How many times have you been to doctor after doctor for yourself or your child seeking an answer for the nagging chronic neck pain you are positive is related to scoliosis, only to be told scoliosis doesn’t cause pain? Most patients find this response very frustrating — and even insulting — because they are positive scoliosis and neck pain are related.
Well, I am here to tell you the pain is real and the link to scoliosis is real, as well.
What Do Scoliosis and Neck Pain Have in Common?
Most doctors and scoliosis specialists don’t believe neck pain is associated with scoliosis, and in some cases it isn’t, but studies have linked abnormal cervical spine (neck) position to patients with moderate-to-severe scoliosis. In 2008, Dr. Mark Morningstar and Dr. Clayton Stitzel published the results of a study that concluded, “Patients with curves greater than 30 degrees had a significant loss of forward curve in the neck 88% of the time, compared to 55% of the time in patients with curves less than 30 degrees.”
Forward head posture, loss of normal neck curve, and neck pain have been linked in numerous studies and articles over the years, so it appears scoliosis and neck pain may actually be linked because of their close association with abnormal neck position!
Now, before you go do a celebratory victory dance and run to your local orthopedic office to shove this article in their faces, it should be understood there are also many causes of neck pain that are often not associated with idiopathic scoliosis.
Possible Causes of Neck Pain
As mentioned in the paragraph above, neck pain may be associated with scoliosis because of a high correlation with loss of normal curve and forward head posture in both conditions; however, various other things can also contribute to neck pain if you have scoliosis.
Note: This is certainly not an exhaustive list, but some of the more common contributing factors:
Going back to the idea that scoliosis and neck pain related to loss of normal forward curve in the neck could explain the reason so many scoliosis patients report symptoms of chronic muscle fatigue in the cervical spine (neck). Metaphorically, forward head posture and loss of curve in the neck has a similar effect as holding a 10 pound bowling ball out in front of you with your arms fully extended. While the weight of the bowling ball doesn’t actually change, the leverage of holding it away from your body makes it feel much heavier, and makes your muscles work much harder to hold it up. This is the same effect scoliosis patients experience when they also have an abnormal neck position.
Let’s face it, some people are their own worst enemy. They simply don’t know when to quit and suffer from “overdid it” syndrome. Whether you lifted something too heavy, or too often, or slept wrong, or have no idea what you did, muscle strain is probably the most common cause of neck pain. The good news is, muscle strain is common for everyone, not just people with scoliosis. It often resolves with some ice, rest, and anti-inflammatory treatment.
Capsular Ligament Entrapment
Have you ever just turned your head a little too fast and felt an instant, sharp, stinging, burning type pain shoot up and down your neck? This is what happens when someone pinches a small part of a capsular ligament in one of the joint spaces in the neck. It generally isn’t a serious injury, but the pain can be unbelievably severe and it certainly feels like something is seriously wrong. While this scenario isn’t generally related to scoliosis and neck pain, one could make the case that the twist of the spine associated with idiopathic scoliosis may “predispose” scoliosis patients to this happening more frequently.
Previous Injuries to the Neck
Remember that fender bender you had 20 years ago? Probably not, but it may remember you. Whiplash injuries are unique because the speed of the crash makes ligament injury in the neck more likely than other ways people hurt their necks. Obviously, this is not related to scoliosis, but again, the case could be made that patients with scoliosis at the time of the car accident may be bio-mechanically more susceptible for these types of injuries.
Our spinal discs begin to lose water as part of the natural aging process, weakening the spinal discs and causing bulges/herniations. This process can cause neck pain, but more often cause shooting pain down one or both arms if it impinges a nerve root.
Bone building up, breaking down, and remodeling are all normal parts of bone metabolism; however, bone remodeling is largely driven by loading of the bone (see Wolff’s law for more information on this process). The asymmetrical loading of bone in patients with scoliosis is significantly more than the general population and could contribute to chronic neck pain in the elderly.
Treatment and Rehabilitation for Scoliosis-Caused Neck Pain
There are many reasons for neck pain if you have scoliosis. Some may be directly related to scoliosis (forward head posture and loss of curve in the neck), some may be more likely due to the presence of scoliosis, and others may not be related to scoliosis at all. Treatment options will vary and range greatly depending on the cause of the neck pain. We have found that most adults with scoliosis and neck pain find relief from time-released curcumin (we recommend ScoliPain Plus to our patients) and rehabilitation exercises that improve the normal forward curve in the neck and reduce forward head posture.