.

So for my adult patients, I know that pain management is likely going to have to be a focus of treatment, but in younger patients, pain isn't a common complaint.

Patient age also indicates a condition's likely progressive rate. In young patients who are still growing, they are at risk for rapid-phase progression because growth and development is the main trigger for increasing condition severity.

So in the treatment of adolescent idiopathic scoliosis, I know that monitoring for progression is going to be a focus of treatment, while progressive rates tend to slow in adulthood, once the progressive trigger of growth is removed.

So when it comes to shoulder pain, or any other type of pain related to compression, it's more likely to be an issue for adults, and in severe cases.

Condition Severity

Condition severity is determined by a measurement known as Cobb angle, and the more severe a condition, the more likely it is to be painful, including shoulder pain.

A patient's Cobb angle is taken during X-ray and involves drawing intersecting lines from the tops and bottoms of the curve's most-tilted vertebrae.

The higher the Cobb angle, the more misaligned the spine is:

• Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
• Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
• Severe scoliosis: Cobb angle measurement of 40+ degrees
• Very-severe scoliosis: Cobb angle measurement of 80+ degrees

The more severe a condition, the more likely its symptoms, including postural deviation, are going to be noticeable.

And, remember, as a progressive condition, where a scoliosis is at the time of diagnosis is not indicative of where it will stay; even a diagnosis of mild scoliosis can progress to moderate, severe, or very severe, particularly if left untreated, or not treated proactively.

Only proactive treatment can counteract the condition's progressive nature and prevent increasing condition severity, escalating symptoms, and being at higher risk of needing invasive treatment in the future.

In addition to the wide range of severity levels, there are also multiple condition types a person can develop, each with its own causation.

Condition Type

The most prevalent form of scoliosis is adolescent idiopathic scoliosis, diagnosed between the ages of 10 and 18.

The idiopathic classification means not clearly associated with a single causative source, and idiopathic scoliosis accounts for approximately 80 percent of known diagnosed cases, while the remaining 20 percent are associated with known causes: neuromuscular, congenital, degenerative, and traumatic scoliosis.

Idiopathic scoliosis is considered typical, with the other 20 percent considered atypical as there are underlying pathologies that have caused the scoliosis to develop.

In neuromuscular scoliosis (NMS), for example, the scoliosis develops as a secondary complication of a more serious neuromuscular condition such as cerebral palsy, muscular dystrophy, and other conditions that affect the spinal column.

In AIS, uneven shoulders and hips are among the condition's earliest indicators, so adolescents experiencing uneven shoulders, where one sits higher than the other, and/or uneven shoulder blades with one shoulder blade protruding more on one side than the other are likely to experience some level of shoulder pain.

Curvature Location

There are three main sections of the spine: cervical (neck), thoracic (middle/upper back), and lumbar (lower back).

While scoliosis can develop in any of the spine's main sections, or in more than one, it most commonly involves the thoracic spine.

Curvature location tells me where to concentrate my treatment efforts, and also indicates likely symptoms; the area of the body that's most likely to feel the direct effects of scoliosis is the area located closest to the unnaturally-curved section of the spine.

For example, lumbar scoliosis is most likely to cause lower back pain, uneven waist issues, hip issues, pain in the legs, and cause mobility issues in the lower body, while thoracic and cervical scoliosis are most likely to cause shoulder pain, radicular pain in the arms, chest pain, upper back pain and mobility issues, development of a rib cage arch, neck pain, and scoliosis shoulder pain.

Scoliosis Shoulder Pain

When a body and spine is in alignment (balanced and straight), the shoulders will sit level with one another and face frontwards; however, when a structural condition like scoliosis causes uneven shoulders, one shoulder can sit higher than the other, and/or one shoulder blade is more pronounced than the other.

If uneven shoulders develop, it can lead to neck pain, shoulder pain, shoulder blade pain, and lower back pain, and this is especially true when other asymmetries have developed in the body, as a result of the condition's uneven forces.

Patients experiencing scoliosis shoulder pain describe it as feelings of tightness, soreness, and pulling in the shoulder that sits higher, or in the shoulder blade that protrudes more.

Patients with significant shoulder pain commonly have scoliosis in the upper back, near the top of the spine, as this means the muscles in that same section are strained trying to support the unnaturally-curved spine.

The extra work for the muscles commonly causes scoliosis related aches and pains in the shoulders and can cause scoliosis shoulder blade pain.

Conclusion

As such a highly-variable condition, symptoms one patient experiences aren't necessarily indicative of what others will face; however, as uneven shoulders are one of the first indicators of the condition in adolescents, shoulder pain can be a complaint.

So to clearly address the question, does scoliosis cause shoulder pain: yes, it can. Whether or not scoliosis is painful will depend on a number of variables that differ from patient to patient.

As scoliosis isn't commonly known as painful for children and adolescents, the condition's main form (AIS), is less likely to involve shoulder pain than in adult scoliosis, for whom the condition is compressive.

In addition, scoliosis that develops in the upper back is more likely to affect the upper body; it's the muscles located closest to the scoliotic curve that have to work the hardest to compensate for the unnatural spinal curve, causing them to become strained, tight, and painful.

Here at the Scoliosis Reduction Center, I address shoulder pain by proactively treating its underlying cause: the condition itself.

Through a chiropractic-centered functional treatment approach, I can help patients work towards reducing their curves on a structural level, improving the spine's biomechanics, and decreasing the amount of adverse spinal tension causing postural deviation, and related shoulder pain.