A man in his mid-forties came to see me the other day. He had been suffering from chronic low back pain and severe scoliosis. While searching on the internet for information about exercise and scoliosis, he came upon an article that was written a few years back and featured an interview with me. The topic was what someone could do to help reduce the onset of scoliosis (https://www.healthline.com/health/scoliosis/exercises-at-home).
He had tried an endless list of approaches to address his spinal contortion, like a spine specialist who put him in a back brace for a couple of years, only to have his supporting muscles atrophy and cause more distortion. He tried an assortment of doctors, physical therapists, and stretching, but nothing seemed to be long-lasting. Nor had anything been able to alleviate his low back pain, other than prescription medication. In the end, he was told to “work on his core” and that it was only a matter of time before he would need surgery and a hip replacement. He said that seeing me was his last resort.
We sat and talked about his health history to see what might have contributed to his change in posture. He had been diagnosed with scoliosis over thirty years ago in middle school. Since he was not born with scoliosis, it makes sense that something must have occurred for his body to change shape. Possibly something like trying to avoid pain or discomfort, which ironically and inevitably led to more pain and discomfort. The spine didn’t just wake up one day and decide to twist and bend for no reason.
He explained that he had never broken any bones or sprained any joints. When asked about surgeries, he said he had torn the meniscus in his knee a few years ago and got it repaired. He also said it was the second time that the meniscus had torn. The first time was in high school. Both of these events occurred after his scoliosis diagnosis, so those were ruled out as contributing factors. If anything, the scoliosis might have contributed to the meniscus tears, not the other way around.
I asked him if there were any other surgeries, and he replied he had a hernia repaired when he was five or six years old. Now that was significant! We know scars pull surrounding tissue toward its center in an attempt to further close what was surgically opened. We also know that when the body encounters pain, it attempts to find the best way to avoid it. Even though the hernia repair was forty years in the past, if the nerves did not fully reconnect how would the brain know that the wound had fully healed? What might happen if he were to provide some stimuli to let the brain know the scar had healed? I had him place his fingers on the hernia scar and stand up from his seated position. I asked him if he noticed a difference when he stood. He answered that his back didn’t pinch like it normally did when he got up. That helped confirm my theory. I do not know why touching a scar can have such an effect, but I have witnessed it too many times for it to be disregarded.
Imagine just exiting the toddler phase of life, while the bones were still fusing and walking was still a relatively new challenge. What effect would severing nerves, skin, and muscle tissue have on how someone moved, carried their weight, and supported their structure? Is it too far-fetched to consider? It is not out of the question that, after going through hernia repair, the body would shift away from the affected area and create a new strategy for movement. Within the span of seven years, this type of compensatory, post-operative movement developed a scoliotic shift. There was no physical therapy after the operation to help restore proper motion (currently that is still not considered necessary). Therefore, whatever way the body chose to organize itself, was now able to be reinforced to a greater degree. Over the next thirty years, the scoliosis increased because gravity never stopped and no intervention effectively corrected the distortion.
Long story short, we found certain movements he was missing and began to let his body experience them. Within one session, he was able to stand up without his lower back giving him trouble. When the session was over, the constant, stabbing pain in his low back was gone. The pain had diminished to a dull ache. This was the first time, in a very long time, that his back had felt so good. The scoliotic spine had also changed a little, and he felt his weight shifting away from the areas which were very compressed.
If there is a dark cloud with this silver lining, it is that through all his searching for answers among the medical world, there was never one time someone thought about a hernia as a factor. Unfortunately, this type of information, about human structure and the effects of injury and surgery have on the body, is not taught to doctors or physical therapists. Like myself, they would have to go outside of traditional institutions to learn more. Hopefully one day this subject will be studied in depth in universities and medical schools. Until then, it might be good to seek out a movement specialist who is familiar such things. I am not the only one. If you need help finding someone in your area, let me know.
